Dr. Sukhvinder S. Saggu, MS FACS (USA), Director, Minimal Access and Bariatric Surgery, Apollo Spectra Hospital, Karol Bagh, New Delhi, India
One everyday tool can help steer many couples struggling with infertility in the right direction rather than any popular piece of advice – the scales! That’s right. Obesity could be the real cause of many couples’ infertility problems. Obesity affects fertility significantly in both men and women1-2 .
In women, obesity can lead to irregular menstrual cycles3, PCOS (Polycystic Ovarian Syndrome), or the way a woman’s body stores sex hormones. Any of these three conditions can cause infertility4th. To make matters worse, many women with obesity may have more than one of these conditions combined.
If an obese woman tries to conceive without resolving the weight problem, she and the baby can expose herself and the baby to three other pregnancy risks caused by obesity: miscarriages5, Gestational diabetes6th and pregnancy blood pressure7th. That’s not all. The increased risk of birth defects such as congenital heart disease and other serious abnormalities in babies is related to the mother’s obesity8th.
For men, a review of 14 studies found that 51% of obese men are more likely to have no or very little sperm in their ejaculate9.
Is there a reliable and permanent escape from the obesity trap? Yes, and understanding obesity could be the first important step.
Define obesity:
Obesity is not defined by your weight alone. It is calculated by a unit called the Body Mass Index (BMI), which measures your weight in relation to your height to determine obesity and its severity.
The World Health Organization (WHO) considers a BMI greater than 30 to be class 1 obesity10. A BMI over 35 is Class II, meaning severe obesity, and a BMI over 40 is Class III, meaning severe obesity11.
Obesity is not a cosmetic disease. It is a complex chronic disease that requires medical treatment by the American Medical Association (AMA) in 2013 due to three decades of research and development12th.
How to Treat Obesity
Does Diet Work?
The restrictive diets do not reduce obesity13th and the majority of people on diet regain the lost weight plus more14th according to several research results.
What about movement?
A review of several studies found that clinically significant weight loss is unlikely. Exercise programs actually play a role in weight gain after the initial weight loss. Overall, aerobic exercise programs that comply with public health recommendations can promote up to a small amount of weight loss (~ 2 kg).15th.
Then what’s the solution?
If you have tried making lifestyle changes, eating diet, exercising, etc. and you have not lost much weight or have not been able to maintain the lost weight for a long time, consulting a qualified obesity expert may be an option to consult. Minimally invasive
Bariatric weight loss surgery may be an option if your BMI is over 32.5 with type 2 diabetes or other obesity-related comorbidity. or if your BMI without comorbidity is more than 37.516.
A review of 18 studies published in April 2020 found that bariatric surgery significantly improved hormonal balance and sexual functions in both men and women, sperm count in men, and pregnancy in women17th.
Another study found that 62.72% of infertile women with obesity became successfully pregnant after bariatric surgery18th.
Due to COVID 19, many doctors offer online consultations these days. You could book an appointment at a center of your choice and discuss your obesity problems with your specialist in the comfort of your home.
Don’t be a victim of obesity or its stigma. Infertility caused by obesity can be treated with permanent results. The time to take action is NOW!
Disclaimer: This article is sponsored by J&J in the public interest. The views and opinions expressed by participating doctors in the article are based on their independent professional judgment. J & J (P) Ltd., BCCL and its group publications disclaim all liability for the correctness or the consequences that arise from adhering to their expert opinions.
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1. Dag ZO, Dilbaz B. Influence of obesity on infertility in women. J Turk Ger Gynecol Assoc. 2015; 16 (2): 111-1. 117.
2. Palmer NO, Bakos HW, Fullston T., Lane M. Influence of obesity on male fertility, sperm function, and molecular composition. Spermatogenesis. 2012; 2 (4): 253- 263.
3. https://www.nejm.org/doi/full/10.1056/NEJM195207102470204
4th Silvestris E, de Pergola G, Rosania R, Loverro G. Obesity as a disorder of female fertility. Reprod Biol Endocrinol. 2018; 16 (1): 22. Published 2018 Mar 9. doi: 10.1186 / s12958-018-0336-z
5. H. Lashen, K. Fear, DW Sturdee, Obesity is associated with an increased risk of first trimesters and recurrent miscarriages: Matched Case Control Study, Human Reproduction, Volume 19, Issue 7, July 2004, pages 1644-1646, https : / /doi.org/10.1093/humrep/deh277
6th Susan Y. Chu et al., Maternal Obesity and Risk of Gestational Diabetes Mellitus, Diabetes Care Aug 2007, 30 (8) 2070 2076; DOI: 10.2337 / dc06-2559a
7th Juliette Madan, Minghua Chen, Elizabeth Goodman, Jonathan Davis, Walter Allan, and Olaf Dammann (2010) Maternal Obesity, Pregnancy Hypertension, and Premature Birth, The Journal of Maternal-Fetal & Neonatal Medicine, 23: 1, 82-88, DOI: 10.3109 / 14767050903258738
8th. https://pediatrics.aappublications.org/content/pediatrics/111/Supplement_1/1152.full.pdf
9. Sermondade N, Faure C, Fezeu L, Lévy R, Czernichow S, Working Group Obesity-Fertility AT. Obesity and increased risk of oligozoospermia and azoospermia. Arch Intern Med. 2012; 172 (5): 440-442. doi: 10.1001 / archinternmed.2011.1382
10. https://www.who.int/health-topics/obesity#tab=tab_1
11. https://asmbs.org/patients/disease-of-obesity
12. Kyle TK, Dhurandhar EJ, Allison DB. Regarding Obesity as a Disease: Evolving Policies and Their Impact. Endocrinol Metab Clin North Am. 2016; 45 (3): 511-520. doi: 10.1016 / j.ecl.2016.04.004
13th Mann T, Tomiyama AJ, Ward A. Promoting Public Health in the Context of the “Obesity Epidemic”: False Starts and Promising New Directions. Perspective Psychol Sci. 2015; 10 (6): 706- 710. doi: 10.1177 / 1745691615586401
14th https://newsroom.ucla.edu/releases/Dieting-Does-Not-Work-UCLA-Researchers-7832
15th Fast DL, Johannsen NM, Lavie CJ, Earnest CP, Church TS. The role of exercise and physical activity in losing weight and maintaining it. Prog Cardiovasc Dis. 2014; 56 (4): 441-447. doi: 10.1016 / j.pcad.2013.09.012
16. https://www.theossi.com/guidelines-obesity-surgery.html
17th Moxthe LC, Sauls R., Ruiz M., Stern M., Gonzalvo J., Gray HL. Effects of Bariatric Surgery on Male and Female Fertility: A Systematic Review. J Reprod Infertil. 2020; 21 (2): 71- 86.
18th Musella M, Milone M, Bellini M, Fernandez LM, Leongito M, Milone F. Effect of bariatric surgery on obesity-related infertility. Surg Obes Dis. 2012; 8 (4): 445- 449
Disclaimer: Content produced by Dr. Saggu