Obesity is associated with infertility in women through multiple and complex mechanisms. Briefly, the adipose tissue through the production of many factors, such as leptin, free fatty acids (FFA), and cytokines may affect both ovarian and endometrium functions, with a final alteration in oocyte maturation and endometrial epithelium receptivity. In addition, through the development of peripheral insulin resistance obesity produces a condition of functional hyperandrogenism and hyperestrogenism that contribute to produce anovulation and to reduce endometrial receptivity and, therefore participate to cause infertility. Weight loss is able to restore fertility in most cases, but there are no practical indications to guide the clinician to choice the best method among increased physical activity, diet, drugs, and bariatric surgery.

肥胖通过多种复杂机制与女性不孕症相关。简而言之，通过产生许多因子（例如瘦素，游离脂肪酸（FFA）和细胞因子）的脂肪组织可能会影响卵巢和子宫内膜的功能，最终改变卵母细胞的成熟度和子宫内膜上皮的接受性。另外，通过周围胰岛素抵抗的发展，肥胖症产生功能性高雄激素血症和高雌激素血症的状况，其导致无排卵并降低子宫内膜的接受性，并因此引起不育。体重减轻在大多数情况下能够恢复生育能力，但是没有实际迹象可以指导临床医生在增加体力活动，饮食，药物和减肥手术中选择最佳方法。