Obesity and Female Infertility: Possible impacts of obesity on the hypothalamic-pituitary-ovarian axis
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2024-04
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FERREIRA, Caroline M.
VIANA, Bruna F.
Moreno, Maria S.
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Resumo
In recent years, global obesity rates have surged unprecedentedly, driven by dietary shifts and sedentary lifestyles. This study delves into the ramifications of this obesity epidemic on female fertility. Obesity disrupts the delicate balance of the Hypothalamic-Pituitary-Ovarian (HPO) axis, essential for reproductive health. The interplay of hormones like leptin, adiponectin, and insulin, altered by excess adiposity, leads to irregularities in the menstrual cycle and ovulation. Leptin, primarily regulating appetite and energy expenditure, exhibits inhibitory effects on folliculogenesis when elevated, contributing to anovulation. Adiponectin, inversely proportional to obesity, influences insulin sensitivity and lipid metabolism, affecting ovarian function and endometrial receptivity. Insulin, essential for glucose uptake, undergoes resistance in obesity, inducing hyperinsulinemia, disrupting gonadotropin secretion, and impairing oocyte quality. Lipotoxicity due to elevated fatty acids further compromises oocyte development and implantation. Consequently, obese women experience reduced fertility, poorer response to assisted reproductive technologies, and increased risk of miscarriage. However, lifestyle modifications leading to weight loss show promising improvements in ovulatory function and pregnancy outcomes. Understanding the intricate hormonal disruptions in obesity-related infertility underscores the importance of holistic interventions addressing weight management and metabolic health for enhancing fertility outcomes. This study emphasizes the imperative of a well-functioning HPO axis for reproductive success and highlights the intricate hormonal mechanisms disrupted by obesity, impacting female fertility profoundly.
Palavras-chave
Infertility, Obesity, HPO axis