Sylvia Kirchengast 22 Evolutionary and medical aspects of body composition characteristics in subfertile and infertile women Sylvia Kirchengast Institute for Anthropology, University of Vienna, Vienna, Austria Address for correspondence: Univ. Prof. Dr. Sylvia Kirchengast, Institute for Anthropology, University of Vienna, Althanstrasse 14 A-1090 Vienna, Austria. E-mail: sylvia.kirchengast@univie.ac.at ACTA MEDICA LITUANICA. 2005. VOLUME 12 No. 1. P. 22–27 © Lietuvos mokslø akademija, 2005 © Lietuvos mokslø akademijos leidykla, 2005 INTRODUCTION The association between body composition charac- teristics and female fecundity seems to be well known since a very long time. According to icono- diagnostic analyses, the famous upper paleolithic Ve- nus figurines such as the Venus of Willendorf or the Venus of Lespugue are interpreted as symbols of beauty and fecundity (1). The majority of these little figurines show an extremely high amount of body fat, especially in the lower region of the body, indicating a typical gynoid kind of fat patterning. Later in our history famous painters such as Ru- bens presented young and attractive females as con- siderably fat. Even today more than 90% of cultu- res listed in the Human Relation area files (HRAF) prefer a slight overweight, a moderate amount of fat tissue and a gynoid kind of fat distribution as attractive, because this body type is associated with health and fecundity (2). Only in contemporary high- ly industrialized societies an extremely slender body is considered as attractive, while in traditional so- cieties body fat is interpreted as an insurance of fecundity, health and high social status (2). The im- portance of body fat for successful reproduction is out of question today (3–5). Body fat is an essential caloric resource, especially important during phases of increased somatic stress such as pregnancy or lactation. Furthermore, body fat indicates a positive energy balance and is essential for the extraovarian estrogen synthesis. On the other hand, fat distribu- tion patterns are also influenced by hormonal chan- ges such as during menopausal transition (6). Thus, body composition parameters as well as fat distribu- tion patterns may be interpreted as extragenital mar- kers of human ovarian function. The aim of the present study was to document body composition and fat patterning of young infertile women and to The association between body composition characteristics and female fecundity seems to be well known since a very long time. The aim of the present study was the documentation of body composition characteris- tics of young infertile women and interpretation of the results in an evolutionary sense. Materials and Methods. 43 young Austrian women aging between 18 and 29 years, suffering from infertility caused by PCOS, anorexia nervosa or primary amenorrhoea, and 19 healthy age-matched controls were enrolled in the present study. Body composition analyses and bone density analyses were performed using dual energy X-ray ab- sorptiometry. For a better description of the sex-typical fat distribution patterns, the fat distribution index was calculated. Results . As could be expected, the three groups of infertile young women differed highly significantly in nearly all body composition parameters. In comparison with healthy controls, anorexia nervosa patients were characterized by a significantly reduced fat percentage, while PCOS patients were charac- terized by a high amount of body fat and an android fat patterning. Primary amenorrhoea was first of all related with a reduced bone mass in comparison with healthy controls. Conclusions. Although anorexia nervosa, PCOS and primary amenorrhoea have completely different etio- logies and hormonal characteristics, the amount of body fat seems to be related with the disturbed ovarian function. Therefore the culturally in- dependent standard of female attractiveness may be interpreted in an evolutionary sense as a visible indicator of potential female reproductive success. Key words : infertility, body composition, weight status, fat distribution, PCOS, primary amenorrhoea, anorexia nervosa