Weight and Fertility

The prevalence of obesity is increasing at alarming rates in India. Obesity in both females and males significantly increases the risks of infertility and is associated with greater usage of costly fertility treatments.

0 If you are trying to get pregnant, or are going to start trying, achieving a healthy weight or getting closer to it increases your chance of conceiving (getting pregnant) and having a healthy baby.

Ideal weight for conception

The ideal weight for conception is different for everyone. Body mass index (BMI) is a number based on your height and weight. The healthy BMI range is between 18.5 and 22.9.

Being overweight

Compared with women in the healthy weight range, women who are carrying extra weight are less likely to conceive. They are also more likely to take more than a year to get pregnant. Being overweight can affect your fertility by causing hormonal imbalances and problems with ovulation (releasing an egg from the ovaries.

There is good evidence that obesity lowers the success rates of in vitro fertilization (IVF). Studies have shown lower pregnancy rates and higher miscarriage rates in obese women. Not only does obesity increase the likelihood of infertility, obesity also makes them prone for adverse maternal and fetal outcomes. This includes increased risk of high blood pressure, pre-eclampsia, gestational diabetes, infection, blood clotting, need for induction of labour, Caesarean birth and stillbirth. Babies born to overweight or very overweight mothers have increased risk of some birth defects and having a high birth weight leading to childhood obesity and long term health problems. If your BMI is above the healthy range it is important to remember that even a modest weight loss will increase your chance of conceiving and having a healthy baby.

If your BMI is >40 then you require special surgical (bariatric surgery) and medical attention before planning a pregnancy.

Being underweight

Having a BMI under 18.5 is considered underweight. Being underweight can reduce a woman’s fertility by causing hormone imbalances that affect ovulation and thereby the chance of getting pregnant. Compared to women in the healthy weight range, underweight women are more likely to take more than a year to get pregnant.

BMI <17.5 is usually associated with eating psychological disorders and might need expert treatment.

Weight and male fertility

Being very overweight, can also affect a man’s fertility. For men, getting into shape at least three months before conception can improve the chance of conception (better sperm count & motility) and the health of the future baby.

Getting ready for pregnancy

If you are planning to get pregnant it is best to start a healthy eating and exercise plan now to increase the odds of getting pregnant and having a healthy baby. By making healthy changes to your diet and increasing your daily physical activity, you’ll be on your way to a healthy weight.

Should I lose weight(BMI) before I am planning to conceive?

That decision you have to take as per the advice of your doctor as multiple factors are involved into it , including your age and any other infertility factors, before making a recommendation about whether you should try to lose weight first. Changing your diet and lifestyle (for example, exercise) combined with a program that may provide group support is an effective step, but not always the appropriate first step if your age or your BMI is above 40. Weight loss surgery (bariatric surgery) is the most effective treatment for weight loss in women with a BMI greater than 40.

If I have polycystic ovary syndrome (PCOS) and am overweight, will I need to do something more?

PCOS is a very common condition in young women (about 8%–10%). Not all women with PCOS are overweight or obese, but many women with PCOS have signs of insulin resistance and/or obesity. A low-calorie diet and exercise may lead to weight loss, regular menstrual cycles, and ovulation.

However, women with PCOS may require additional treatment to get pregnant, including medications to decrease insulin resistance. These women should seek the assistance of a reproductive endocrinology and infertility specialist.

If I have polycystic ovary syndrome (PCOS) and am overweight, will I need to do something more?

PCOS is a very common condition in young women (about 8%–10%). Not all women with PCOS are overweight or obese, but many women with PCOS have signs of insulin resistance and/or obesity. A low-calorie diet and exercise may lead to weight loss, regular menstrual cycles, and ovulation.

However, women with PCOS may require additional treatment to get pregnant, including medications to decrease insulin resistance. These women should seek the assistance of a reproductive endocrinology and infertility specialist.

Small steps to a healthy weight:

• Swap sugary drinks and alcohol for water.
• Eat fast food less often and make healthier choices when you can.
• Make half your plate vegetables at lunch and dinner.
• Use a smaller plate to help reduce your portion sizes.
• Get moving every day. Fit in regular physical activity like walking to the shops, taking the stairs and walking with a friend.
• Spend less time sitting by getting up regularly while using a computer or mobile device and swapping ‘screen time’ for other activities.
• Choose healthy snacks like fruit, low fat yoghurt or a small portion of plain nuts.
• Choose reduced-fat dairy and lean meat.
• Set a realistic weight goal- it can help you feel motivated and active. Aiming for weight loss, 0.5-1 kg per week is a good goal.
• Start a healthy eating and exercise plan together with your partner to increase the odds of getting pregnant and having a healthy baby.
  It’s good to remember that making these lifestyle changes are good for you, even if they don’t lead to weight loss or you are already a healthy weight.

Summary-

The environment in which eggs and sperm develop also influences the future baby’s health. Having a lot of extra body fat is harmful to this environment. Getting into shape before conception increases the chance of the baby being healthy at birth and into adulthood.