Excess visceral fat negatively affects the entire body, including female fertility. Overweight and obesity affect a total of 75 percent of patients having trouble getting pregnant. An abnormal BMI can therefore be a significant obstacle for those women who dream of motherhood.

Endocrine disruption, metabolic changes and other adverse effects of obesity can significantly affect women’s reproductive capacity.

In today’s post, we will focus on understanding the mechanisms underlying these difficulties, and discuss therapeutic strategies to increase the chances of pregnancy in obese patients.

Why does obesity cause fertility disorders?

Excessively high body weight causes a number of adverse phenomena in the body, including impaired fertility in women. Patients with obesity, i.e. with a BMI ≥ 30 kg/m2, have lower reproductive prospects in both natural and assisted cycles.

Why is this happening?

Visceral adipose tissue is a hormonally active organ and, like the thyroid, testes and ovaries, among others, produces hormones. We can refer to excess visceral fat tissue as hyperfunction of this organ.

Women with obesity experience a disruption of the hypothalamic-pituitary-ovarian axis.

This is influenced by steroid metabolism and changes in the secretion of hormones such as:

  • insulin,
  • leptin,
  • resistin,
  • ghrelin,
  • adiponectin.

Excess of these hormones can interfere with follicle growth, corpus luteum function, early embryonic development, trophoblast function and endometrial receptivity.

In conclusion, endocrine and metabolic disorders are responsible for infertility in women with obesity.

How does obesity affect fertility?

Women with excessive body weight can have a significant problem getting pregnant, as obesity causes ovulation disorders. Patients with abnormal body weight have a 3-fold increased risk of ovulation disorders or lack of ovulation!

What is responsible for this mechanism?

Visceral adipose tissue, or more specifically adipocytes, produce leptin, a hormone responsible for, among other things, reduced fertility.

Excess leptin:

  • inhibits the pituitary gland from working properly with hormones that stimulate the ovary to work,
  • inhibits the maturation of egg cells,
  • blocks the hormonal work of the ovary.

In addition, in obesity there is an increase in insulin and the production of angrogens, which interfere with the development of the oocyte, i.e. egg cell.

Excess insulin acts similarly to testosteone, causing menstrual disorders, which manifests itself in the form of prolonged and irregular cycles, often also very heavy. Such changes are the result of hypertrophy of the endometrium, or endometrium.

Women with obesity may not only have a problem with getting pregnant, but also with maintaining a pregnancy. When conception occurs, whether spontaneous or induced (with hormones or in vitro), there is an increase in the frequency of miscarriages.


Excess visceral fat weakens the embryo and negatively affects its implantation in the uterus.

How to improve fertility in obese patients?

The key to improving fertility in obese women is weight reduction.

Obese patients with procreative plans should reduce their body weight from about 5%. However, patients with obesity and PCOS (polycystic ovary syndrome) up to 15%!

Lowering BMI can significantly improve ovulation and increase the chances of getting pregnant.

The first step to losing weight in a healthy way is to change your lifestyle. Make sure to eat wholesome, regular meals, exercise and get enough sleep.

However, it is important to remember not to lose weight too rapidly. Losing too much weight in a short period of time can cause a shock to the body’s hormonal economy, which will be associated with further problems with getting pregnant.

Therefore, treatment of obesity before a planned pregnancy is best done under the supervision of a doctor and nutritionist.