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December 28th, 2016

How obesity can affect a woman’s ability to conceive

By uclahealth

How obesity can affect a woman’s ability to conceive

You’ve likely heard about the health issues caused by obesity. It raises your risk for heart disease and diabetes, increases your blood pressure and makes it difficult to do everyday activities such as walking or climbing stairs.

For women specifically, obesity also may be a contributing factor in infertility. If you are overweight and having trouble getting pregnant, the excess weight could be the reason. Obesity has shown to cause hormone imbalances in women, potentially interfering with normal ovulation and consequently fertility. For women undergoing in vitro fertilization (IVF), obesity can also reduce the chance of successful outcomes.

Once pregnant, overweight women also face additional risks associated with obesity, including gestational diabetes, preeclampsia, infection, labor problems and pregnancy loss.

Lose weight, get pregnant?

Yijun Chen, MD, a bariatric surgeon with the UCLA Center for Obesity and METabolic Health (COMET), has good news for overweight women experiencing infertility. When obese women who are struggling to conceive undergo weight-loss surgery, Dr. Chen says they are 50 percent more likely to get pregnant. Additionally, those women have a better chance of undergoing a smooth, complication-free pregnancy and giving birth to a normal-weight child.

IVF … or bariatric surgery?

Dr. Chen says if a woman is experiencing infertility, and she is both young and obese, then weight-loss surgery is better than opting for fertility treatments such as IVF. Weight-loss surgery has multiple benefits for both mother and baby, including:

  • A higher chance of conceiving without needing fertility treatments (about half of women who have trouble getting pregnant before the weight-loss surgery are able to have successful pregnancies afterward)
  • A healthier pregnancy if the woman loses weight first.
  • A healthier child

Is weight-loss surgery right for you? If you are unable to lose weight through diet and exercise, you may be a candidate. You also need to have either a:

  • Body mass index (BMI) of 40 or more, or
  • BMI of 35 with related health problems (such as high blood pressure, sleep apnea, heart disease or diabetes)

Lose the weight, then wait

Weight-loss surgeons agree that women should wait a year following bariatric surgery before trying to conceive. Dr. Chen says this is because there may be nutrition deficits after surgery. Due to the rapid weight loss, it can take time to ensure that your body is getting the nutrients and vitamins it needs. After a year, when your body has self-regulated, you can begin trying to get pregnant.

Because of the recommendation to wait, your age may determine if fertility treatments or weight-loss surgery is the right option for you:

  • If you are obese and experiencing infertility in your 20s or early 30s, then doctors recommend trying weight-loss surgery before fertility treatments.
  • If you are 35 or older, then you may want to begin fertility treatments first.

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