Fertility is a gift. It is one that some individuals never receive, and others may be putting at risk as a result of particular lifestyle choices. As a gynecologist and tubal reversal specialist, I see patients frequently who are surprised to hear that their weight struggles have impacted their ability to conceive.
In fact, when I am working with a patient to evaluate candidacy for reversal of a Fallopian tube ligation to restore their ability to conceive, I consider weight as a primary factor. My staff and I work with patients to help them achieve a body-mass index (BMI) closer to their ideal in order to be more likely to conceive after their surgical procedure.
Many of us already know that body fat plays a critical role in the reproductive system. Too much or too little body fat therefore contributes to infertility. Really, it's the deviation from an ideal body weight that is a primary cause of infertility in the 12% or more of couples dealing with infertility. According to the American Society for Reproductive Medicine (ASRM), if a woman's body weight is less than 95% or greater than 120% of ideal body weight, then appropriate weight gain or weight loss should be the primary therapeutic recommendation.
Here are three facts about weight and infertility that often amaze my patients:
1. Being overweight affects your ability to conceive.
Overweight women face a whole host of fertility challenges such as lower response or over-response to fertility medication and challenges when in vitro fertilization (IVF) is used like retrieval of fewer eggs and difficulty retrieving eggs. Obesity also can result in lower IVF success rates.
Ideal body weight provides the best outcome for fertility and pregnancy. The good news is that a moderate reduction in weight may help overweight patients ovulate without the need for fertility medications.
ASRM cites studies showing that more than 70% of women who are infertile due to body weight disorders will conceive spontaneously through appropriate weight gaining or weight loss.
2. Yes, you can be too thin.
Yes, low body weight impacts fertility. Underweight women may have hormonal imbalances that make them extra slender that undermine conception. But, also, the lack of body fat itself is a vital part of sexual development and fertility. Fat collects estradiol, a necessary hormone for the reproductive system. Overly slender women metabolize estradiol into an anti-estrogen compound that over time shuts down the reproductive cycle. In most cases of otherwise healthy women, an increase in weight can restore fertility.
3. Men's fertility, too, is affected by obesity.
One third of fertility problems that couples face are related to the male. A small portion of that is related to severe obesity in men. Excessive body fat imbalances hormones related to sperm production. Emerging evidence points to male obesity altering the physical and molecular of the cells that ultimately mature into sperm affecting fertility and fetal health. Couples with an overweight obese male partner and normal-weight female have a much higher chance of it taking a longer time to conceive. It is an excellent reminder that infertility is not a "woman's problem."
When it comes to fertility, and to your health in general, you can help your body with a healthy lifestyle consisting of nutritious, fiber-filled meals and frequent exercise that gets the heart and lungs working.