With the improvement of living conditions and the acceleration of the pace of life, the obesity rate is growing, but have you ever thought that the growth of the obesity rate also increases the probability of infertility to a certain extent, so what is the connection between obesity and infertility? According to statistics, at present, every 8 couples in China, there is 1 pair of infertility, which brings serious impact to the harmony of family and society. Infertility caused by ovulation disorders between the pituitary and ovaries of the female partner accounts for about 20% to 40%, most of which are direct consequences of endocrine diseases (including premature ovarian failure, polycystic ovary syndrome, hyperprolactinemia, thyroid disease, etc.). In recent years, the adverse effects of many metabolic diseases, such as obesity and abnormal glucolipid metabolism, on female/male fertility have also been increasingly recognized. For women with endocrine metabolic disorders, even if assisted reproduction is successful, the future health of the fetus growing in such a maternal intrauterine environment is a concern. Therefore, active screening and treatment of endocrine metabolic disorders in women is essential for normal and healthy human reproduction. Polycystic ovary syndrome (PCOS) accounts for 30% to 60% of ovulatory infertility and is a common endocrine metabolic disorder in adolescent and childbearing women with a prevalence of about 5% to 10%. resistance and/or hyperandrogenemia, endocrine metabolic abnormalities such as abnormal glucose and lipid metabolism, fatty liver, hyperuricemia and obesity, while the latter is likely to be one of the root causes of the former. Insulin resistance and hyperinsulinemia are now known to play an important role in the development of PCOS, while obesity (especially abdominal obesity) also has a catalytic role in the development of PCOS. With the prevalence of unhealthy lifestyles and the proliferation of environmental endocrine disruptors, women’s health is facing more and more challenges, and PCOS is gradually becoming a major killer of modern women’s health and beauty. Many patients experience a significant decrease in quality of life, especially in emotional and social functioning, due to changes in appearance such as hirsutism, acne, obesity, lack of feminine features, as well as hormonal disorders and internal anxiety associated with fear of infertility. These in turn affect the emotional center and lead to abnormal secretion in the pituitary hypothalamus, further aggravating the endocrine disorder and affecting ovulation, making the chances of conception even lower. Adipose tissue plays an important role in the formation and maintenance of the PCOS phenotype, not only because fat is an energy store, but more importantly, it is the largest endocrine gland in the body and is involved in a variety of physiopathological processes, such as the regulation of insulin sensitivity which is closely related. Studies have found that a 10% weight loss can significantly improve insulin resistance and hyperandrogenemia, as well as improve menstruation and ovulation; therefore, a healthy lifestyle and prevention of overweight or obesity are the cornerstones of PCOS treatment. In addition, pharmacological interventions have an important place, including drugs that increase insulin sensitivity, such as metformin, which can improve the androgenized ovarian microenvironment due to hyperinsulin resistance, restore ovulatory menstruation and correct metabolic abnormalities; and drugs that correct hyperandrogenemia and regulate menstruation, as well as ovulation-promoting drugs. The treatment of PCOS is a comprehensive management process, and individualized prevention and treatment strategies and follow-up plans should be developed according to the different complaints of patients. Patients with PCOS should be better informed about the possible clinical manifestations, signs and long-term complications in order to achieve early detection, early treatment and standardized management of the disease.