The rapid development of economy and society in recent years has made people’s diet more and more abundant and their life more and more comfortable, meanwhile, more and more people join the ranks of obesity. It is well known that obesity is related to many chronic diseases, which can easily lead to metabolic syndrome, hypertension, type 2 diabetes, coronary heart disease and other diseases, but the impact of obesity on the reproductive endocrine system is often easy to be ignored. It is clinically found that compared with normal weight women, obese women are more likely to have menstrual disorders and conception becomes more difficult. The following will introduce some knowledge about obesity and infertility for friends. First, obesity is a disease obesity refers to the body fat cells increase in number or volume, so that the weight of more than 20% of the normal value. Human understanding of obesity has gone through a long historical process. In the ancient times when food was scarce, people not only did not think that obesity was a disease, but even often took fat as beauty. China’s Tang Dynasty, obesity is seen as the embodiment of wealth and dignity, Yang Guifei was recognized as a beautiful woman by the people of the time, lies in the plump. Most other countries and other nationalities in the world have also experienced such a stage of fat as beauty. But with the development of modern medicine, people found that obesity will not only cause bloated body, mobility, and easy to induce a variety of chronic diseases, is the killer of human health, obesity itself is a major disease. Especially after the 1980s, obesity has aroused widespread concern in society, the treatment of obesity and research has made many new advances, the understanding has been newly improved. Second, the diagnosis of obesity There is a lack of uniform diagnostic standards for obesity. Often use the weight measurement method and body fat measurement method. (a) weight measurement method 1, body mass index (BMI): BMI = weight (kg) / height (m2), is the most commonly used clinical evaluation of the degree of obesity indicators. In 1998, the World Health Organization (WHO) obesity advisory committee according to the BMI classification of obesity. Because of the difference of human race, in 2000, the international obesity research association and the international obesity working group jointly developed the diagnosis standard of obesity and overweight in the Asia-Pacific region. 2, standard weight calculation method (1) height <165cm, standard weight (kg) = height (cm) - 100; (2) height of 166 ~ 175cm, standard weight (kg) = height (cm) - 105; (3) height of 176 ~ 185cm, standard weight (kg) = height (cm) - 110; (4) standard weight (kg) = [ Height (cm) - 100] × 0.9. The weight of normal people fluctuates around ±10%. Standard weight of 120% for obesity, of which ≥ 120% for mild obesity, ≥ 150% for severe obesity. (B) body fat measurement method Measurement methods include underwater determination of body density method, bioelectrical impedance analysis method, ultrasonic examination method, computerized X-ray tomography (CT) or magnetic resonance imaging method (MRI) and many other methods. Body fat determination method is highly accurate, but the operation is complicated and the feasibility is poor, and it is mostly used in clinical basic research. (iii) Classification of obesity Obesity-related diseases are closely related to fat distribution. According to the different distribution of fat, the clinical concept of "centripetal" obesity and "non-centripetal" obesity is proposed. Patients with adipose tissue mainly distributed in the abdomen subcutaneously and in the abdominal cavity are "centripetal" obese (also called abdominal obesity). This type of obesity is more likely to be combined with lipid metabolism disorder, glucose metabolism disorder and cardiovascular disease. Commonly measured waist circumference (WC), hip circumference (HC) for obesity classification. Waist circumference (WC), hip circumference (HC) measurement method is as follows: wearing thin underwear, measurement of waist circumference, the measured person's feet apart 25-30cm, weight evenly distributed on the legs, measurement position at the level of the midpoint of the line between the anterior superior iliac spine and the lower edge of the 12th rib. The measurer sits beside the subject and holds the tape measure close to the body, but does not compress the soft tissues. Hip circumference is obtained by measuring the circumference around the most prominent point of the hip. The Chinese Obesity Task Force recommends that men with a waist circumference ≥ 85 cm and women with a waist circumference ≥ 80 cm or a waist-to-hip ratio (WHR) > 0.9 for men and 0.8 for women be considered “centripetal” obese. Scientists have found that “centripetal” obese women are more likely to have their reproductive function affected. Those WHR>0.8 abdominal obese women compared with WHR≤0.8 lower body obese women, irregular menstruation and amenorrhea, the relative risk of 1.56 and 2.29 respectively; breast cancer and endometrial cancer risk also increased. Third, the impact of obesity on female reproductive function Normal menstruation and reproductive function need sufficient fat storage, but too high and too low weight will make fertility decline. Scientists have found that obesity, especially “centripetal” obesity, easily lead to insulin resistance and hyperinsulinemia. Insulin resistance is a state in which the target organ is less sensitive to the action of insulin, i.e., a normal dose of insulin produces less than the normal biological effect. The compensatory secretion of insulin by the pancreas increases, creating hyperinsulinemia. Insulin resistance can cause hyperandrogenemia through a variety of mechanisms that affect follicular growth and development. For example, about 75% of patients