Weight and Fertility
One in seven couples in the United States experiences
fertility problems, which can stem from a variety
of health issues. One health issue associated
with infertility is a woman’s weight. Being
overweight or underweight can greatly affect her
ability to conceive.
How does being overweight affect fertility?
Women who are overweight or obese may have imbalances
in reproductive hormones that affect menstrual
cycles and prevent ovulation.
Clarisa Gracia, MD, a reproductive endocrinologist
at Penn Fertility Care
states, “The relationship between obesity
and reproductive problems is complicated. However,
insulin resistance and estrogen production from
fat cells can affect the ovaries and prevent eggs
from being released every month. This condition
is called anovulation.
If an egg is released, the egg may not be healthy
enough to result in a pregnancy.
“Fertility problems related to weight usually
affect women who are at least 10 percent over
their ideal body weight. While fertility treatments
are available to improve the chances of becoming
pregnant, weight loss alone may correct infertility
in some cases,” Dr. Gracia said.
A condition known as polycystic
ovary syndrome (PCOS) is also associated with
obesity
and affects a woman’s ability to conceive.
PCOS results from a hormonal imbalance that leads
to excess production of androgens
by the ovary,
which can prevent or delay ovulation.
Symptoms of PCOS:
- Irregular, scanty or absent menstrual
periods
- Increased levels of male hormones
- Obesity or weight gain
- Insulin resistance
- Infertility
Excess hair growth (hirsutism)
- High blood pressure (over 140/90)
- Acne
- Male pattern baldness
- Dark patches of skin on back of neck,
under arms, groin
Weight reduction
is an important factor in the treatment of PCOS.
Maintaining good general health through careful
food choices and exercise can help eliminate the
complications of obesity and diabetes in women
with PCOS. Weight loss may improve fertility and
pregnancy outcomes.
How can I tell if I am at a healthy weight?
A good way to assess your weight is to calculate
your Body Mass
Index (BMI). Your BMI estimates can tell you
if you are at a healthy weight. Use our BMI
calculator to find out if you are in a healthy
weight range.
BMI Categories:
Below 18.5 = Underweight
18.5 - 24.9 = Healthy
25.0 - 29.9 = Overweight
30.0 - 39.9 = Obese
Over 40 = Morbidly Obese
In general, the term “overweight”
refers to a weight that is 10 percent above the
expected body weight for height and build. The
term “obese” refers a weight 20 percent
over the target weight range.
Can weighing too little lower my chances of getting
pregnant?
The degree to which weight loss affects fertility
will vary. The American Society for Reproductive
Medicine (ASRM) says: “In mild cases, the
ovaries may still produce and release eggs, but
the lining of the uterus may not be ready to receive
a fertilized egg because of inadequate ovarian
hormone production.
“In more severe cases, ovulation does not
occur, and menstrual cycles are irregular or absent.
In men, low weight or weight loss may lead to
decreased sperm function or sperm count. If low
weight or weight loss has been identified as the
cause of one's infertility, the preferred treatment
would be to stop losing weight or even to gain
weight if needed.”
If a woman is dealing with an
eating disorder, she should talk with her
health care provider to determine her best course
of achieving a healthy lifestyle and the return
of her fertility.
A variety of fertility medications are available
and may be used as an alternate treatment for
fertility issues related to a woman being over
or underweight.
Dr. Gracia advises, “In general, these
medications stimulate the production and release
of eggs from the ovaries. These medications are
often followed by inseminating sperm into the
uterus to improve the chances of pregnancy. If
these methods do not result in pregnancy it may
be necessary for a woman to pursue in vitro fertilization.”
While fertility drugs may help a woman become
pregnant, the use of these drugs can be complicated,
at times expensive and can cause multiple pregnancies.
If I conceive and am still over or underweight,
are there risks to the pregnancy?
When a woman becomes pregnant, excessive weight
increases the risks associated with pregnancy.
“Unfortunately, overweight women appear
to have a higher risk of miscarriage as well,”
notes Dr. Gracia. “In addition, a pregnancy
can be more complex due to gestational diabetes
and other complications.”
Your reproductive endocrinologist or OB/GYN may
refer you to a maternal
fetal medicine specialist, a physician who
specializes in high-risk pregnancy care.
Women have control over many things that can
affect fertility. Lifestyle choices such as smoking,
drinking caffeine or alcohol, making unhealthy
food choices, weight and sexual practices all
have an impact on future fertility. To achieve
the best success at conceiving, focus on maintaining
a healthy lifestyle.
For more information, or to schedule an appointment
with a Penn Fertility Care specialist, please
visit the Penn Fertility
Care website or call 1-800-789-PENN (7366).
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