Obesity and Fertility

Being overweight can harm a women’s fertility by causing:

• Irregular periods (are caused by hormonal imbalances that interfere with ovulation -the release of an egg from the ovaries)
• Polycystic ovaries that is a significant cause of infertility
• Miscariage
• Impair the outcomes of assisted reproductive technologies such as IVF, ovulation induction, and intracytoplasmic sperm injection (ICSI).

Being overweight can harm a men’s fertility by causing:

• Low testosterone levels
• Erectile dysfunction
• Decrease libido
• Decrease production of sperms and affects the quality of sperms as well

Getting to a healthy weight in both male and females at least three months before conception can increase the likelihood of a successful pregnancy and the likelihood that the newborn will be healthy at birth and throughout life.

In men, sperms take around 3 months to form, and being in a healthy weight range during this time aids in the development of healthy sperm count.

In women, healthy weight promotes balance of hormones that regulate timely ovulation and implantation.

Obesity and excessive weight gain during pregnancy lead to a variety of pregnancy-related complications, such as:

• High blood pressure causing preeclampsia (high blood pressure with organ damage) and eclampsia ( high blood pressure with seizures)
• Gestational diabetes (pregnancy induced diabetes)
• Likelihood of miscarriage (chemical pregnancies) or stillbirths
• Larger babies
• Complications during delivery, baby’s shoulder and head getting stuck
• Assisted deliveries like vacuum, forceps or cesarean section
• Difficulty losing weight after pregnancy
• Secondary infertility (hard to get pregnant next time)
• Babies born to mothers who have higher weight, have a higher chance of childhood and adult obesity, as well as other long-term health issues

Natural history suggests that the higher the pre-pregnancy weight of a woman, the higher is their postpartum weight gain and they have more difficulty losing weight after pregnancy.

The current obesity guidelines suggest that women who are overweight and wish to conceive, try to reduce their weight before getting pregnant. Even a 5% reduction in weight can improve fertility outcomes. These women once pregnant need to be and should be supervised by their health professional to monitor their weight gain and pregnancy complications.

Weight gain doesn’t need to happen much during the first trimester; most women with obesity can still lose weight in the first trimester. Weight gain is important mostly in the third trimester when the baby is growing weight. Weight gain in pregnancy should be according to the pre-pregnancy BMI.

This concept of “eating for two” is a myth. No, that baby’s nutrition is dependent on the mother, but women do not require to eat double the amount of calories during their pregnancy, and if they do they increase weight that leads to complications of weight gain.