Preconception preparation of women with obesity without comorbidities
DOI: 10.32364/2618-8430-2026-9-3-9
Preconception preparation of women with obesity without comorbidities
A.V. Tiselko1, F.F. Burumkulova2, I.M. Tokeshev3
1 D.O. Ott Research Institute of Obstetrics, Gynecology, and Reproduction, St. Petersburg, Russian Federation
2 Moscow Regional Research Institute of Obstetrics and Gynecology named after аcademician V.I. Krasnopolsky, Moscow, Russian Federation
3 Geropharm LLC, St. Petersburg, Russian Federation
Obesity is a modifiable risk factor for reproductive dysfunction. At a BMI ≥30 kg/m2, time to conception is prolonged, and a risk of subfertility is increased nearly 1.7-fold. Preconception weight correction is a priority strategy for restoring natural fertility and optimizing pregnancy outcomes. Excessive body weight (BW) is associated with anovulation, decreased oocyte quality, impaired endometrial receptivity, increased risks of congenital malformations, gestational diabetes, and preeclampsia, and a risk of surgical delivery and perinatal pathology. Non-pharmacological strategies (diet, physical activity) provide modest weight loss (on average, 3.5 kg within 14 weeks) that is insufficient for ovulation recovery in a significant proportion of patients. Tirzepatide, a dual GIP/GLP-1 receptor agonist, leads to 20–24% weight loss and 40% visceral fat reduction. Rapid recovery of ovulation associated with the therapy and decreased efficacy of oral contraceptives provides a risk of unintended pregnancy; since the drug withdrawal induces metabolic rebound (~14% of lost weight regained over 52 weeks), organized withdrawal and nutritional support should be arranged. Preconception weight correction requires a combination of non-pharmacological strategies, pharmacotherapy, and nutritional support with reliable non-oral contraception throughout the treatment period.
Keywords: obesity, preconception preparation, fertility, incretins, tirzepatide, GLP-1, gestational diabetes, preeclampsia, contraception, metabolic rebound.
For citation: Tiselko A.V., Burumkulova F.F., Tokeshev I.M. Preconception preparation of women with obesity without comorbidities. Russian Journal of Woman and Child Health. 2026;9(3):281–288 (in Russ.). DOI: 10.32364/2618-8430-2026-9-3-9
About the authors:
Alyona V. Tiselko — Dr. Sc. (Med.), Senior Scientific Officer, D.O. Ott Research Institute of Obstetrics, Gynecology, and Reproduction; 3, Mendeleevskaya line, St. Petersburg, 199034, Russian Federation; ORCID iD 0000-0002-2512-833
Fatima F. Burumkulova — Dr. Sc. (Med.), Professor, Leading Scientific Officer at the Department of Obstetrics, Moscow Regional Research Institute of Obstetrics and Gynecology named after аcademician V.I. Krasnopolsky; 22a, Pokrovka str., Moscow, 101000, Russian Federation; ORCID iD 0000-0001-9943-0964
Ilya M. Tokeshev — Medical Marketing Manager, GEROPHARM LLC; 6, bldg. 2, entrance 3, Presnenskaya emb., Moscow, 123112, Russian Federation.
Contact information: Fatima F. Burumkulova, e-mail: fatima-burumkulova@yandex.ru
Financial Disclosure: the review was prepared with the sponsorship of Geropharm LLC.
Conflict of interest: I.M. Tokeshev is an employee of Geropharm LLC. The other authors declare that there is no conflict of interest.
There is no conflict of interest.
Received 04.06.2026.
Revised 24.06.2026.
Accepted 20.07.2026.
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