Tehran University of Medical Sciences Journal of Family and Reproductive Health 1735-8949 15 2 2021 06 20 118 124 Michela Cirillo Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy AND Center for Assisted Reproductive Technology, Division of Obstetrics and Gynecology, Careggi University Hospital, Florence, Italy Maria Boddi Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy Maria Coccia Center for Assisted Reproductive Technology, Division of Obstetrics and Gynecology, Careggi University Hospital, Florence, Italy AND Department of Clinical and Experimental Biomedical Sciences, University of Florence, Florence, Italy Monica Attanasio Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy Cinzia Fatini Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy AND Center for Assisted Reproductive Technology, Division of Obstetrics and Gynecology, Careggi University Hospital, Florence, Italy 2021 02 03 2021 04 24 Objective: We evaluated cardiometabolic burden in women planning assisted reproduction in order to identify subgroups at higher risk of pregnancy complications and cardiovascular disease. Materials and methods: In this cross-sectional study we investigated 60 infertile women with BMI≥25 kg/m2 referred to the Center for Assisted Reproduction. All women underwent metabolic, anthropometric parameters and ultrasound evaluation of ectopic fat depots. Results: All women had waist ≥80 cm. We found that 93.3% of women had pathological subcutaneous, 58.3% visceral and 80% para-perirenal fat; all women had fatty liver. Visceral fat and severity of steatosis were significantly related to the presence of metabolic syndrome (OR =5.7; p=0.03). A significant negative correlation between low HDL-c and para-perirenal fat (p<0.0001), a significant positive correlation with fasting plasma glucose and para-perirenal fat (p=0.001) were found. We observed a significant positive correlation between visceral fat and hs-CRP (p=0.002), HOMA-IR (p=0.04) and triglycerides (p=0.002), a significant negative correlation with HDL-c (p=0.05). Conclusion: This study by highlighting a clinically “dangerous liaison” between ectopic fat depots and metabolic/inflammatory markers, might permit to identify women with a worse metabolic phenotype and encourage lifestyle changes for improving their general and reproductive health together. https://jfrh.tums.ac.ir/index.php/jfrh/article/view/1689 https://jfrh.tums.ac.ir/index.php/jfrh/article/download/1689/562