Female infertility: which role for obesity?

Gambineri, Alessandra; Laudisio, Daniela; Marocco, Chiara; Radellini, Stefano; Colao, Annamaria; Savastano, Silvia

doi:10.1038/s41367-019-0009-1

Cited by 89 publications

(78 citation statements)

References 100 publications

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“…The pathophysiological mechanisms by which PCOS negatively impacts on fertility are complex and not completely understood. Undoubtedly, hyperandrogenism, the consequent hyperestrogenemia, IR, and compensatory hyperinsulinemia play an important role acting on both the ovary and the endometrium (16)(17)(18)(19). In addition, there is emerging evidence that proinflammatory cytokines and oxidative stress may directly impact on oocyte quality and may induce endothelial dysfunction, thus contributing to infertility (6,12,13).…”

Section: Resolution 1: Pcos Is a Well-established Medical Condition Tmentioning

confidence: 99%

“…Furthermore, these metabolic alterations are wellknown additional risk factors for cardiovascular diseases (CVDs), although strong evidence in PCOS is lacking. Additionally, chronic low-grade inflammation is a risk factor for IR and T2DM (16,(27)(28)(29). In addition, many recent studies have clearly shown that PCOS is associated with anxiety (30)(31)(32)(33)(34)(35)(36) and depression (26-32, 37, 38), and with a poorer quality of life (27,32,34,(39)(40)(41)(42), even in adolescence and young age (43).…”

Section: Resolution 1: Pcos Is a Well-established Medical Condition Tmentioning

confidence: 99%

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Fundamental Concepts and Novel Aspects of Polycystic Ovarian Syndrome: Expert Consensus Resolutions

et al. 2020

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Polycystic ovary syndrome (PCOS) is a very common endocrine and metabolic disorder with the involvement of both genetic and environmental factors. Although much has been clarified on its pathogenesis, diagnosis, clinical manifestations, and therapy, there are still areas of uncertainty. To address fundamental concepts, novel aspects and hypotheses, and future perspectives, including the possible additional benefits of treatment with nutraceuticals, an expert consensus panel formed by endocrinologists and gynecologists was established. After an independent review of the literature, the panel convened electronically on February 3, 2020, and six resolutions were created, debated, and agreed upon discussion, and finally approved in their final form in a consensus livestream meeting held on April 15. The summary of the resolutions are: (1) PCOS is a well-established medical condition that negatively affects reproduction, general health, sexual health, and quality of life; (2) the symptoms and signs of PCOS appear early in life especially in female newborns from PCOS carriers; (3) women with PCOS have significantly increased risk of pregnancy-related complications including gestational diabetes mellitus; (4) a male PCOS equivalent exists, and it may impact on metabolic health and probably on reproduction; (5) the evidence supports that medical therapy for PCOS is effective, rational, and evidence-based; (6) the evidence supports a major research initiative to explore possible benefits of nutraceutical therapy for PCOS. The proposed resolutions may be regarded as points of agreement based on the current scientific evidence available.

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Section: Resolution 1: Pcos Is a Well-established Medical Condition Tmentioning

confidence: 99%

Section: Resolution 1: Pcos Is a Well-established Medical Condition Tmentioning

confidence: 99%

Fundamental Concepts and Novel Aspects of Polycystic Ovarian Syndrome: Expert Consensus Resolutions

et al. 2020

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“…1,2 Obesity has a detrimental effect on female health, and of which a particular concern was paid on the reproductive disorders. 3 It has been demonstrated that in obese women, the "hypothalamic-pituitary-ovarian axis" was perturbed, and frequently present menstrual dysfunction, as well as anovulation and infertility. 2,4 The therapeutic intervention has largely involved prescribed lifestyle modifications including caloric restriction (CR) and increasing exercise, which is the common choice of anti-obesity.…”

Section: Introductionmentioning

confidence: 99%

Time‐restricted feeding improves the reproductive function of female mice via liver fibroblast growth factor 21

Hua

Feng

Huang

et al. 2020

Clinical & Translational Med

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Background: There has been a significant increase, to epidemic levels, of obese and overweight women of reproductive age, causing impairments to reproductive health. Time-restricted feeding (TRF) including isocaloric intake has shown to be preventive of obesity-related disorders. However, its therapeutic ability to improve the reproductive function of female remains largely unknown. Methods: Here, we investigated the ability of TRF to improve the reproductive function in wild-type and liver-specific FGF21 knockout female mice. To study fertility, a continuous and a short-term fertility test, gonadotropin releasinghormone (GnRH), and Kisspeptin test were performed. Immortalized GnRH neuron was used to examine the direct role of liver fibroblast growth factor 21 (FGF21) on GnRH secretion. Results: We found that TRF rescues female mice from bodyweight gain and glucose intolerance, as well as ovarian follicle loss and dysfunction of estrus cyclicity induced by high-fat diet. Furthermore, the beneficial effects of the TRF regimen on the reproductive performance were also observed in mice fed both chow and high-fat diet. However, those beneficial effects of TRF on metabolism and reproduction were absent in liver-specific FGF21 knockout mice. In vitro, FGF21 directly acted on GnRH neurons to modulate GnRH secretion via extracellular regulated protein kinases (ERK 1/2) pathway. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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“…For example, products of adipose tissue such as leptin, cytokines, and free fatty acids can affect the function of ovaries and endometrium. Peripheral insulin resistance as well as functional hyperandrogenism and hyperestrogenism may affect fertility, too [41]. While there is evidence for improved fertility due to weight loss, the role of bariatric surgery is a current research topic.…”

Section: Fertilitymentioning

confidence: 99%

Review: Sex-Specific Aspects in the Bariatric Treatment of Severely Obese Women

Jäger

Wolicki

Spohnholz

et al. 2020

IJERPH

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This systematic literature review aims to point out sex-specific special features that are important in the bariatric treatment of women suffering from severe obesity. A systematic literature search was carried out according to Cochrane and Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) guidelines. After the literature selection, the following categories were determined: sexuality and sexual function; contraception; fertility; sex hormones and polycystic ovary syndrome; menopause and osteoporosis; pregnancy and breastfeeding; pelvic floor disorders and urinary incontinence; female-specific cancer; and metabolism, outcome, and quality of life. For each category, the current status of research is illuminated and implications for bariatric treatment are determined. A summary that includes key messages is given for each subsection. An overall result of this paper is an understanding that sex-specific risks that follow or result from bariatric surgery should be considered more in aftercare. In order to increase the evidence, further research focusing on sex-specific differences in the outcome of bariatric surgery and promising treatment approaches to female-specific diseases is needed. Nevertheless, bariatric surgery shows good potential in the treatment of sex-specific aspects for severely obese women that goes far beyond mere weight loss and reduction of metabolic risks.

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Female infertility: which role for obesity?

Cited by 89 publications

References 100 publications

Fundamental Concepts and Novel Aspects of Polycystic Ovarian Syndrome: Expert Consensus Resolutions

Fundamental Concepts and Novel Aspects of Polycystic Ovarian Syndrome: Expert Consensus Resolutions

Time‐restricted feeding improves the reproductive function of female mice via liver fibroblast growth factor 21

Review: Sex-Specific Aspects in the Bariatric Treatment of Severely Obese Women

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