Endocrine Abstracts

Obesity is on the increase worldwide and mainly in women of reproductive age. In turn, it is associated with various reproductive complications. To assess the detrimental effect of obesity on reproductive health and the means of its management, this retrospective cohort study of 40 obese and infertile women has been conducted in the department of endocrinology and diabetology of Hedi Chaker hospital in Sfax-Tunisia from 2009 to 2014. These patients have a mean age of 34 years and a mean BMI of 37.29 kg/m². They were to suffer from infertility for a mean period of 5,7 years. The polycystic ovary syndrome was the most common cause of infertility diagnosed in 52.5%. Classic morbidities of obesity were dominated by metabolic (52.5%) and cardiovascular (37.5%) complications. Ovulation disorders were identified in 77.5% of cases and serious complications during pregnancy were observed. These complications affect the obese mother as well as the child: abortions (52.5%), delivery by caesarean section (35%), gestational diabetes (20%), foetal malformation (12.5%), neonatal death (7.5). Though the management of the combination of obesity and infertility was quite difficult, a weight loss of 5–8% has resolved 61.2% of menstrual irregularities and improves the chances of pregnancy in 20% of cases. Insulin resistance and hyperleptinemia are the main mechanisms linking obesity to infertility. Thus the establishment of a healthy lifestyle since a young age is the best therapeutic solution for obesity-induced infertility. Obese women have a higher prevalence of infertility, maternal morbidity, mortality and foetal anomalies. For these reasons it’s necessary to raise the public awareness on the detrimental effects of obesity on reproductive health.