We’ve all heard it. We are getting fatter as a nation. Obstetricians are having to lower normal caloric intake in pregnant women because of lower activity levels, and this is in normal weight women. What about the nearly 50% of women who are obese and of reproductive age? How are those extra pounds affecting their chances of conceiving, especially when they have tried and failed?
Obesity may be affecting their ability to ovulate. Women with a Body Mass Index > 27 have a three-time higher chance of experiencing problems ovulating than their lean counterparts. Ovulatory function normalizes after weight loss.
Obesity also requires women to use higher doses of medications to induce ovulation. In our practice women weighing over 200 pounds are prescribed a higher dose of Letrozole. Clomid dosing is similar with obese women requiring higher dosing, and less often responding.
But it is not just ovulation that obesity affects. Obese women undergoing IVF also have a reduced chance of conceiving and delivering a child compared to normal weight women. Their response to fertility injections is impaired. They require more, take it longer, and have less eggs retrieved.
Controlling for embryo quality, a BMI of 30 to 35 reduces the chances of a live birth by 37%, 61% if BMI is between 35 and 39.9 This is one of the reasons Carolina Conceptions has BMI restrictions for fertility treatment (no treatment for BMIs 40+, no IVF or egg recipiency for BMIs 37+, no embryo recipiency for BMIs 35+). If you don’t know your own BMI, try this free BMI calculator to see where you are at.
Maternal obesity is strongly associated with pregnancy and perinatal complications. Risks for gestational diabetes, hypertension, preeclampsia, preterm delivery, stillbirth and cesarean delivery are all increased with maternal obesity. Major birth defects are also increased in obese women. A study from Atlanta showed that obese women were more apt to have offspring with heart defects, neural tube defects, etc.
We are compiling weight loss resources in the office to assist you in obtaining your goal weight prior to beginning fertility treatments. Here are a list of options to consider if you are working toward a goal of lowering your BMI:
“Stop Dieting, Start Healing” with Dr. William Ferro – free 15 minute phone consult.
“Nutritional Education & Results-Driven Weight Loss” with Katy Harris – 8 & 12 week programs
“Personalized Medical Solutions” for weight loss typically covered by insurance
“Surgical Weight Loss Options for Women Seeking Pregnancy”