Westerman, R., & Kuhnt, A. K. (2022). Metabolic risk factors and fertility disorders: A narrative review of the female perspective. Reproductive Biomedicine & Society Online, 14, 66-74. https://doi.org/10.1016/j.rbms.2021.09.002
Westerman R, Kuhnt AK. Metabolic risk factors and fertility disorders: A narrative review of the female perspective. Reprod Biomed Soc Online. 2022;14:66-74. doi:10.1016/j.rbms.2021.09.002
Westerman, Ronny, and Anne-Kristin Kuhnt. "Metabolic risk factors and fertility disorders: A narrative review of the female perspective." Reproductive Biomedicine & Society Online, vol. 14, 2022, pp. 66-74.
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RRM Academy Synopsis
Obesity directly affects female fertility, a review concludes
A narrative review of 50 studies concludes that obesity directly affects female fertility. The 50 studies comprised 19 on obesity, 24 on the female athlete triad and seven on other risks. Large population studies must still confirm the effect of those other risks.
Key Findings
The review included 50 studies: 19 on obesity, 24 on the female athlete triad and seven on other risk factors, including reactive oxygen species.
After screening, the authors could not identify studies with statistical association measures linking infertility to the female athlete triad or lifestyle factors. Such measures were available only for obesity.
The review cites a three-fold higher risk of infertility in obese women than in non-obese women (Wise et al., 2010).
Pandey et al. (2010), cited in the review, reported a relative risk of 2.7 (95% CI 2.0–3.7) for obesity as a risk factor for the absence of ovulation.
The review cites Ray et al. (2012) for a prevalence of unexplained infertility that ranges from 8% to 37% among women.
Interpretation
This narrative review is a selective summary of published work. The authors searched five databases for studies from 2006 to 2020 and excluded trials of drug treatments. According to the authors, the studies reviewed do not permit the conclusion that metabolic risk factors cause infertility. For the female athlete triad, they report that a significant correlation with infertility remains unknown. The review is written from a female perspective.
RRM Context
Restorative reproductive medicine looks for the cause of infertility. Body weight, energy intake and ovulation belong to that search. The review's search found 1611 results on unexplained infertility. The same search found 19,309 on PCOS, now also named PMOS (Polyendocrine Metabolic Ovarian Syndrome). The authors say better diagnostic capabilities can reduce the proportion of unexplained cases.
Our editorial summary of this paper, not the article's abstract.
Abstract
Metabolic risk factors such as obesity are considered major obstacles to female fertility. Chronic infertility imposes psychological and social burdens on women because infertility violates societal gender roles. Although the prevalence of obesity among women is expected to increase in the future, the relevance of metabolic status for fertility is still underestimated. However, the assessment of metabolic risk factors is highly relevant for understanding fertility disorders and improving infertility treatment. This narrative review discusses the associations of metabolic risk factors (e.g. obesity, female athlete triad, oxidative stress) with significant infertility. An electronic search was conducted for studies published between 2006 and 2020 in Cumulative Index to Nursing and Allied Health Literature, ScienceDirect, PubMed, Scopus, Google Scholar and related databases. In total, this search identified 19,309 results for polycystic ovary syndrome, 28,969 results for endometriosis, and only 1611 results for idiopathic and/or unknown infertility. For the present narrative review, 50 relevant studies were included: 19 studies were on obesity, 24 studies investigated the female athlete triad, and seven studies addressed other risk factors, including reactive oxygen species. This narrative review confirms the direct impact of obesity on female infertility, while the effect of other risk factors needs to be confirmed by large-scale population studies.
Reproductive Endocrinology › Thyroid and Metabolic Function › Insulin and Metabolism · Lifestyle and Environment › Nutrition and Metabolic Health › Body Weight and Composition
Ronny Westerman, Anne-Kristin Kuhnt
R Westerman, A Kuhnt
PMID 34765754 34765754 DOI 10.1016/j.rbms.2021.09.002 10.1016/j.rbms.2021.09.002 Westerman et al. 2022, Westerman 2022
