Obesity, Fertility and IVF
When couples strive to increase their chances of fertility, a multitude of factors may be considered. They may be more conscious of the foods they eat, alcohol or caffeine consumed, or exercise regimen maintained. Although these day-to-day habits are certainly good to keep in mind, it is also important to remember that one’s weight plays a part in his or her overall health, and when it comes to fertility, weight is yet another factor that may influence success rates.
To become pregnant, a healthy weight matters. Being overweight or obese can impact your fertility. Obesity is a rising epidemic affecting millions worldwide. Obesity also significantly affects a woman’s capacity to carry on a pregnancy to term. Obesity is defined by an extraordinarily high Body Mass Index (BMI) in which the index is a reflection of body fat content. Around 1 in 4 women are at least overweight as per surveys and studies. The rates are higher among women facing problems of conception. Obese women are three times more likely to suffer infertility than women with a normal body mass index. Overweight or obese women experience longer times to pregnancy and reduced probabilities of conception relative to their normal-weight counterparts. Moreover, they are at an increased risk of early and recurrent miscarriage. These women generally have reduced oocyte quality, lower developmental potential, and poor clinical outcomes when they undergo assisted reproduction treatment.
“Healthy women have healthy eggs and are more likely to have healthy children,”
Obesity has a number of different effects on fertility of men and women as follows:
1. Obesity affects hormones
When body mass index goes past the overweight category (BMI of 25-29.9) into the obese category (BMI of 30 and above), hormonal changes may occur in the female body. When the levels of natural hormones change, the chances of conception decrease.
2. Obesity leads to insulin resistance
The hormonal imbalance that comes with obesity often leads to insulin resistance. That is a major risk factor on the road to diabetes – but it also affects fertility and can create abnormal menstrual cycles. Insulin resistance can lead to anovulation, in which body does not produce eggs properly.
3. Obesity affects natural and assisted pregnancies
Obesity makes it more challenging to become pregnant, no matter whether a couple is using natural means or reproductive technologies such as in-vitro fertilization (IVF). It also increases the risk for a miscarriage. This issue may be caused by the hormonal issues or because of poor quality eggs.
4. Obesity decreases Men’s fertility, too
Although much of the focus on obesity and infertility is on women, it absolutely affects men, too. For men, obesity leads to a drop in testosterone, which can lead to infertility. On top of that, erectile dysfunction occurs at a higher rate among obese men.
5. Losing weight can improve all of the above
In recent years, the connection between lifestyle, weight, nutrition and fertility is gaining more public exposure. A multidisciplinary approach to weight management is more likely to be a successful treatment option. The emphasis should be on lifestyle change, education about proper diet, exercise, and behavior modification. A more holistic approach to obesity and reproductive health can help increase the chances of conception in obese women. In doing so, it would also have a positive impact on the general health.
As a result of weight loss, the hormonal imbalances and other effects of obesity begin to decrease.
More specifically, the greater a woman’s body-mass index (BMI) is, the less likely she is to have a successful IVF experience. A Recent study has shown that to a large extent, today’s generation is what their moms and dads ate prior to and around their conception. “This is a huge issue that really does carry through to certainly the next — and probably the next two — generations.”
Obesity has negative effects on reproductive health. It has been established that obesity is associated with decreased natural fecundity, a decreased ovulation rate, increased time until conception, and increased rates of miscarriage. Additionally, an increased rate of pregnancy complications, including gestational hypertension, preeclampsia, gestational diabetes, postpartum hemorrhage, and fetal macrosomia, are all associated with obesity. Since the incidence of obesity is continually rising, an increasing number of overweight and obese women are seeking fertility treatments through assisted reproduction technology (ART).
There is nothing in medical science that says that IVF can’t be done on fat or obese women. IVF remains more complicated for Obese Women and they require different medication doses than normal weight women. Consequently, there is a need to understand the full impact of obesity on in vitro fertilization (IVF) treatments. In vitro fertilization is used to help women become pregnant by mixing the sperm and egg outside the body, then implanting the embryo into the woman’s uterus.
