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Obesity and Reproduction.

Neal Mahutte1, Carole Kamga-Ngande2, Arya Sharma3

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Summary

This guideline offers evidence-based recommendations for fertility care in women with obesity, addressing impacts on conception, treatments, and outcomes. It provides 21 recommendations on weight management and BMI cut-offs for improved reproductive health.

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Area of Science:

  • Reproductive Endocrinology
  • Maternal-Fetal Medicine
  • Clinical Practice Guidelines

Background:

  • Obesity significantly impacts female fertility, assisted reproductive technologies (ART), and maternal-fetal outcomes.
  • Existing literature highlights the need for evidence-based guidance in managing fertility for women with obesity.

Purpose of the Study:

  • To provide comprehensive, evidence-based recommendations for fertility care delivery to women with obesity.
  • To address the multifaceted effects of obesity on natural fertility, ART, and pregnancy outcomes.

Main Methods:

  • Systematic review of published literature, including systematic reviews, clinical trials, observational studies, and clinical practice guidelines.
  • Searches conducted in MEDLINE and CINAHL using relevant keywords.
  • Evidence evaluated by the Canadian Fertility & Andrology Society (CFAS) Clinical Practice Guideline Committee.

Main Results:

  • Twenty-one evidence-based recommendations were developed.
  • Recommendations cover the impact of obesity on natural fertility, ART success rates, and short/long-term maternal-fetal health.
  • Strategies for weight loss and Body Mass Index (BMI) cut-offs are specifically addressed.

Conclusions:

  • The guideline provides actionable recommendations to assist clinicians in counselling and managing reproductive care for women with obesity.
  • Implementation of these recommendations aims to improve fertility outcomes and maternal-fetal health in this population.
  • The guideline has been approved by the CFAS membership, CPG Committee, and Board of Directors.