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Obesity presents an increasing prevalence in developed countries and impairs human reproduction in both natural and assisted conception cycles. A healthy liveborn is less probable among obese women due to a combination of lower implantation and pregnancy rates, higher preclinical and clinical miscarriage rates and more frequent complications during pregnancy for both mother and fetus. Gametes, embryos and uterus seem to be negatively affected by the abnormal hormonal and metabolic environment present in obese men and women. Lifestyle therapy for weight reduction based on hypocaloric diet and exercise is the best approach for improving the reproductive performance of these patients. Pharmacotherapy does not seem to be useful and bariatric surgery indicated only for fertility purposes is currently considered a risky and understudied procedure.
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