Obesity and Infertility/ infertility caused by obesity

\"AppleStethescopeHeart\"The health burden of escalating overweight and obese adults is well documented in the medical literature, as well as well communicated to the public. (1,2,3)  Attention is commonly focused on the association of obesity with chronic diseases such as diabetes, cardiovascular disease and hypertension.  Although the problems with obesity and infertility are as well documented they aren’t as well known.  Infertility caused by obesity reduces the ability of both men and women to conceive a child spontaneously or without medical intervention. (4)

Infertility caused by obesity is usually defined by a woman who has 30% or greater of her weight made up of fat tissue.  While the rates of US citizens who are overweight and obese are rising, so also are the infertility rates.  They do not always correlate completely but obesity and infertility appear to be linked.<./p>

Women who are obese often have the symptoms of a woman with Polycystic Ovarian Syndrome.  These symptoms will resolve spontaneously after weight loss.  Sometimes with as little as a 15-20 pound weight loss, a woman will begin ovulating again.  The US Women’s Health Study concluded that even a slightly elevated BMI (Body Mass Index – measurement of height compared to weight) at the age of 18 was a risk factor for anovulatory infertility, or infertility resulting from no ovulation.  Women with an elevated BMI are also at risk for decreased rate of pregnancy from assisted fertilization.

The risk of infertility caused by obesity doesn’t end at conception.  Women who suffer from obesity also had adverse affects to both the mother and baby after conception.  Risks include a higher incidence of hypertension, miscarriage, gestational diabetes, pre-eclampsia, sleep apnea and caesarean section births. (5)
Additionally the babies are also more likely to need hospitalization beyond the normal post-natal hospital stay of the mother.

In an obesity and infertility study from Athens Greece reported in 2001 researchers found that women who have upper body obesity have insulin resistance, increased risk of peripheral aromatization (hormones leach into the fat tissue and are not available for use by the body) and several other hormone related events that are thought to be an influence in the disrupted ovulatory process in obese women.  (6)  In an infertility caused by obesity study published in 2005 from Poland, researchers confirmed that factors that affect fertility are obesity and cigarette smoking. (7)

Another infertility and obesity study performed in Kuwait and published in the Archives of Gynecology and Obstetrics in 2004, researchers found that the most effective treatment for infertility in women who suffered from obesity was weight loss. This research was confirmed in 2006 by researchers from Italy and reported in Maturitas.  Weight loss often leads to improved conception rates because ovulation tends to resume.

The need for intervention for infertility caused by obesity is before the woman is attempting to conceive.  Weight loss should be a gradual lifestyle change and not a desperate attempt to lose those pounds so ovulation will begin.  Once a woman has conceived, obesity and infertility lead to obesity and higher risk to mother and baby.  Weight loss during pregnancy is difficult and dangerous to both the mother and child.

There is varying beliefs about stabilized weight during pregnancy.  Although weight loss is definitely a problem for the baby and mother, a stable weight during pregnancy without weight gain is acceptable to some physicians especially in women who are severely overweight.

Obesity and infertility is a growing concern as the percentage of the population that becomes overweight increases.  The risks to obesity and infertility will extend from conception to gestation and then to the birth process, leaving children of obese parents at risk for health issues for the remainder of their lives.

(1) USA Today: Rising Obesity will Cost US Health Care $344 Billion A Year

(2) Medical News Today: Obesity Healthcare Costs 147 Billion Dollars a Year, New Study

(3) ABC News: Almost 10 Percent of US Health Costs tied to Obesity

(4) Johns Hopkins Children Center: Johns Hopkins Researchers Unravel Unravel Clues to Infertility Among Obese Women

(5) March of Dimes: Overweight and Obesity During Pregnancy

(6) Obesity Reviews: The Influence of Obesity on hyperandrogenism  and infertility in the Female

(7) Ginekol Pol.: The Influence of Body Mass and Stimulants on Female Fertility