ART Unit for Obesity
Obesity, visceral fat, and infertility
How often do questions such as “Doctor, I’m overweight, can I have a baby?” or “Professor, I’ve been advised to lose weight before trying to get pregnant, but I can’t” come up during consultations with couples? The truth is that it is not simply body weight that reduces the chances of conception, but excess visceral fat. This problem is common in obese women, but it can also occur in women of normal weight or older women. Visceral fat is not simply a store of energy, but a metabolically active tissue that can significantly interfere with female fertility. In the following pages, we will explore this complex relationship and possible solutions.
The link between obesity, visceral fat, and fertility problems is one of the most significant challenges for many women who wish to conceive. Visceral fat, which accumulates around the internal organs, is particularly insidious as it negatively affects the female hormonal balance. This type of adipose tissue is not just a passive deposit, but an active endocrine organ that produces hormones and inflammatory substances, interfering with the delicate mechanisms of reproduction. The following presentation will explore this complex relationship in detail, offering up-to-date scientific information and practical strategies for improving fertility.
Mechanisms of visceral fat interference with fertility
Hormonal imbalances
Visceral fat increases estrogen production, altering the hormonal balance necessary for regular ovulation and causing menstrual cycle disorders.
Polycystic Ovary Syndrome
Excess visceral fat is linked to PCOS, a condition characterized by high levels of androgens that disrupt ovulation and impair fertility.
Insulin resistance
Visceral fat promotes insulin resistance, which interferes with ovarian function and hormone production essential for fertility.
Chronic inflammation
Pro-inflammatory cytokines produced by visceral fat damage egg quality and the uterine environment necessary for implantation.
Excess visceral fat interferes with multiple biological mechanisms that are fundamental to female fertility, creating an environment that is unfavorable to reproduction through hormonal, metabolic, and inflammatory alterations.
Impact on reproductive health
Chronic inflammation and hormonal imbalances damage the structure and function of eggs, significantly reducing the chances of conception.
Difficulty in egg retrieval
In women with excess visceral fat, the egg retrieval (pick-up) procedure is technically more complex, limiting the effectiveness of the procedure.
Impaired embryo implantation
The imbalance between pro-inflammatory and anti-inflammatory factors alters the delicate molecular mechanisms necessary for proper embryo implantation.
Cardiovascular problems
Reduced blood flow to the reproductive organs compromises ovarian and uterine function, hindering the physiological processes necessary for fertility.
Complications during pregnancy
Excess visceral fat significantly increases the risk of developing hypertension and gestational diabetes, compromising maternal and fetal health.
Reduced success of ART techniques
The presence of visceral fat decreases the effectiveness of assisted reproductive technology treatments, including in vitro fertilization.
Excess visceral fat triggers a vicious cycle of metabolic and hormonal changes that negatively affect every stage of the reproductive process, from egg maturation to embryo implantation, to the proper development and maintenance of pregnancy.
Physical activity and stress management
Aerobic exercise
L'allenamento cardiovascolare di intensità moderata (camminata veloce, nuoto, ciclismo) per 150 minuti settimanali è particolarmente efficace nel ridurre il grasso viscerale. Questo tipo di attività migliora la sensibilità insulinica e ottimizza il profilo metabolico, con benefici diretti sulla funzionalità ovarica.
Muscle strengthening
Strength training twice a week increases muscle mass, accelerating basal metabolism and improving body composition even at rest. Muscle mass is metabolically active and contributes to the reduction of visceral fat even between training sessions.
Anti-stress techniques
Excess visceral fat interferes with multiple biological mechanisms that are fundamental to female fertility, creating an environment that is unfavorable to reproduction through hormonal, metabolic, and inflammatory alterations.
Visceral fat beyond obesity
Some individuals may accumulate visceral fat despite having a normal Body Mass Index, due to genetic factors that influence fat distribution.
Chronic stress
Prolonged exposure to cortisol promotes the accumulation of visceral fat even in women of normal weight, negatively affecting the reproductive hormone profile.
Body morphology
The “apple” (abdominal) distribution of fat is associated with greater metabolic risks than the “pear” (gluteofemoral) distribution, regardless of total weight.
Aging
With age, there is a redistribution of body fat towards the visceral region, a phenomenon accentuated by the hormonal changes of premenopause.
It is essential to understand that the amount of visceral fat is not directly proportional to body weight. Even women who are apparently thin or of normal weight may have a clinically significant accumulation of visceral fat with repercussions on fertility.
Clinical monitoring and evaluation
Advantages: Inexpensive, easy to measure, predictive
Limitations: Does not distinguish between subcutaneous and visceral fat
Advantages: Good indicator of fat distribution
Limitations: Less specific for visceral fat
Advantages: Non-invasive, quick
Limitations: Variability of results
The assessment of visceral fat should be an integral part of female fertility screening. The simplest screening methods, such as waist circumference measurement, can provide useful information and should be routinely incorporated into clinical assessments.
For patients with fertility problems, especially those with irregular cycles or PCOS, a more thorough assessment of body composition is recommended, even in the absence of obvious overweight.
The assessment of visceral fat should be part of the clinical evaluation of female fertility.
Integrated and personalized approach
Integration of gynecological, endocrinological, and nutritional expertise for a comprehensive view of the fertility-obesity problem.
Periodic assessment of metabolic and hormonal parameters and body composition to adapt therapeutic strategies.
Blood tests such as cytokine balance or immunohistochemical assay of CD killer lymphocytes.
Strategie di intervento calibrate sulla base del profilo metabolico, ormonale e della distribuzione adiposa individuale.
Assistance in dealing with the emotional aspects of conception difficulties and lifestyle changes.
Oxygen-ozone therapy, RMT, PRP, IV DRIP, and Tirzepatide can be used to treat excess visceral fat.
Managing visceral fat is a key therapeutic goal in fertility preservation and recovery. An integrated approach combining dietary changes, physical activity, and stress management, tailored to the individual characteristics of the patient, offers the best chance of success.
Early treatment of metabolic changes associated with visceral fat not only improves the chances of conception, but also reduces the risks of gestational complications and optimizes the long-term health of the mother and unborn child.
Contacts
For consultations and appointments at our specialized centers
Chianciano Terme (SI)
Via Concetto Marchesi, 73
Tel. 0578 62713
Rome
Viale di Villa Massimo, 8 Tel. 06 69305982
