ABSTRACT
Background: Infertility is well-known global health problem
that has significant impacts on an individual, families and communities. Many modifiable lifestyle risk
factors increase the risk of women to several reproductive disorders. Aim:
This study established the relationship between obesity and Hypothalamic-Pituitary-Ovarian (HPO) axis
hormones in infertile women in the Niger Delta Region, Nigeria. Methodology:
Six hundred and twenty-six (626) women aged
18 - 40 years comprising of 513 obese infertile women and 113 non obese women who served as control were recruited for
the study. Anthropometric measurements were taken and Body Mass Index was
calculated. A non-fasting venous blood sample was collected from the women and
analyzed for serum Estrogen, Luteinizing Hormone (LH), Follicle Stimulating
Hormone (FSH), Progesterone, Inhibin B, and Prolactin using Enzyme linked immunosorbent
assay method. Results: In the present study, the Body Mass Index of
women with primary (1°) infertility is significantly (p < 0.05) higher than
secondary (2°) infertility women. Whereas, women with 2° infertility were older
and have a higher height than women with 1° infertility. The result revealed
that serum estrogen, luteinizing hormone, follicle stimulating hormone and
prolactin levels were significantly (p < 0.05) higher in the obese infertile
women, while inhibin B and progesterone levels were significantly (p < 0.05)
reduced in the obese infertile women compared to the control subjects. However,
women with 1° infertility have a significantly higher LH and FSH levels than
the 2° infertility women. Furthermore, the study revealed that hyperestrogenism is the most prevalent gonadal
disorder in women with primary infertility and secondary infertility.
The BMI of infertile women suffering Hyperestrogenism is significantly higher
than any other female gonadal disorder. The result also showed that there is
statistically significant positive correlation between BMI and Hypogonadism,
Hypogonadotropic and Amenorrhoea in obese infertility women. While, no
significant correlation between BMI and Hypergonadism and Hypergonadotropic was
observed. Furthermore, there was a positive correlation between BMI and
Hypothalamus-Pituitary Ovarian hormones, as BMI showed a positive correlation
with LH, FSH, Estrogen, progesterone, and prolactin in women with primary and
secondary infertility, while Inhibin B showed a negative correlation with BMI. Conclusion: There is a relationship between BMI and Hypothalamus-Pituitary Ovarian hormones, signifying that obesity could affect female reproduction and directly impact ovarian function. Therefore,
body weight maintenance should be
considered as a first line of management of Hypothalamus-Pituitary Ovarian hormonal related infertility.