Weight and Fertility
One in seven couples in the United States experience
fertility problems, which can stem from a variety
of health issues. One health issue associated
with infertility is a person's body weight – in
particular, the female partner's weight.
Being overweight or underweight can greatly affect
a woman's ability to conceive.
How does being overweight affect fertility?
Women
who are overweight or obese may have imbalances
in reproductive hormones, which 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 ovary and prevent eggs from being released
every month. This condition is called anovulation.
If
by chance an egg is released, the egg may not
be healthy enough to result in a pregnancy.”
Dr. Gracia continues, “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.”
A condition known as polycystic
ovary syndrome (PCOS) is 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
The following symptoms are related to 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 (readings 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 to 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 whether you are at a healthy
weight.
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” typically
refers to a weight that is 10 percent above the
expected body weight for height and build. The
term “obese” refers to being 20 percent
over the target weight.
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) states, “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 a weight and eating
disorder, she
should talk with her health care provider to
determine her best course of achieving a healthy
lifestyle and ultimately the return of her fertility.
Fertility medications can be used as an alternate
treatment for fertility issues related to a woman
being over or underweight. Dr. Gracia advises, “A
variety of fertility medications are available
to enhance fertility related weight problems.
In general, these medications stimulate the production
and release of eggs from the ovaries. Often these
medications are followed by inseminating sperm
into a woman's 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.”
It should be noted that while fertility drugs
can help a woman achieve a pregnancy, 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
pregnancy is achieved, 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 of the things
that can affect fertility. The lifestyle choices
of smoking, drinking caffeine or alcohol, unhealthy
food choices, weight, and sexual practices have
an impact on future fertility. To achieve the
best success at conceiving, focus on maintaining
a healthy lifestyle.
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