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Female infertility: which role for obesity?

Abstract

Obesity is associated with infertility in women through multiple and complex mechanisms. Briefly, the adipose tissue through the production of many factors, such as leptin, free fatty acids (FFA), and cytokines may affect both ovarian and endometrium functions, with a final alteration in oocyte maturation and endometrial epithelium receptivity. In addition, through the development of peripheral insulin resistance obesity produces a condition of functional hyperandrogenism and hyperestrogenism that contribute to produce anovulation and to reduce endometrial receptivity and, therefore participate to cause infertility. Weight loss is able to restore fertility in most cases, but there are no practical indications to guide the clinician to choice the best method among increased physical activity, diet, drugs, and bariatric surgery.

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Acknowledgements

Obesity Programs of nutrition, Education, Research and Assessment (OPERA) group members served as collaborators and approved the final version of the manuscript: Annamaria Colao, Antonio Aversa, Barbara Altieri, Luigi Angrisani, Giuseppe Annunziata, Rocco Barazzoni, Luigi Barrea, Giuseppe Bellastella, Bernadette Biondi, Elena Cantone, Brunella Capaldo, Sara Cassarano, Rosario Cuomo, Luigi Di Luigi, Andrea Di Nisio, Carla Di Somma, Ludovico Docimo, Katherine Esposito, Carlo Foresta, Pietro Forestieri, Alessandra Gambineri, Francesco Garifalos, Cristiano Giardiello, Carla Giordano, Francesco Giorgino, Dario Giugliano, Daniela Laudisio, Davide Lauro, Andrea Lenzi, Silvia Magno, Paolo Macchia, MariaIda Maiorino, Emilio Manno, Chiara Marocco, Paolo Marzullo, Chiara Mele, Davide Menafra, Silvia Migliaccio, Marcello Monda, Filomena Morisco, Fabrizio Muratori, Giovanna Muscogiuri, Mario Musella, Gerardo Nardone, Claudia Oriolo, Uberto Pagotto, Pasquale Perrone Filardi, Luigi Piazza, Rosario Pivonello, Barbara Polese, Paolo Pozzilli, Giulia Puliani, Stefano Radellini, Gabriele Riccardi, Domenico Salvatore, Ferruccio Santini, Giovanni Sarnelli, Lorenzo Scappaticcio, Silvia Savastano, Bruno Trimarco, Dario Tuccinardi, Paola Vairano, Nunzia Verde, Roberto Vettor.

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This article is published as part of a supplement funded by Endocrinology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy.

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The author’s responsibilities were as follows: AG, DL, CM, and SR were responsible for the concept of this paper and drafted the manuscript; AG, SS, and AC provided a critical review of the paper.

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Correspondence to Alessandra Gambineri.

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Gambineri, A., Laudisio, D., Marocco, C. et al. Female infertility: which role for obesity?. Int J Obes Supp 9, 65–72 (2019). https://doi.org/10.1038/s41367-019-0009-1

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