[Eating disorders and fertility]

Common gynecological complications of various eating disorders include infertility, unwanted pregnancy, miscarriage, sexual dysfunction and complications in the treatment of gynecological cancers. Women with eating disorders typically see their gynecologists because of menstrual and other endocrine disorders or unexplained gastrointestinal symptoms, and often report on psychological symptoms (anxiety, depression or decreased libido). In spite of anovulation, menstruation may occur and ovulation without menstruation may be possible, which may lead to an increased incidence of unwanted pregnancies in case of prior or current eating disorders. Ovulation induction due to anovulation associated with weight loss or inappropriate dietary habits, or pregnancy with amenorrhoea may be a significant risk among women with unrecognized eating disorders. In such cases, the primary care is the change of dietary lifestyle and only secondary care is the ovulation induction. The prevalence of eating disorders is high among women who approach infertility clinics. If an eating disorder is confirmed prior to infertility treatment, the patient should be informed of the possible consequences and referred to the necessary psychological support. Such a multidisciplinary approach would allow successful infertility treatments without complications.