What are the symptoms of infertility caused by obesity

Obesity leading to infertility may be related to endocrine disorders, ovulation disorders, endometrial abnormalities, insulin resistance, polycystic ovary syndrome, and other factors. Obese women may experience symptoms such as menstrual irregularities, increased body hair, acne, acanthosis nigricans, and long-term anovulation.

1. Endocrine disorders

Excessive secretion of estrogen by adipose tissue can interfere with the function of the hypothalamic pituitary ovarian axis. Abnormal elevation of estrogen levels in the body can inhibit the secretion of follicle stimulating hormone, leading to hindered follicular development. This hormonal environmental change may cause luteal insufficiency, affecting the implantation of fertilized eggs. Long term endocrine disorders can also reduce endometrial receptivity.

2. Ovulation disorders

Obese women often experience anovulation or infrequent ovulation. The leptin resistance produced by adipocytes can interfere with the secretion of gonadotropin-releasing hormone pulses, directly affecting follicle maturation and discharge. Ultrasound examination can detect the presence of multiple small follicles in the ovary without dominant follicle development, and the basal body temperature curve shows a monophasic change.

3. Endometrial abnormalities

Chronic inflammation caused by obesity may lead to endometrial hyperplasia or decreased receptivity. inflammatory factors secreted by adipose tissue can alter gene expression in the endometrium, affecting embryo implantation. Hysteroscopy examination reveals thickening of the endometrium or accompanied by polypoid changes, while tissue biopsy shows asynchronous glandular development.

4. Insulin resistance

About 60% of obese women have insulin resistance, and hyperinsulinemia can stimulate the ovaries to secrete excessive androgens. Androgens are converted into estrogen in adipose tissue, forming a vicious cycle. These patients often have elevated fasting insulin levels, abnormal glucose tolerance tests, and symptoms of cutaneous echinoderms.

5. Polycystic ovary syndrome

Obesity is an important cause of polycystic ovary syndrome, and patients' ultrasound shows an increase in ovarian volume with multiple small follicles arranged around it. The clinical manifestations include high hormone symptoms such as infrequent menstruation, hirsutism, and acne. Laboratory tests show an inverted ratio of luteinizing hormone to follicle stimulating hormone, with some cases accompanied by mild elevation of prolactin.

It is recommended that obese and infertile patients improve their reproductive function through scientific weight loss, by combining dietary control with aerobic exercise, with a weekly weight loss rate controlled at around 1% of their body weight. Diet should choose low glycemic index foods, ensure high-quality protein intake, and avoid excessive dieting. We recommend moderate intensity aerobic exercise such as brisk walking and swimming, with a total of 150 minutes or more per week. At the same time, it is necessary to monitor basal body temperature and menstrual cycle changes. After weight loss, most patients can recover their ovulation function on their own. For patients with polycystic ovary syndrome, medication treatment and fertility guidance should be carried out under the guidance of a doctor.