Saturday, 22 December 2018

Obesity and infertility

The often overlooked role of obesity in infertility

The 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?


There are numerous ways obesity can affect fertility and several theories are floating to explain the pathophysiology of infertility due to obesity. Scientists speculate that Obesity affects ovulation by causing mayhem among the reproductive hormones as the excess body fat disrupts the menstrual cycle and hampers ovulation via the elevated levels of insulin. This leads to a decrease in the synthesis of sex hormone-binding globulins (SHBG) which in turn can cause a surge in the level of free sex steroids such as testosterone. The hormone oestrogen is produced mostly by the ovaries and in less important amounts by the adrenal glands and adipose tissue (fat cells). Therefore, if a woman has excessive body fat, there will be an abundance of oestrogen.

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)


A review published in the Journal of Human Reproductive Sciences in 2010 stated that women with a higher BMI don't respond as well to fertility treatments like in vitro fertilization.  Meanwhile, Australian researchers confirmed that, compared to obese women, those with a BMI between 20 -24.9kg/m2 had a 60% greater chance of a successful assisted reproduction treatment.

Is there an ideal weight for getting pregnant?


Consult with a healthcare provider. They will consider all factors, including your age and any other infertility factors, before making a recommendation about whether you should try to lose weight first.  If losing weight seems like a significant challenge, talk to your doctor to find out what next steps would be most beneficial for you.   And keep in mind; "weight loss quickly" schemes are just ‘schemes’. Anything that promises fast weight loss through cleanses, supplements, miracle cure or too-good-to-be-true fixes usually is not your best bet, and could even be dangerous.

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.

The Laparoscopic and Bariatric Surgery Department at Max Super Specialty Hospital, New Delhi is one of the obesity and infertility treatment New Delhi, India.  Dr. Nikhil Agnihotri (Bariatric Surgeon ) who is a highly qualified, accomplished Weight Loss Surgeon for Minimal Access, Metabolic and Bariatric Surgery is the head of this best Obesity Treatment Centre in New Delhi. Dr. Nikhil has over 11 years of experience in the field of Weight Loss Treatment in New Delhi.

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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Obesity and infertility

The often overlooked role of obesity in infertility The prevalence of obesity and overweight are alarming and has become an epidemic worl...