Influence of overweight and obesity on the development of reproductive disorders in women

Abstract

Obesity remains a serious health problem in all countries due to its prevalence and the development of significant health consequences associated with high morbidity and mortality. According to the World Health Organization, over 1.5 billion adults in the modern world are overweight. According to domestic studies, about 40% of the population of Ukraine is overweight and 25% is obese. The literature review focuses on the problem of obesity in the peri- and postmenopausal periods. Because adipose tissue is the site of conversion of bioactive estrogens from androgenic precursors, it could be assumed that obese women should be less likely to develop symptoms of menopausal disorders such as vascular disorders, osteoporosis. Obesity affects ovulation, oocyte maturation, processes in the endometrium, and the process of implantation. Obesity impairs reproductive function not only through the mechanisms of ovulation disorders: reduced fertility is observed in patients with regular ovulatory cycles. Other mechanisms (the complex influence of psychosocial factors; the level of proinflammatory cytokines secreted by adipose tissue is increased in obesity) have not only a direct embryotoxic effect, but also limit the invasion of the trophoblast, disrupting its normal formation. Excessive amounts of pro-inflammatory cytokines lead to local activation of prothrombinase and as a result to thrombosis, trophoblast infarction, its detachment and, ultimately, early miscarriage. The relationship between obesity and reproductive dysfunction has long been proven. At the same time, weight loss is known to improve this function in overweight and obese women. It is especially important that women with this pathology, who visit specialist physicians, receive the necessary recommendations and support aimed at weight loss.