“Is it true that heavy women have a harder time getting pregnant?
Obesity affects reproductive function; however, there are likely many other factors that contribute to infertility and success of fertility treatment among obese women. In treating obese women with infertility, it is important to weigh the risks and benefits of treating the woman immediately versus delaying treatment for attempts at weight loss.
The most informative data supporting weight loss among obese women to improve pregnancy outcomes comes from gravid women who have undergone bariatric surgery and have had subsequent pregnancies. The data support weight loss to decrease complications during pregnancy, but studies have failed to demonstrate a difference in pregnancy or neonatal outcomes.
When considering treatment strategies for obese women who wish to conceive, it is important to keep in mind that weight loss will not guarantee pregnancy in those women who are experiencing infertility, nor will it guarantee a normal pregnancy outcome in those who do conceive. Weighing the risks and benefits of weight loss versus treatment for infertility is necessary.
Obesity is a common problem among reproductive age women, and it is associated with numerous reproductive problems including anovulation, irregular menses, subfertility, miscarriage, and adverse pregnancy outcomes with lasting effects for children born to obese mothers. These reproductive sequelae result from obesity’s effects on several different steps in the reproductive process including ovarian follicular recruitment, oocyte development and quality, oocyte fertilization, and embryo development and implantation. Understanding obesity and its impact on female reproductive function is important as ultimately the weight of the impact will be carried by future generations—namely the children of obese women.
Over-weight and obese individuals usually have a very unhealthy diet, and most are sedentary. It has been shown that obese women who regularly exercised had an over three-fold higher success rate with IVF compared with those who were sedentary. Therefore, a healthy diet and regular exercise are lifestyle changes that over time are likely to result in gradual, progressive, and sustained weight loss and improved overall health. Diets resulting in short-term weight loss are usually followed by regain of the weight. As such, we should encourage positive lifestyle changes over 3–6 months before and during and after IVF rather, than requiring a marked weight loss, which lacks evidence of efficacy and may be harmful.
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