Are there any reasons why obese women should be denied assisted reproductive technologies?

Epidemiological evidence clearly shows that obesity contributes to menstrual disorders, infertility and poor pregnancy outcome. Clinicians face two problems: obesity-related infertility and, consequently, obesity in women using assisted reproductive technologies. Whereas weight loss constitutes the first-line therapy for the former, the same does not always apply for the latter. Much debate surrounds the relationship between overweight patients and the outcome of IVF treatment. Adjusting the dose of gonadotropins is the most characteristic feature of IVF treatment in such patients. Nevertheless, considering the poorer outcome of pregnancies in obese patients, all efforts (changes in lifestyle habits, psychological counseling, antiobesity medical therapy and, possibly, bariatric surgery) should be made to encourage weight loss before fertility treatment is begun.