This article reviews the literature data on the mechanisms of the obesity effect on the in vitro fertilization (IVF) clinical efficacy and discusses the main directions of improving assisted reproductive technology data for overweight women. It was noted that the multi-level effect of obesity is manifested by a decrease in the frequency of clinical pregnancy with IVF, these women having a higher frequency of pregnancy complications, with, in particular, the risk of spontaneous miscarriages increased. It is believed that such disorders are associated with changes in the morphology of oocytes and embryos in this category of patients, as well as with impaired endometrial receptivity. A number of studies have shown that achieving normal body weight through lifestyle modifications that include healthy eating and exercise for several months before and during the IVF program and contribute to gradual and sustained weight loss can significantly improve the assisted reproductive technology outcomes.