Research shows that obesity is a significant risk factor for female infertility, and that fertility often improves after bariatric surgery. While improvements in fertility have previously been attributed to various hormonal changes after surgery, a recent study suggests that those improvements are not just about the physiology of the person but also the psychology.
This study of 29 women over a two-year period, investigated ovulation rates (pre and post-surgery) as well as a questionnaire designed to assess sexual functioning. While improvements in the hormonal parameters of the menstrual cycle were noted after surgery, what was most significant was a marked improvement in the scores on the sexual function questionnaire, with the biggest improvements seen in sexual desire and arousal.
Conversely, different psychological factors have been shown to adversely affect the fertility and reproductive ability of both males and females. Depression, anxiety, poor self-esteem has all been associated with obesity and psychological factors have been shown to negatively affect the reproductive ability of both males and females.
Possible changes in physiology attributable to the depressed state which could directly affect infertility involve elevated prolactin levels, disruption of the hypothalamic-pituitary-adrenal axis, and thyroid dysfunction. One study of 10 depressed and 13 normal women also suggests that depression is associated with abnormal regulation of, a hormone that regulates ovulation.