The impact of diabetes and obesity on fertility and the potential role of gut hormones as treatment

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Aims: Alongside its metabolic implications, obesity and associated diabetes impair female reproductive function, causing infertility and polycystic ovarian syndrome (PCOS). Recently, gut hormones and their receptors have been identified in various reproductive organs indicating their potential regulatory effects on reproductive function. This review aims to give an overview of their potential effects. Methods: This review focuses on literature that outlines modifications during obesity, diabetes and related infertility with an emphasis on gut hormones and their therapeutic potential. Results: Evidence suggests that bariatric surgery has positive effects on fertility and PCOS where major alterations in metabolism occurs through restoration of gut hormone levels. This is thought to be due to the indirect effect weight loss and regulation of blood glucose has on the hypothalamic–pituitary–ovarian and hypothalamic–pituitary–adrenal axis influencing reproduction. Conclusions: Further research is required to elucidate the cellular mechanisms involved in the direct effects of gut hormone receptor activation on reproductive tissues. Current observations suggest a therapeutic role for gut hormones in infertility/PCOS associated with metabolic pathophysiology.
Original languageEnglish
Article numbere15230
Pages (from-to)1-10
Number of pages11
JournalDiabetic medicine
Issue number12
Early online date21 Sept 2023
Publication statusPublished online - 21 Sept 2023

Bibliographical note

Funding Information:
RC Moffett is funded by a Diabetes UK RD Lawrence Research Fellowship.

Publisher Copyright:
© 2023 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.


  • Obesity
  • diabetes
  • PCOS
  • infertility
  • gut hormones
  • insulin
  • incretins
  • obesity


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