Obesity and Infertility

Couple looking concerned at result of pregnancy test
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According to recent data, infertility affects one out of every seven couples. Obesity and overweight have been identified as possible contributors to infertility.

How Obesity May Contribute to Infertility

Obesity has been found to be associated with several reproductive problems, including anovulation (absence of ovulation), infertility, and increased risk of miscarriage. The effects of overweight and obesity impact fertility in both men and women.

In men, for example, obesity has been linked to low levels of testosterone.

Obesity and Female Infertility

Obesity can impact ovulation as well as increase the risk for miscarriage and poor pregnancy outcomes. In addition, women who have polycystic ovary syndrome (PCOS) often face a double-edged sword, so to speak, as nearly 50% of women with PCOS are obese. Obesity has been found to exacerbate the clinical and hormonal aspects of PCOS, and the tendency of obesity to contribute to anovulation can make it more difficult for medication-based infertility treatments to work in PCOS.

Obesity and Male Infertility

Several studies have found that there is a significant connection between obesity and low testosterone levels in men. One study found that hypogonadism (inability to make enough testosterone) can be found in 75% of men who are considered to be extremely obese (with a body mass index greater than 40).

Another study found that this link between obesity and lower testosterone levels holds true for men of all ages, even in teenagers.

Reducing Obesity’s Impact

Experts recommend diet and lifestyle changes for all obese patients before attempting conception. Weight loss that amounts to as little as 5% of excess weight has been found to lead to great gains in health.

In men, researchers have also found that weight loss and exercise can improve and even reverse low testosterone levels. Other healthy lifestyle choices, like getting enough sleep, have also been found to improve testosterone levels. Since getting enough sleep is also important for preventing obesity, this particular intervention is extremely valuable.

Most national and international guidelines recommend getting at least 150 minutes of moderate-intensity exercise every week for both men and women. This can translate into 30 minutes of moderate-intensity exercise five times per week, for instance.

What counts as moderate-intensity exercise? Physical activities such as general gardening, brisk walking, ballroom dancing, and the equivalent fall into the category of moderate-intensity exercise.

Research is limited regarding any potential benefits from the use of anti-obesity medications or bariatric surgery, and it should be noted that all of the anti-obesity medications currently on the market are contraindicated (must not be taken) in women who are pregnant or breastfeeding.

Sources

Talmor A, Dunphy B. Female obesity and infertility. Best Pract Res Clin Obstet Gynaecol 2014; doi: 10.1016/j.bpobgyn.2014.10.014. [Epub ahead of print]

Messinis IE, Messini CI, Anifandis G, Dafopoulos K. Polycystic ovaries and obesity. Best Pract Res Clin Obstet Gynaecol. 2014; doi: 10.1016/j.bpobgyn.2014.11.001. [Epub ahead of print]

Mogri M, Dhindsa S, Quattrin T, et al. Testosterone concentrations in young pubertal and post-purbertal obese males. Clin Endocrinol (Oxf) 2013;78:593-599.

Naderpoor N, Shorake S, Joham A, et al. Obesity and polycystic ovary syndrome. Minerva Endocrinol 2014. [Epub ahead of print]

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