Obesity can cause infertility

What effects the BMI has on your fertility

  • A body mass index (BMI) that is too high or too low can affect your fertility.
  • Anyone who is overweight or obese can increase fertility and the chances of conceiving by losing weight.
  • Weight is closely related to basic fertility problems for both men and women.

If you are trying to get pregnant, a healthy weight can help increase your chances of conceiving. A body mass index (BMI) that is too high (> 25) or too low (<18) can affect fertility and even cause complications during pregnancy, says Emily Osman. She is a gynecologist and obstetrician and reproductive endocrinologist for the RMA network in New Jersey.

"Weight is closely linked to basic fertility problems in both men and women," says Osman. In addition, being unhealthy can also “reduce the chances of successful fertility treatment.” Below you will learn more about how weight affects fertility and what you can do about it.

This is how weight affects fertility

According to the American Society of Reproductive Medicine (ASRM), about 12 percent of female infertility is related to a patient's weight that is too high or too low. “In women, underweight or overweight can be associated with what is known as ovulatory dysfunction. This is the name given to the ability to regularly release an egg in order to become pregnant, ”explains Osman.

Ideally, people trying to get pregnant should make sure they are within the healthy BMI range of 18.5 to 24.9. However, this is not possible for everyone. In Germany, around 53 percent of people over the age of 18 are overweight and have a BMI of at least 25. Even a moderate weight loss of seven percent and an increase in activity can improve fertility, says Osman's colleague and specialist in infertility, Jason Franasiak.

This is because body fat affects hormones, including those needed for an egg to mature and release. Underweight women often stop releasing gonadotropin releasing hormone (GnRH). This in turn leads to a condition known as hypothalamic amenorrhea, which is called the cessation of the menstrual cycle. Since no egg cells are released in this state, no egg cells can be fertilized.

Obese people are more likely to have higher levels of estrogen. A high level of estrogen can bring the woman's menstrual cycle to a standstill, which prevents egg cells from being fertilized. But a higher level of estrogen can also have a negative effect on men: it can impair testicular function, which leads to a lower sperm count and thus reduces the chances that a sperm will fertilize an egg.

Overweight women are also at higher risk of physical illnesses such as polycystic ovarian syndrome (a metabolic disorder), fallopian tube infections, and endometriosis. All of them can make conception and bearing a pregnancy difficult.

This is how weight affects health during pregnancy

In addition to the effects on fertility, weight can also affect the outcome of pregnancy. “Maternal obesity is strongly associated with complications for both mother and child,” says Franasiak. Both underweight and overweight carry a number of risks:

  • Underweight has been associated with complications such as premature labor and low birth weight.
  • Obesity increases the risk of almost all pregnancy complications, including miscarriage, high blood pressure, and preeclampsia.

The following pregnancy complications can be caused by obesity:

  • Miscarriages and stillbirths: Obese (BMI> 30) pregnant women have an approximately 20 percent increased risk of first-trimester miscarriages. They are also three times more likely to have recurring miscarriages than pregnant women with a healthy BMI. The risk of stillbirth also increases with a higher BMI.
  • Gestational diabetes: Overweight (BMI 25-29.9) and obese (BMI> 30) pregnant women have a higher risk of gestational diabetes. They make up about half of gestational diabetes cases. This can also increase the risk of other complications, including high blood pressure, birth injuries to the baby and mother, and stillbirths.
  • Birth defects: Children born to overweight mothers are at higher risk of heart or neural tube defects, such as spina bifida. In addition, premature births occur more frequently, which is associated with various lifelong health risks for the baby.

How Does Weight Loss Increase Fertility?

Before trying to get pregnant, you should make an effort to get your body weight closer to a healthy range, says Franasiak. Anyone who has a BMI much higher than 24.9 can increase fertility and have a healthier pregnancy with even small changes. “Current recommendations include weight loss of seven percent of body weight and increased weekly physical activity of at least 150 minutes - or 30 minutes for five out of seven days. Just going for a walk helps, ”says Fransiak.

Eating healthy and exercising regularly can help you achieve moderate weight loss. You can ask your doctor to refer you to a nutritional counselor who can help you lose or gain weight. This way you can increase your chances of conception and a healthy pregnancy.

In the event of insulin resistance or a diagnosis of PCOS, drugs such as metformin are often prescribed. However, there are no suitable weight loss drugs that are recommended to people trying to get pregnant. So if you are very overweight and have difficulty losing weight, you can also consider surgical weight reduction. In this case, however, you shouldn't try to get pregnant for at least a year after the operation, says Fransiak.

What we learn from it

Weight can therefore have an impact on fertility in both men and women and also on the health of both mother and child. It is of course still possible to get pregnant and have a healthy pregnancy if you are overweight or obese. However, a BMI less than 18.5 or greater than 24.9 can affect hormonal health, which can affect fertility and make conception difficult.

In overweight people, even a small weight loss of five to seven percent of body weight can increase fertility and the chances of conceiving. At the same time, it can reduce the health risks during pregnancy. You can work with your doctor to create a healthy weight loss plan. "Weight loss can be challenging, but it will help increase the chances of conception and a healthy pregnancy," says Osman.

This article was translated from English and edited by Ilona Tomić. You can read the original here.