SCIENTIFIC ARTICLE REVIEW: Obesity and overweight and associated factors among women with infertility undergoing assisted reproductive technology treatment in a low income setting
In this section of our newsletter, we review scientific articles authored by society members, showcasing significant research conducted in Ghana on ART and related fields.
The article, titled "Obesity and overweight and associated factors among women with infertility undergoing assisted reproductive technology treatment in a low income setting" by Christian Amoah et al., published in Scientific Reports in February 2025, investigates the prevalence of elevated Body Mass Index (BMI) and its associated socio-demographic factors among infertile women in Ghana undergoing assisted reproductive technology (ART) treatments. Click here to access the article: DOI https://doi.org/10.1038/s41598-024-82818-5
Why is this Study important?
This study is important because it discusses the rising global and national burden of obesity, now prevalent even in low- and middle-income countries like Ghana, where both undernutrition and overnutrition coexist. Most critically, it draws attention to how elevated BMI negatively impacts fertility and assisted reproductive technology (ART) outcomes; leading to poor ovarian response, lower embryo quality, reduced pregnancy rates, and higher miscarriage risks. Despite this, there is a lack of local data on BMI among women seeking infertility treatment in Ghana. By filling this gap, the study provides essential evidence to inform integrated healthcare approaches and targeted interventions that link reproductive health with weight management and broader public health strategies.
Key Findings:
High Prevalence of Elevated BMI: Among 3,660 women studied over five years, 76.83% had elevated BMI—39.56% were obese, and 37.27% were overweight.
Age Association: Elevated BMI was most prevalent among women aged 30–49 years.
Education Correlation: Higher levels of education were significantly associated with increased BMI and infertility prevalence.
Secondary Infertility: Overweight and obesity were more common among women experiencing secondary infertility.
Occupational Influence: Traders exhibited the highest prevalence of elevated BMI, followed by civil servants and health workers, possibly due to sedentary lifestyles.
Limitation: The findings did not assign causality of infertility as due to elevated BMI from this work.
4 Practice Points to take Home:
Empower Women to Act: Encourage women to monitor their BMI and adopt healthier lifestyles, especially between ages 30–49.
Public Health Education: Use media, community leaders, and workplaces to promote awareness about weight and fertility.
Enhance Fertility Clinic Practices: Integrate BMI checks and multidisciplinary care regarding weight management and ART.
Strengthen Policy and Research: Embed weight management in national fertility policies and support data-driven public health solutions.
Practice Point 1
Empower Women to Act: Personal Responsibility for Weight and Fertility Health
Know Your BMI and Act on It: Every woman seeking fertility treatment should know her BMI. Those who are overweight (BMI 25–29.9) or obese (BMI ≥30) should work with a healthcare provider to create a personal weight management plan.
Adopt a Healthy Lifestyle: Integrate daily physical activity (e.g., brisk walking, aerobics, dancing, etc) and a balanced, low-sugar, low-fat diet into lifestyle. Consistent lifestyle modification is critical—seek the help of a nutritionist or fitness coach if possible. Women aged 30–49 are at highest risk should be particularly vigilant about managing weight and avoiding sedentary habits.
Monitor Weight During Infertility Treatment: Track weight changes regularly before and also during assisted reproductive technology (ART) cycles to optimise hormonal balance and treatment success. Optimising weight can change fertility and even trigger ovulation in some women.
Practice Point 2
Public Health Education: Creating Awareness and Shaping Community Behaviors
Launch Targeted Educational Campaigns: Use mass media, social media, and community radio to spread messages on the link between BMI and infertility. Tailor messages for urban, peri-urban, and rural settings, focusing on common misconceptions and the interventions possible and appropriate per segment.
Leverage Social Media and Influencers: Partner with fertility experts, health influencers, and media personalities to normalize conversations around weight and fertility, especially among educated and working women.
Involve Community Leaders and Churches: Engage local leaders, religious groups, and traditional authorities in sensitization programs on reproductive health and lifestyle. Their endorsement boosts credibility and cultural relevance.
Corporate Wellness Advocacy: Encourage companies, especially those in civil service and trading sectors, to include physical activity breaks, nutrition education sessions, and healthy meals in their staff wellness programs.
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Practice Point 3
Enhance Fertility Clinic Practices
Routine BMI Screening for All Clients: Integrate BMI measurement and documentation into the initial and follow-up fertility consultations. Categorize risk and create individualized weight management plans accordingly. Managing elevated BMI before initiating ART may contribute to an increase in success rates.
Offer Integrated Lifestyle and Fertility Counseling: Include dieticians, physiotherapists, and psychologists in the fertility care team. Provide clients with structured programs on nutrition, exercise, and behavior change. Run tailored sessions and support groups for women aged 30–49 to address their specific weight and fertility concerns with a clear action plan.
Corporate Outreach Programs: Centers can partner with employers and women’s groups to deliver seminars and mini health screenings focused on fertility and weight. Offer workplace BMI checks and counseling as part of corporate wellness packages. Encourage employers to set up weight management programs at workplaces.
Practice Point 4
Strengthen Policy and Research in fertility
Incorporate Weight Management into National Fertility Guidelines: Ministries of Health should update ART and infertility guidelines to include BMI screening, referral pathways for weight management, and patient education requirements.
Support Community-Based Interventions: Public health authorities should fund and scale up community-level programs that promote physical activity and nutritional literacy among women of reproductive age.
Fund Research and Monitoring: Allocate research grants to study how BMI affects ART outcomes in low-income settings, and monitor the effectiveness of weight management interventions.
Research on the effect of elevated BMI on fertility outcomes in Ghana: Invest in research data to understand how elevated BMI influences ART outcomes. Use this data to drive targeted interventions.
Research Topics!
So in conclusion, we asked Chat GPT to generate some research topics related to this study by Christian Amoah et al. that you could tackle and add to the knowledge pool regarding the topic in Ghana. Here are the edited results:
Research Topic 1:
“Impact of Pre-ART Weight Reduction Interventions on Pregnancy Outcomes in Overweight and Obese Women”
Action Points:
Design and test a structured weight loss program (diet, exercise, counseling) before ART.
Measure pregnancy rates, live birth rates, or treatment duration among participants vs controls.
Develop guidelines for pre-ART BMI optimization.
Research Topic 2:
“Effectiveness of Community-Based Educational Campaigns on BMI Reduction and Fertility Awareness in Women of Reproductive Age”
Action Points:
Implement educational interventions using churches, radio, and social media in selected communities.
Monitor changes in BMI, knowledge levels, and ART uptake pre- and post-intervention.
Develop scalable public health education modules based on findings.
Research Topic 3:
“Health System Readiness for Integrating Lifestyle and Weight Management into Fertility Services in Low-Income Countries”
Action Points:
Assess the current capacity of fertility clinics (personnel, tools, referral systems) for lifestyle counseling.
Identify gaps and barriers to integrated care.
Propose a cost-effective, scalable model for integrating nutrition and physical activity into ART clinics that include dietitians, psychologists, physical trainers and coaches.
Citation of the article
Amoah, C., Adageba, R.K., Appiah, E.K. et al. Obesity and overweight and associated factors among women with infertility undergoing assisted reproductive technology treatment in a low income setting. Sci Rep 15, 6163 (2025). https://doi.org/10.1038/s41598-024-82818-5