On the free fertility app, GLOW, last week we provided participants the opportunity to ask questions of Shady Grove Fertility physician, Dr. Shruti Malik about how weight affects fertility and the hormone imbalances that could make weight management more difficult.

Dr. Malik Discusses How Weight Affects Fertility


Whether underweight or overweight, your health can be adversely affected: being overweight can increase the likelihood of diabetes, heart disease, and hypertension. Being underweight can increase the possibility of nutritional deficiencies, a decline in energy, anemia, and osteoporosis.

But what should my body mass index (BMI) be in order to increase my chances of conception? What if it’s harder for me to lose weight because of PCOS? And does weight affect male infertility as well?

Dr. Malik stresses the importance of having healthy, long-term lifestyle goals in order to reach the body weight conducive to conception and healthier pregnancies. Read a few of the most popular questions about how weight affects fertility and Dr. Malik’s answers below:

  • Q:“Can being too thin be a problem?”
    • A: “Having a healthy BMI (18.5-24.9) is important. When a woman is significantly underweight or is under physiological stress (such as marathon running, regular swimmers, and women with anorexia or bulimia) the body may essentially react by affecting ovulation. Some women may have irregular or absent cycles and others may have regular cycles but not ovulate. Sometimes gaining a little weight if you’re underweight or decreasing the amount of running you do may temporarily help. If you’ve been trying for 6 months, I would see a specialist and have your hormone levels evaluated.” – Dr. Malik   
  • Q:“Hi Dr. Malik-Welcome Back! And thank you for doing this again! It seems to me that plenty of overweight women have no trouble getting pregnant every day. Is it JUST being overweight that leads to problems? Or is it overweight + something (like PCOS)?” 
    • A: “Weight itself can definitely lead to lower pregnancy, delivery, and increased miscarriage rates. It can also make it more difficult for a woman to respond to fertility medications and put them at higher risk during procedures. Even in pregnancy, it can increase the odds of diabetes or blood pressure-related complications and even lead to complications for the baby.” -Dr. Malik
  • Q:“I’m fine. But my (boyfriend) BF is pretty big. Does that matter? Can weight be bad for sperm?” 
    • A:“Yes, a man’s weight matters too. Men who are overweight can have lower sperm counts and sperm motility. In severe cases, it can affect the testosterone balance and sperm production and survival. If you’ve been trying to conceive (TTC) for over 6 to 12 months, it may be helpful to get a full evaluation done including a semen analysis to see if that has an effect.” – Dr. Malik
  • Q:“How do you know you have PCOS (without going to the GYN)? How many symptoms do you need before you are diagnosed with it?” 
    • A: “Most physicians use the Rotterdam criteria for diagnosing PCOS. You need to have 2/3 things: 1) irregular or absent periods, 2) signs of increased male hormone levels (like worsening acne or coarse midline hair growth in the lip, chin, chest, or stomach) or actual blood tests confirming increased testosterone levels, and 3) a ‘PCOS appearance to the ovaries,’ which essentially looks like a lot of small cysts commonly described as a ‘string of pearls.'”– Dr. Malik   
  • Q:“One more question. Have you seen any medication have a positive weight loss effect on a woman with PCOS?” 
    • A:“While there is a number of weight loss supplements and medications, there’s nothing I recommend to patients. I encourage them to try healthy realistic ways to lose weight. Some women opt to work with a dietitian or personal trainer. Binge diets and rapid weight loss medications can stress the body and affect a woman’s reproductive function. In severe cases, surgery may be warranted and that is something that should be discussed with a physician.” – Dr. Malik     

Managing Weight Expectations with Healthy and Long-term Goals

At Shady Grove Fertility, we measure weight and height by checking body mass index (BMI). While a BMI of 18.5-24.9 is ideal, only 1/3 of women fall into this category. The expectation for women is to bring their BMI below 30; any move in that direction can be one step closer to helping couples conceive.

To join the next GLOW Q&A with Dr. Malik or other SGF guest physicians, download the GLOW App on iPhone or Android. The Q&A sessions are hosted each Wednesday evening beginning around 4:30 p.m. To learn more about how weight affects fertility, or to schedule an appointment with one of our reproductive endocrinologist, please contact our New Patient Center by calling 888-971-7755.