News | Study Finds Ovarian Function Remains Suppressed in Women With Obesity Despite Regular Periods, Potentially Explaining Reduced Fertility



News | Study Finds Ovarian Function Remains Suppressed in Women With Obesity Despite Regular Periods, Potentially Explaining Reduced Fertility


Many women assume regular periods mean normal ovulation and fertility. However, a study presented at the Endocrine Society's annual meeting (ENDO 2022) in Atlanta found that even with regular cycles, women with obesity had suppressed follicular development and disrupted reproductive hormone secretion, which may help explain reduced fertility.


Led by Dr. Marla Lujan of Cornell University, the study was the first systematic comparison of follicular development across natural menstrual cycles in women with obesity and women of normal weight.


“How obesity affects female reproductive health remains incompletely understood,” Dr. Lujan said. “Even in women who report regular periods, obesity negatively affects ovarian function.”


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Follicular development and hormone levels were suppressed

Follicles are small fluid-filled sacs in the ovaries containing immature eggs. During monthly ovulation, a mature egg is released from one of these follicles.


The study included 42 women aged 19 to 38 who reported regular menstrual cycles; half had obesity and half were of normal weight. Beginning with an ovulatory cycle, researchers used ultrasound every other day to monitor follicular development and collected blood regularly to measure hormone levels.


Women with obesity had notably suppressed follicle number and size, as well as significantly lower levels of reproductive hormones closely involved in follicular development, including progesterone and estrogen.


Luteal phase defects were more common in women with obesity

The study also found that luteal phase defects (LPD) occurred more often during natural ovulatory cycles in women with obesity. In LPD, the ovaries do not produce enough progesterone after ovulation or the endometrium responds inadequately to it, preventing an optimal environment for embryo implantation. It is considered a contributor to difficulty conceiving or early miscarriage.


“Our study provides clear evidence that obesity suppresses normal follicular development,” said lead author and doctoral candidate Alexis Oldfield. “We also found that this suppression disrupts development at multiple stages, reducing hormone secretion.”


Regular periods ≠ healthy ovarian function

Oldfield emphasized that this was the first comprehensive comparison of follicular growth across natural menstrual cycles in women with and without obesity. “Even when women believe their cycles are normal, obesity may quietly alter ovarian physiology. This has important implications for optimizing fertility treatment and contraception.”


Dr. Lujan added that the findings offer a new perspective on improving contraceptive and infertility treatments that currently perform less well in women with obesity.


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