Ovchar I. Clinico-pathogenetic substantiation of treatment infertility in women with obesity.

Obesity and overweight are common conditions that have consequences not only on general health but also to a great extent on reproductive health. There is a high prevalence of obese women in the infertile population and numerous studies have highlighted the link between obesity and infertility. Obesity contributes to anovulation and menstrual irregularities, reduced conception rate and a reduced response to fertility treatment. It also increases miscarriage and contributes to maternal and perinatal complication. Reduction of obesity, particularly abdominal obesity, is associated with improvements in reproductive functions; hence, treatment of obesity itself should be the initial aim in obese infertile women before embarking on ovulation-induction drugs or assisted reproductive techniques. While various strategies for weight reduction, including diet, exercise, pharmacological and surgical intervention exist, lifestyle modification continues to be of paramount importance. High BMI is associated with an increase in serum and follicular fluid leptin concentration. Leptin acting through the receptors on the theca and granulosa cells inhibits ovarian steroidogenesis. In the intervention arm, patients will participate in six-months during structured lifestyle program aiming at a weight loss of at least 5-25% of the original body weight.