Wednesday, April 25, 2012

Obesity & Infertility Are They Linked?

Can weight impact a woman's ability to conceive?

Obesity has reached epidemic proportions in this country, with 31 percent of white, 38 percent of Hispanic, and 49 percent of African American women considered overweight or obese. Obesity is defined as a body mass index (BMI) greater than 30. (Calculate your body mass index here

Obesity has been linked to multiple medical problems including infertility. Infertility in obese and overweight women is primarily related to ovulatory dysfunction. Anovulation often results in irregular menstrual cycles. Indeed, studies have shown that 30% to 47% of obese women will have irregular menstrual cycles. The likelihood of irregular menstrual cycles increases in direct proportion to increases in weight. Furthermore, it has been demonstrated that weight reduction often leads to resumption of normal menses and increased pregnancy rates.

What can women do?
First line treatment for obesity-related infertility is weight loss and lifestyle modification (both of which I teach in my health and wellness program). While any amount of weight loss in obese women may improve fertility, a loss of 5 percent to 10 percent in overall body weight can result in spontaneous ovulation in 60 percent of patients. Efforts should be made to restrict calories and to exercise for at least 30 minutes, three times a week. Participation in a formal weight loss program can be very helpful. (Here is one you might find interesting)

Apart from weight loss, treatments for infertility in obese women do not differ substantially from treatments in non-obese women. For anovulation, first line treatment generally consists of ovulation induction with oral medications such as clomiphene citrate. Women who fail to achieve pregnancy with oral medications are often treated with injectable ovulation induction agents such as recombinant or urinary gonadotropins. In vitro fertilization is often performed if these treatments fail or if there are other factors contributing to infertility.

It has been shown that obesity is associated with a longer duration of treatment, increased dosage of medication, and an increased risk of treatment cancellation due to poor response. Studies have also shown that pregnancy rates are approximately 30 percent lower in obese women undergoing IVF compared to women of normal weight. It has been proposed that the IVF is less successful for several reasons. Some of these include impaired absorption of medication due to increased fat stores, limited ability to visualize ovaries during ultrasound monitoring, and more challenging egg retrieval.

Moreover, once pregnancy occurs, obese women have a higher rate of pregnancy loss. In fact, studies show they have up to a two-fold higher risk of miscarriage compared to normal weight women. It is not clear why this occurs. Nonetheless, weight loss can dramatically decrease the risk of miscarriage.

 The bottom line: 
Obesity is a major health problem that is associated with infertility and miscarriage. Weight loss is extremely valuable in the management of these issues and can enhance fertility and decrease miscarriage rates.

The Last Note:
This post is not intended to mislead anyone by saying, "all you have to do is lose weight and the magic will happen". Losing weight to get pregnant will not work for everyone. The goal was to point out that there is a link between infertility and obesity and show that by losing weight you stand a better chance of conceiving. Always, always, always, consult your doctor for guidance on your specific conditions! 


Danielle said...

I have been told by doctors that they do not know if losing weight will help me get pregnant but I thought it was worth a try. I am only down 30lbs but I am on my way. We will see what happens but I loved your post.

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