Following are the effects of obesity on in vitro fertilization (IVF) success rates.
1. Obese women need higher doses of drugs: Obesity is associated with higher doses of medications to stimulate the ovaries. Obese women also take longer to respond, have increased cycle cancellation rates, and fewer eggs retrieved.
2. Obese Women are less likely to get Pregnant: IVF pregnancy rates are lower in obese women. The age-adjusted odds of live birth are reduced due to high BMI. In other words, the chances of having a baby decrease as the woman’s weight increases.
3. Obesity Affects Eggs and Embryos: Egg quality, fertilization rate and embryo quality all decrease in obese women. This means that eggs retrieved may result in a failed IVF cycle. Obese women are less likely to have successful IVF from their own eggs (and not donor eggs), due to poorer egg quality. When it comes to IVF with donor eggs, obese women apparently have normal success rates. It is apparent that women with a BMI of >25 and especially those with a BMI of >30 exhibit a poorer ovarian response to fertility drugs (impaired follicle and embryo development with fewer blastocysts becoming available for transfer). These women also tend to have a reduced ability to implant transferred embryos into their uterine linings because of its thickness, perhaps due to reduced endometrial receptivity.
4. Obesity Affects the Uterine Lining: An obese woman is at a greater risk of developing abnormal thickening of the uterus lining. This is because estrogen is secreted in excess in an obese woman. The uterine lining becomes thick and is less receptive in obese women. It is apparent that women with a BMI of >25 and especially those with a BMI of >30 exhibit a poorer ovarian response to fertility drugs (impaired follicle and embryo development with fewer blastocysts becoming available for transfer). These women also tend to have a reduced ability to implant transferred embryos into their uterine linings because of its thickness, perhaps due to reduced endometrial receptivity.
Women who are planning to get pregnant or to enter IVF programs should be advised to lose weight before starting so, as very strict diets are not allowed during pregnancy or while on IVF. The clinical significance of a growing population of overweight women is enormous because not only can this compromise their overall reproductive performance, but it also compounds the risk of chronic medical conditions such as diabetes, and coronary/cerebral/peripheral vascular disease, and thus compromises life expectancy as well as the quality of life. As such, being overweight represents an overall life hazard that should be addressed by the medical profession as well as by society as a whole. The answer is surely not a simple one, but the solution does not lie in dieting alone. Instead, it requires an overall modification in lifestyle.
It is important to note that reducing BMI through weight loss has been demonstrated to significantly improve fertility treatment outcomes and to lower both treatment and pregnancy complications. In other words, not only does obesity make it much more difficult to conceive, but it also exposes both the mother and the infant to all manner of risks before and after birth.
IVF Center in India is for IVF, IUI, ICSI, Surrogacy, Egg & Sperm Donation. The clinic offers IVF (In Vitro Fertilization) treatment to infertile couples from all over the world. Clinics expertise in fertility treatment and cutting edge technology has helped majority of the patients achieve pregnancy. Obese women coming for fertility and infertility treatment are advised to reduce weight and to get BMI corrected. All options related to pregnancy for obese women are explained in detail. Finally, it is important to emphasize that overweight women are at far greater risk during pregnancy than are women of normal body weight. Women who are planning to get pregnant or to enter IVF programs are advised to lose weight before starting, as weight loss “improves ovulatory function” as well as pregnancy outcomes. It is important to note that reducing BMI through weight loss has been demonstrated to significantly improve fertility treatment outcomes and to lower both treatment and pregnancy complications. In other words, not only does obesity make it much more difficult to conceive, but it also exposes both the mother and the infant to all manner of risks before and after birth. “Because of the complex nature of obesity and of reproduction, when an obese woman with sub fertility presents for fertility treatment, an individualized yet systematic approach is needed.
Source by R. Shah