Международный эндокринологический журнал Том 21, №6, 2025

Глобальне зростання частоти ожиріння та його виражений негативний вплив на жіночу репродуктивну систему набуває особливого значення для клінічної практики. Мета даного огляду — виділити основні патофізіологічні механізми впливу ожиріння на розвиток фертильності у жінок репродуктивного віку. На сьогодні ожиріння досягло епідемічного рівня серед жінок репродуктивного віку з безліччю наслідків. Ожиріння схильне до кількох репродуктивних ускладнень, які зрештою впливають на рівень фертильності. Ожиріння призводить до змін у рівнях статевих гормонів через підвищення рівня естрогену, що порушує нормальні процеси, необхідні для розвитку рецептивного ендометрія. Жінки із синдромом полікістозних яєчників та ожирінням характеризуються більш тяжким метаболічним і репродуктивним фенотипом, мають знижену фертильність навіть за наявності еуменореї та демонструють гірші результати при застосуванні екстракорпорального запліднення. Таким чином, вплив ожиріння на фертильність є багатогранним: гормональні порушення, інсулінорезистентність, запальні процеси та дисфункція адипоцитокінів створюють несприятливе середовище для нормального функціонування яєчників і забезпечення якісної овуляції. Вплив цієї пандемії на репродуктивну здатність жінок є актуальною та нагальною проблемою сьогодення, яку необхідно дослідити. Пошук проводився в Scopus, Science Direct (від Elsevier) і PubMed, включно з базами даних Medline. Використано ключові слова «ожиріння», «фертильність жінок», «безпліддя». Для виявлення результатів дослідження, які не вдалося знайти під час онлайн-пошуку, використовувався ручний пошук бібліографії публікацій.

The global increase in obesity and its pronounced nega­tive impact on the female reproductive system is of particular importance for clinical practice. The purpose of this review was to highlight the main pathophysiological mechanisms of obesity influence on the development of fertility in women of reproductive age. Currently, obesity has reached epidemic levels among women of reproductive age with a multitude of consequences. It predisposes to several reproductive complications that ultimately affect the level of fertility. Obesity leads to changes in sex hormone content due to increased estrogen levels, which, in turn, disrupts the normal processes necessary for the development of a receptive endome­trium. Women with polycystic ovary syndrome, who also suffer from obesity, demonstrate a more severe metabolic and reproductive phenotype and have reduced fertility even with eumenorrhea and worse results when using in vitro fertilization. Thus, the impact of obesity on fertility is multifaceted: hormonal disruptions, insulin resistance, inflammatory processes and adipocytokine dysfunction create an unfavorable environment for normal ovarian function and ensuring high-quality ovulation. The influence of this pandemic on women’s reproductive capacity is a relevant and urgent problem of today that needs to be investigated. The search was conducted in Scopus, Science Direct (from Elsevier) and PubMed, including MEDLINE databases. The keywords used were “obesity”, “female fertility” and “infertility”. A manual search of the bibliography of publications was used to identify study results that could not be found during the online search.

ожиріння; фертильність жінок; надлишкова маса тіла; безпліддя; репродуктивний вік; огляд

obesity; female fertility; overweight; infertility; reproductive age; review

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