Recent advances in understanding the relationship between long- and short-term weight change and fertility

The impact of excess body weight on fertility is well recognized among both women attempting to conceive spontaneously and those attempting to conceive with medical assistance. Although many leading societies of reproductive medicine have proposed weight loss as a means to counteract the negative consequences of obesity on fertility, there is limited research on this topic. In this review, we provide a brief overview of the recent advances in the literature focused on how long- and short-term weight change affects fertility among women. Overall, despite initial hope that weight loss may be beneficial for fertility, two large well-conducted randomized controlled trials have consistently shown that short-term weight loss among overweight and obese women undergoing infertility treatment does not improve a woman's probability of live birth. The observational evidence among women attempting to conceive without medical assistance also suggests limited benefits of weight loss on fecundity or pregnancy loss. In contrast, substantial weight gain between consecutive pregnancies, in the year prior to pregnancy attempt, and throughout adulthood appears to be harmful for not only time to pregnancy but also pregnancy maintenance. Future research focused on efforts to prevent weight gain during adulthood is needed to better understand whether these types of interventions may have beneficial effects on fertility.