**6. Conclusion**

Obesity is increasing globally in men and women, and the negative impact of overweight and obesity on reproductive health, fertility, pregnancy outcomes, and also transgenerational health is significant. Obesity impairs both natural and assisted conception and has been found to affect endocrine function, oocyte and sperm quality, embryo quality, and also endometrial receptivity and implantation. Pregnancy and live birth rates are lower, and miscarriage rates are higher in the setting of obesity. The metabolic and reproductive health of the offspring is also negatively affected by both maternal and paternal obesity.

Preconceptional weight loss is recommended for all women seeking fertility treatment, firstly through counseling, lifestyle intervention, and behavior modification and then with adjunctive pharmacological agents or bariatric surgery, with a delay to conception of at least 1 year following this. Careful consideration of the benefits of delaying conception for weight loss must be balanced against the possibility of declining fertility due to advancing age of the couple.
