This American Society for Reproductive Medicine (ASRM) Practice Committee report provides clinicians with strategies for the evaluation and treatment of couples with infertility associated with obesity. The report states that obesity in women is associated with anovulation, reduced ovarian responsiveness to ovulation-inducing agents, and altered oocyte as well as endometrial functions or lower birth rates, while obesity in men may be associated with impaired reproductive function. Conclusions and recommendations include:
• Lifestyle modification is the first-line treatment for obesity, followed by adjunctive medical therapy.
• Bariatric surgery is an important adjuvant to lifestyle medication and medical therapy for weight loss, but pregnancy should be deferred for 1 year postoperatively.
• Preconceptional counseling for obese couples should address the reproductive and maternal-fetal consequences of obesity.
• The benefits of postponing pregnancy to achieve weight loss must be balanced against the risk of declining fertility with advancing of age of the couple.
Citation: The Practice Committee of the American Society for Reproductive Medicine. Obesity and reproduction: a committee opinion. [Published online ahead of print October 1, 2015]. Fertil Steril. doi: 10.1016/j.fertnstert.201508.018.