Obesity and infertility: a double whammy

Purpose of review Alongside its impact on cardio-metabolic parameters, obesity has been linked to infertility. This article aimed to provide a comprehensive review of the most current evidence linking male and female obesity and infertility. Recent findings The risk of infertility affects both sexes: in males, excess adiposity alters the optimal functioning of the hypothalamic–pituitary–gonadal axis, affects function of the testicles and causes disruptions in spermatogenesis and sperm maturation whereas in females, obesity upsets the normal hormonal milieu which negatively impacts ovarian and uterine function leading to anovulation, menstrual irregularities, difficulties in development of embryo and implantation and recurrent miscarriages, especially in women with polycystic ovarian syndrome (PCOS) where hyperinsulinemia, hyperandrogenemia and other metabolic disruptions are involved. Summary Numerous studies have established clear links between male and female obesity with infertility and to its pathophysiology and demographics. Evidence on treatment of obesity and impact on fertility outcomes is variable and needs further exploration.