Journal Mobile Options
Table of Contents
Vol. 47, No. 1, 1999
Issue release date: January 1999
Gynecol Obstet Invest 1999;47:1–5

Upper Body Obesity and Hyperinsulinemia Are Associated with Anovulation

Morán C. · Hernández E. · Ruíz J.E. · Fonseca M.E. · Bermúdez J.A. · Zárate A.
aResearch Unit of Reproductive Medicine, bGynecologic Endocrinology Section, Hospital Luis Castelazo Ayala, and cEndocrine Research Unit, Instituto Mexicano del Seguro Social, Mexico City, Mexico

Individual Users: Register with Karger Login Information

Please create your User ID & Password

Contact Information

I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in


The objective of this study was to determine the effect of body fat distribution and hyperinsulinemia on the occurrence of ovulation. Fifty-six women (20–35 years old) either with overweight or obesity (body mass index ≥25) were studied. They were classified in two groups according to waist/hip ratio (WHR); one with predominance of adiposity in the upper body segment (n = 29, WHR >0.85) and the other with predominant adiposity in the lower body segment (n = 27, WHR ≤0.85). Basal body temperature and serum progesterone were determined in each cycle during 6 months. Serum insulin levels were measured at baseline and 30, 60, 90, 120 and 180 min after a 75-gram oral glucose load. The mean insulin values in response to oral glucose load in patients with upper body segment obesity were significantly higher than those corresponding to women with lower body segment obesity. Furthermore, the ratio between ovulated cycles and all the cycles studied in patients with upper body segment obesity was significantly lower than that observed in patients with lower body segment obesity. Upper body obesity seems to affect the ovulatory process and this may be related to the presence of hyperinsulinemia.

Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.


  1. Hartz AJ, Barboriak PN, Wong A, Katayama KP, Rimm AA: The association of obesity with infertility and related menstrual abnormalities in women. Int J Obes 1979;3:57–73.
  2. Friedman CI, Kimm MH: Obesity and its effect on reproductive function. Clin Obstet Gynecol 1985;28:645–663.
  3. Barbieri RL, Smith S, Ryan KJ: The role of hyperinsulinemia in the pathogenesis of ovarian hyperandrogenism. Fertil Steril 1988;50:197–212.
  4. Kissebah AH, Vydelingum N, Murray R, Evans DJ, Hartz AJ, Kalkhoff RK, Adams PW: Relation of body fat distribution to metabolic complications of obesity. J Clin Endocrinol Metab 1982;54:254–260.
  5. Lapidus L, Bengtsson C, Larsson B, Pennert K, Rybo E, Sjostrom L: Distribution of adipose tissue and risk of cardiovascular disease and death: A 12-year follow-up of participants in the population study of women in Gothenburg. Sweden. Br Med J 1984;289:1257–1261.
  6. Reid RL, Van Vugt DA: Weight-related changes in reproductive function. Fertil Steril 1984;48:905–913.
  7. Shoupe D, Kumar DD, Lobo RA: Insulin resistance in polycystic ovary syndrome. Am J Obstet Gynecol 1983;147:588–592.

    External Resources

  8. Poretsky L, Kalin MF: The gonadotropic function of insulin. Endocr Rev 1987;8:132–141.

    External Resources

  9. Nader S: Polycystic ovary syndrome and the androgen-insulin connection. Am J Obstet Gynecol 1991;165:346–348.
  10. Bray GA: Overweight is risking fate. Ann NY Acad Sci 1987;499:14–28.
  11. WHO Expert Committee: Physical status: the use and interpretation of anthropometry. WHO Tech Rep Ser No 854. Geneva, WHO, 1995.
  12. Seidell JC, Flegal KM: Assessing obesity: Classification and epidemiology. Br Med Bull 1997;53:238–252.
  13. Evans DJ, Hoffmann RG, Kalkhoff RK, Kissebah AH: Relationship of androgenic activity to body fat topography, fat cell morphology and metabolic aberrations in premenopausal women. J Clin Endocrinol Metab 1984;57:304–310.
  14. Israel R, Mishell DR, Stone SC, Thorneycroft IH, Moyer DL: Single luteal phase serum progesterone assay as an indicator of ovulation. Am J Obstet Gynecol 1972;112:1043–1046.

    External Resources

  15. Hull MGR, Savage PE, Bromham DR, Ismail AAA, Morris AF: The value of a single serum progesterone measurement in the midluteal phase, as a criterion of a potentially fertile cycle (‘ovulation’) derived from treated and untreated conception cycles. Fertil Steril 1982;37:355–360.
  16. Morán C, Alvarado Durán A, Rodríguez M, Ramírez E, Murillo A, Murrieta S, Guzmán F, Sauer R: Analysis of a single measurement of progesterone as an index of ovulation in inexplainable sterility. Arch Invest Med (Méx) 1988;19:107–111.
  17. Kramer MS: Clinical Epidemiology and Biostatistics. Berlin, Springer, 1988, pp 159–163, 191–193.
  18. McKeigue PM, Shah B, Marmot MG: Relation of central obesity and insulin resistance with high diabetes prevalence and cardiovascular risk in South Asians. Lancet 1991;337:382–386.
  19. Pasquali R, Antenucci D, Casimirri F, Venturoli S, Paradisi R, Fabbri R, Balestra V, Melchionda N, Barbara L: Clinical and hormonal characteristics of obese amenorrheic hyperandrogenic women before and after weight loss. J Clin Endocrinol Metab 1989;68:173–179.
  20. Zaadstra BM, Seidell JC, Van Noord PAH, te Velde ER, Habbema JDF, Vrieswijk B, Karbaat J: Fat and female fecundity: Prospective study of effect of body fat distribution on conception rates. BMJ 1993;306:484–487.

Pay-per-View Options
Direct payment This item at the regular price: USD 38.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 26.50