This year BFC main topic is Healthy Lifestyle, and when it comes to health… weight matters.
Underweight, over-weight and obese women and men, are at higher risk for several health problems and an unhealthy body weight may lead to infertility.
We do not want you with a cover magazine perfect bikini body! (by the way, what is perfect?!) We love our smiling patients as they are, real women, but too much or too low it is never too good!
Body weight must be adequate for your sex, age and your height, in other word you should have a normal Body Mass Index (BMI).
You can find out whether your weight is considered normal, overweight, obese or underweight by calculating your BMI. There are many online tools that will tell you your BMI based on height, weight, waist measurement, sex and age. A BMI between 19 and 24 is considered normal; a BMI between 25 and 29 is considered overweight; a BMI over 30 defines you as obese; and a BMI below 19 is considered underweight.
How being overweight or obese negatively affects a woman’s fertility?
Despite the accuracy of data, many women react to these comments noting they’d been able to get pregnant and deliver a baby despite their weight. This is true for some women, but others – both obese and under-weight – will have problems conceiving, often due to problems with irregular periods and ovulation. Other weight-related problems affecting the metabolic and endocrine systems may also lead to infertility. A BMI in the obese range the additional fat increases estrogens which can interfere with ovulation.
However, even obese women with normal ovulation cycles have lower pregnancy rates than normal weight women, so ovulation isn’t the only issue. It may be related to other disorders affected by weight that impact the ability to get pregnant including thyroid disease, insulin resistance and diabetes. For instance, polycystic ovarian syndrome which affects about 10% of young women is present in 30-75% of women with obesity. Among other things PCOS may cause irregular menstrual cycles and increases hormonal and metabolic problems that affect fertility.
Having an overweight or obese partner may also affect your ability to get pregnant. Certain hormones, including testosterone, that are essential to reproduction may be affected by obesity. Low sperm counts and poor sperm motility are also more often associated with men who are overweight or obese than men who have a normal weight.
There is evidence that obesity may lower the success rates of IVF. Specifically, higher doses of gonadotrophins (the hormones given by injection to stimulate the ovaries to produce eggs) are required, the response to ovarian stimulation may be poor, and fewer eggs are usually harvested. Further, fertilization rates are lower, the quality of embryos is lower and there are higher miscarriage rates.
Going forward and working together!
The good news for any woman who is overweight or obese and trying without success to get pregnant is that a weight loss as small as 5%-10% can improve pregnancy outcomes. In some not severe cases losing as little as 5% of body weight can result in a regular menstrual cycle, increase the frequency of ovulation and improve endocrine systems such as lowering fasting insulin levels.
However whether you should try and lose weight – and how much– before pursuing infertility treatment may be different for older women who must also consider how waiting and being older may affect the likelihood of getting pregnant and therefore you should always discuss this with your fertility specialist first. In fact, the doctor who knows your unique situation including medical history, health and fertility status, should explain and discuss with you all the issues and possible complications to help in the informed decision-making process. This may include help with a healthy weight loss program to lower your BMI before starting treatment, excluding or treating other related diseases, always taking into account pros and cons in delaying your fertility treatment.
While having to discuss your weight may be uncomfortable and losing weight may be daunting, weight loss – unlike other factors that affect infertility – is one of the few areas where it is possible to take control and achieve change that lead to a real increase in your chances of a successful pregnancy.
So, do not be scared or ashamed and help us to help yourself, remember we have your same ultimate goal, a healthy lovely family.
– Dr Corona