Unraveling the Complex Web: Obesity’s Toll on Male and Female Fertility – ARC Summit

In male infertility among obese individuals, several complications are prevalent. Increased erectile dysfunction, elevated scrotal temperatures, and higher rates of obstructive sleep apnea are common, impacting nocturnal testosterone levels. Additionally, obesity is linked to decreased sperm concentration, compromised sperm quality, and reduced sperm volume. Moreover, increased estrogen levels are observed, establishing an inverse linear relationship between BMI and testosterone levels. In men with higher BMI, there is a noticeable reduction in testosterone, accompanied by elevated insulin and leptin levels.

For women, obesity affects fertility through several mechanisms. There is decreased endometrial receptivity, atresia of early follicles, and elevated levels of inflammatory markers such as TNF, free fatty acids, interleukins, leptin, estrogen, and androgens, which collectively contribute to infertility. High insulin levels or insulin resistance play a pivotal role by decreasing sex hormone-binding globulins, which in turn reduces the bioavailable testosterone and estrogen levels. This hormonal imbalance leads to decreased levels of follicle-stimulating hormone (FSH) and luteinizing hormone (LH), resulting in poor ovulation or anovulation.

The compounded effect of these factors is a significant challenge in managing reproductive health in obese individuals. The altered hormonal environment not only diminishes the quality of reproductive elements but also complicates assisted reproductive technologies. Understanding these interactions is crucial for developing targeted treatments that address the specific needs of obese patients struggling with infertility. This comprehensive approach is vital in improving the chances of conception and achieving successful pregnancies in this demographic.