Does obesity cause infertility?

Recent researches have shown that one of the main causes of infertility is excess body weight. Read on to know the hindrances obesity can cause along with solutions for the same

By Zoha Tapia

Obesity not only alters our physical appearance but also disrupts the balance of hormones and enzymes inside our body. Recent reports indicate that men and women with increased body mass index (BMI) are more likely to be infertile than those of normal-weight. Statistics suggest that nearly 70% of women suffering from infertility also suffer from obesity. Data suggests that a 9 kilograms increase in a man’s weight may increase the chance of infertility by about 10%, as obese men are known to have a lower sperm count, which in turn decreases the chances of conception.

Dr Jayshree Todkar, director of bariatric, Metabolic & Laparoscopic Department, Ruby Hall Clinic, Pune & Dr LH Hiranandani Hospital, Mumbai says, “Obesity causes mechanical, psychological and interpersonal problems in both men and women. The amount of fat in the body is directly related to the concentration of several important hormones inside the body. An undesired change in the concentration of sexual hormones can lead to fertility related problems. Hormonal imbalances are the major cause of low testosterone and sperm levels in males and Polycystic Ovary Syndrome (PCOS) in females.”

Infertility is dependent on various factors such as genetic predisposition, diet and environmental factors but body weight plays a major role in almost all hormonal disorders. Excess body weight greatly affects conception rates and libido concentration. Body fat distribution often also acts as a mechanical and physical obstacle in the mating process. Studies show that obese people, who are unable to conceive naturally, are able to conceive after losing the excess weight.

Warning signs of infertility
Some warning signs of infertility are:

• Unwanted hair growth
• Dark pigmentation in the folds and nape of neck (Acanthosis)

“Furthermore, the chances of developing insulin resistance and gestational diabetes during pregnancy increase significantly if there is a family history of obesity and diabetes,” adds Dr Shashank Shah, director, Laparo-Obeso Centre, Pune, Department of Laparoscopic and Bariatric Surgery, Ruby Hall Clinic, Pune and Dr LH Hiranandani Hospital, Mumbai.

Obesity and infertility in women
Body weight and fat distribution affect conception rates. Obese and overweight women are more prone to suffering ovulatory dysfunction and anovulation leading to irregular menstrual cycles.

In the case of Polycystic Ovary Syndrome (PCOS), hormonal imbalances in the body lead to the production of small cysts in the ovaries that often lead to pregnancy related complications and infertility.

Obesity and infertility in men
The testicular function may be hampered because of the presence of unwanted body fat. Dr Shah informs, “Peripheral fat deposition leads to conversion of male hormones into female hormones. This not only increases the deposition of fat in the breast region but also results in a reduction of sperm production.”

Obesity during pregnancy
Some of the complications obese women face during pregnancy are

• Miscarriages: Even if some obese women get to the stage of conception, they face difficulty in getting past this stage. In most cases hypertension during pregnancy leads to miscarriages.
  
  
• Delivery problems: Excess body weight can result in severe complications during the delivery process. “Obesity is closely linked to various potentially life threatening conditions such as type 2 diabetes, cardiovascular disorders, liver disorders, depression etc, which can negatively impact the health of both the expecting mother and the unborn child.  Often the obese pregnant women suffer from high blood pressure and gestational diabetes which prevent their full term completion of pregnancy,” says Dr Todkar.
  
  
• Health problems: Obesity leads to glucose intolerance and pregnancy induced hypertension among females. “Pregnancy induced weight can make females morbidly obese in the future, significantly increasing the risk of developing metabolic syndrome, cardiovascular disorders and type 2 diabetes,” says Dr Shah.

Solutions and treatment
The treatment of obesity and related illnesses requires a holistic approach. The first step is to prevent infertility among men and women through awareness of the problem, in order to tackle it in the early stages. 

Dr Todkar says, “Overweight (Body Mass Index (BMI) between 23.5kg/m2 - 27.5 kg/m2) and obese (BMI between 27.5kg/m2 - 37.5kg/m2) individuals can achieve this through diet and exercise.”

However, for those who are morbidly obese it is important to consult and expert. Dr Shah says, “Rather than going to a gym or a diet counsellor, it is important to recognize the problem as a medical condition and adopt a clinical approach. In the case of morbidly obese patients (BMI>37.5kg/m2) bariatric surgery is the only safe and viable option for sustainable weight loss. Individuals with a BMI greater than 37.5 kg/m2 or having a BMI of 32.5kg/m2 and suffering from one of more co morbidities (such as type 2 diabetes, cardiovascular disorders, osteoarthritis, liver disorders etc) are eligible for weight loss surgery.”

With weight loss surgery, the internal environment of the body changes making it easier for the patient to adhere to a healthy lifestyle. It has been observed that fertility levels in both men and women increase post weight loss surgery. However, surgery isn’t a one step solution. One should understand that exercise and diet are effective tools for maintaining healthy body weight both before and after weight loss surgery.

Picture credit: MoodBoard Value/India picture