Obesity, overweight and female and male fertility: why they don’t get along
Excessive weight has negative consequences on the health of those who suffer from it. Obesity is an increasingly widespread disease in industrialized countries with significant consequences on public health and on the budgets of the health systems themselves.
There are many pathologies deriving from being overweight. To name a few I remember diabetes, hypertension, sleep apnea, cardiovascular diseases, joint problems. I guess you’ve already heard about it frequently. However, what is often underestimated is the effect of being overweight on fertility.
Obesity is a constantly increasing phenomenon among women of childbearing age. In addition to having aesthetic effects, obesity alters the hormonal and enzymatic balance of the body with negative effects on reproductive capacity.
Obesity in recent years has become one of the main causes of infertility in women but also in men.
In men, fertility is affected both directly and indirectly. Very overweight males have alterations in sleep, sexual behavior, hormonal profile, scrotal temperatures and sperm quality.
Very overweight men can suffer from high estrogen levels which alter the composition of the sperm and lead to low testosterone levels .
An increase of 9 kg of weight in a man increases the probability of infertility by 10%. Obese men generally have a lower sperm count which in turn reduces the likelihood of conception.
In women , obesity is a widespread cause of infertility and is associated with irregular, sometimes infrequent or absent menstrual cycles. The irregularity of the menstrual cycle is often associated with an ovulatory dysfunction which causes infertility. This in turn can be due to hormonal imbalances, always due to being overweight. Optimal levels of androgens, estrogens and progesterone are essential in order to conceive a child.
Furthermore, fat deposits in the ovaries can interfere with embryonic development and cause miscarriages.
One of the most common problems among obese young women is ovarian polycystosis (PCOS) which significantly reduces the ability to conceive a child. In addition to obesity, polycystosis is associated with other symptoms such as menstrual dysfunction and hirsutism, conditions that further affect a woman’s quality of life.
Obesity worsens a pre-existing condition of ovarian polycystosis by accentuating certain PCOS-related conditions such as per-insulinemia and insulin resistance.
So overweight women suffering from polycystosis of the ovary should first of all reduce their weight. It is not easy because often a vicious circle is established between PCOS and obesity from which it is difficult to get out.
Obesity and IVF:
Obese women who use assisted fertilization also have a lower probability of treatment success and have a greater risk of early miscarriage after IVF.
Very overweight women who manage to get pregnant have a three times greater risk of incurring early and recurrent miscarriages.
Obesity and pregnancy
During pregnancy, obesity also increases the risk of developing gestational diabetes (risk 3 times greater than in a woman of normal weight), preeclampsia (risk increases 4 times), cesarean delivery (40% more), term and infections.
There is also an increased risk of operative morbidity.
Unfortunately, neonatal deaths and stillbirths are twice as high in overweight women as in women of normal weight who make a few lifestyle changes. Altering your diet will go a long way in losing weight. Your diet should include more of whole grains, vegetables, fruits and lean meats. In addition to food changes make exercise a routine. Despite repeated attempts at weight loss through diet and exercise when there is no other option available, weight loss surgery is a promising option.
Conclusion:
The solutions to obesity come from: surgery, exercise and a healthy diet. For anyone undergoing surgery, maintaining weight after surgery is essential.
In summary, studies have shown that modest weight loss can have a significant effect on fertility which results in a regular menstrual cycle, increased ovulation and conception rate. Ideally, weight loss should be achieved before conception and pregnancy. It is therefore believed that weight loss before pregnancy can significantly reduce the maternal and fetal risks associated with pregnancy.
Kathryn Barlow is an OB/GYN doctor, which is the medical specialty that deals with the care of women's reproductive health, including pregnancy and childbirth.
Obstetricians provide care to women during pregnancy, labor, and delivery, while gynecologists focus on the health of the female reproductive system, including the ovaries, uterus, vagina, and breasts. OB/GYN doctors are trained to provide medical and surgical care for a wide range of conditions related to women's reproductive health.