The often overlooked role of obesity in infertilityThe prevalence of obesity and overweight are alarming and has become an epidemic worldwide. Obesity has harmful influences on all systems, including reproductive health. The prevalence of obesity in infertile women is high and now it is acknowledged that obesity is evidently one of the most common causes of infertility and miscarriage. It is a proven fact that women who are above a healthy weight tend to undergo perturbations of the ‘hypothalamic pituitary ovarian axis’ and suffer from hormonal imbalances, missed periods,alterations in the ovulation cycle and Polycystic ovarian disease all of which are linked to infertility and miscarriages. They are also more susceptible to cancer of the ovaries, breast, cervix and uterus.
The links between infertility and female obesity are well established, but recent studies have suggested that a prospective father’s weight may also have a considerable impact on a couple’s ability to conceive. There may be numerous ways that surplus body fat impacts male fertility, and in many cases more than one may have a say to the problem at the same time such as lower levels of testosterone, higher levels of the female hormone estrogen, increased testicular heat, low sperm count, low libido and erectile dysfunction.
How does weight affect fertility in women?
Women’s body needs a fine balance of hormones to ovulate properly, and having too much estrogen can throw off that balance. The high levels of oestrogen and/or free sex steroids signal the brain to stop stimulating the development of follicles needed for the eggs to mature and develop; consequently, ovulation does not occur. No ovulation… no pregnancy.
Insulin resistance is a common feature in patients who are obese or type 2 diabetes or who have metabolic syndrome. Insulin resistance can also have a negative impact on fertility. Essentially, insulin’s job is to shift glucose from the bloodstream to the cells. But in cases of insulin resistance, cells “disregard” to insulin’s request to move glucose into the cells. When there is lots of glucose in the blood, consequently, in an effort to help out, the pancreas pumps out more and more insulin. And here it affects fertility: Having a high level of insulin in your blood can cause metabolic disturbances that can affect ovulation.
Obesity and ART (assisted reproductive technology)
Is there an ideal weight for getting pregnant?
The healthiest way to start trying to conceive is having a normal-range body mass index (BMI) of 18.5-24.9, although not all women who are overweight or obese experience infertility. If you're concerned about your weight, know that you don't need to pull off a coup to improve your fertility and health. Research shows that losing as little as 5-10 percent of your body weight (For instance, 8 to 16 pounds for someone who weighs 160 pounds) can be enough to help rebalance hormones to enhance your odds of conceiving.
When overweight or obese women become pregnant, it's important to stay on track with prenatal appointments.
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Dr. Nikhil Agnihotri (Bariatric Specialist) has been actively involved in promoting, improving and teaching the science of Minimal Access Bariatric Surgery, Hormonal imbalance New Delhi treatments to aspiring surgeons across the nation and has participated in numerous national and international conferences.
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