OBESITY AND FEMALE REPRODUCTIVE FUNCTION

Obesity has consistently been demonstrated to have a detrimental effec t upon the female reproductive system. This review explores the common association of obesity with polycystic ovary syndrome (PCOS), the eff ect of obesity on the clinical and endocrinological parameters, and th e role of insulin resistance in the expression of this disorder. An im provement in menstrual function, a decrease in the clinical androgenic profile, and significant increase in spontaneous pregnancy rates have been reported following weight loss. Obesity is associated with poor pregnancy outcome and miscarriage in both women with PCOS, and in thos e with normal ovarian morphology. The optimal weight gain during pregn ancy remains controversial, but obesity is a risk factor for both mate rnal and fetal complications, and dietary advice should be offered on an individual basis according to the prepregnancy BMI. Weight gain at the time of menopause is common, and dietary advice is paramount as ob esity is an independent risk factor for thrombosis, coronary heart dis ease (CHD), and breast and endometrial cancer. Effective nutritional c ounselling should be offered at all stages of the female reproductive lifecycle.