Impact of Obesity on Fertility and ICSI Outcome

Abstract

Obesity is a growing global health concern and has been increasingly associated with reproductive dysfunction in women of childbearing age. Excess adiposity affects the hypothalamic–pituitary–ovarian axis, insulin resistance, and hormonal balance, leading to ovulatory disorders, menstrual irregularities, and reduced natural fertility. In assisted reproductive technologies, particularly intracytoplasmic sperm injection (ICSI), obesity may negatively influence ovarian response, oocyte quality, embryo development, implantation rates, and pregnancy outcomes. Furthermore, obese women undergoing ICSI often require higher gonadotropin doses and longer stimulation periods, with potentially lower clinical pregnancy and live birth rates compared to women with normal body mass index (BMI). However, findings remain inconsistent, and the magnitude of obesity’s impact on ICSI outcomes is still under investigation. Understanding the impact of obesity on assisted reproductive outcomes is essential for optimizing patient counseling and individualized treatment strategies. The aim of this study is to evaluate the effect of maternal obesity on fertility parameters and ICSI outcomes, including ovarian response, embryo quality, implantation rate, clinical pregnancy rate, and live birth rate.