with ovarian syndrome are obese in combination. In addition to this, obese patients also have leptin resistance (i.e., high circulating leptin does not achieve its proper biological effect). Leptin inhibits follicle development and ovulation by blocking the stimulatory effect of follicle-stimulating hormone through various mechanisms, resulting in reduced fertility in obese women. High concentrations of leptin also inhibit the production of androstenedione by follicular membrane cells, prevent androstenedione aromatization, reduce estradiol synthesis, and affect endometrial development, leading to infertility. It is well documented that obesity has a significant impact on fertility and can lead to menstrual disorders, anovulation, infertility, miscarriage, and poor pregnancy outcomes. Patients with infertility or reduced reproductive function also often present as obese or overweight. Obese women have a 35% to 60% chance of developing anovulation and polycystic ovaries, and adolescent girls with a BMI of 28-33 are 2.7 times more likely to develop anovulatory infertility in the future than those with a BMI of 18-22. Obese women have lower pregnancy rates in both natural and infertility treatment cycles, and even lower rates of ovulation induction and IVF success compared to normal weight women. The process of ovulation promotion in obese patients requires high amounts of gonadotropins and low ovulation rates, even affecting the growth of the endometrium. It can be seen that obesity also has a negative impact on the treatment outcome of infertility. Fourth, the impact of obesity on male reproductive function Obesity also has an impact on male fertility. In recent years the United States and the United Kingdom scientists found that obesity will reduce male testosterone secretion, thus reducing the number and quality of sperm, leading to oligospermia, sperm motility decline, affecting male fertility. Among them, men with a BMI greater than or equal to 30 are 36% more likely to be infertile than normal men. Only men of moderate weight, that is, with a body mass index between 18.5D24.9, have normal sperm quality. In addition to this, obesity leads to decreased libido and increased erectile dysfunction. These factors work together to weaken the fertility of obese men. Fifth, change lifestyle, reduce weight is the primary treatment measures for infertile obese patients Change lifestyle can reduce weight, reduce insulin resistance, and become the primary treatment measures for infertile obese patients, is their basic treatment, but also the safest and cheapest effective treatment means. Studies have found that weight loss of 5-10% significantly improves reproductive endocrine abnormalities in obese patients, corrects insulin resistance, restores ovulation, and improves response to ovulation medication. The method of weight loss includes a combination of “diet control + exercise + behavior”. Exercise and diet modification are the basis, and behavior change is the key. The basic occasion is daily life, family members and obese people participate together to create a relaxed environment and make it persistent. 1, diet therapy: the purpose of diet therapy is to reduce weight by reducing calories in food, the total caloric intake of the body to control. Recommended daily caloric intake of 3344 to 5016 kilojoules, you can ask a nutritionist for a diet with nutrients. 2, exercise therapy: exercise therapy is through the fat tissue stored in the decomposition of triacylglycerol, its decomposition of fatty acids released as a source of energy consumed by muscle tissue, so that the body is balanced or negative balance of caloric income and expenditure, so as to reduce fat, control the role of obesity. It is recommended to use aerobic exercise, such as jogging, cycling, swimming, etc.. Exercise intensity to medium intensity is most appropriate, low intensity exercise can not achieve the therapeutic effect. Exercise intensity is generally guided by heart rate, that is, quiet heart rate + 2O times / min or use the age projection method, that is, the target heart rate (times / min) = 170 an age. Each exercise time lasts at least > 30 min, 3-5 times a week. Exercise therapy to reduce weight effect is certain, and can enhance physical fitness, has been the basic method of weight reduction. 3, behavior therapy: behavior therapy is under the guidance of the psychiatrist, the family’s help and supervision, so that patients gradually and consciously change the psychological state and life habits that are easy to cause disease, and replace them with psychological state and life habits that are conducive to disease treatment. Research found that obese patients because of obesity and increasingly low self-esteem, reluctant to interact with people, reluctant to exercise so as not to expose themselves to everyone; menstrual disorders, infertility so that they feel doubtful about their fertility, low self-esteem, depression, anxiety, some even self-loathing, overeating, reluctant to exercise. In fact, in actual life, it is not very difficult to reduce weight, the difficulty is to maintain the weight. Under the guidance of the psychiatrist and the help and supervision of the family, the behavioral treatment that makes patients gradually and consciously change their bad habits is especially important. 4, other: through the above treatment, most patients can effectively reduce weight, individual ineffective patients, you can also consider drug therapy, acupuncture and other treatment. Obesity is not only closely related to infertility, but also poses a risk to long-term health. Reducing weight through a series of measures not only improves reproductive endocrine abnormalities and infertility, but also benefits physical health and improves quality of life. Getting rid of obesity is the first choice for conceiving a baby and a rational choice for a healthy life.