Regulation of ovarian function in obese women: pathogenetic mechanisms

Considering the universally high rates of obesity among the population, including women of reproductive age, and the negative impact of obesity on female fertility, the interest in this problem in the modern world becomes understandable. Many researchers have confirmed the pattern of ovulatory dysfunction development because of metabolic disorders in obese women. The exact mechanism for the development of anovulation and infertility in women with obesity has not been established, however, many pathogenetic factors that affect reproductive function are already known. Obese women have a high risk of developing ovulatory dysfunction due to insulin resistance, hyperandrogenism, as well as subclinical inflammation, lipotoxicity, and disruption of adipokines due to excess adipose tissue, which generally leads to impaired steroidogenesis and regulation in the hypothalamic – pituitary – gonadal axis. Due to the high prevalence of obesity in women of reproductive age, the objective of this review was to examine the pathogenetic mechanisms of the impact of obesity on female fertility, as well as the impact of high body mass index on the results of assisted reproductive technology (ART) cycles. We carried out a literature search in the PubMed database for the entire period of publications using phrases such as “ovarian function + obesity,” “pathogenesis of ovarian dysfunction in obesity,” “ART + obesity,” and “perinatal outcomes + bariatric surgery”. The most relevant studies being selected, with domestic and foreign clinical recommendations used in preparing the manuscript.