During this time of the year many of us are still thinking about our recent New Year’s resolutions and for most Americans, losing weight and getting in better shape topped that list. Couples who are trying to get pregnant, however, may have a
different priority for weight loss- doing whatever is in their own power to improve their chances of having a baby.
Well, it turns out that weight and fertility are so intimately linked that these two goals might just as well become one.Studies have shown that losing as little as 5% of body weight can dramatically improve chances of pregnancy- and we’re not just talking about the female partner here – men can improve their fertility by losing weight too.
Dr. Jeffrey McKeeby of Shady Grove Fertility’s Annapolis office says that most of the couples he sees are so determined to have a baby that it can motivate them to lose weight even if their previous attempts have failed.
“Women are always asking, what can I do to improve my chances of becoming pregnant?” says Dr. McKeeby. “The answer is clear. Whether you are trying on your own or you’re starting fertility treatment, getting your BMI as close to the normal range as possible will improve your chances – not only of getting pregnant but of having a safe and healthy pregnancy.”
What is my BMI?
When healthcare professionals talk about weight, they usually refer to Body-Mass Index or BMI. BMI is a calculation based on your height and weight. A BMI within the 19-25 range is considered normal while a BMI in the 25-30 range is considered overweight. A BMI over 30 is considered obese.
“Unfortunately, most of us in the US don’t have a BMI of 25,” says Dr. McKeeby, “so I always tell my patients that a good goal is to try to get under 30 before we start treatment. Of course, it depends on where you start. Your weight loss doesn’t have to be dramatic to improve your chances of success. Any movement toward the normal BMI range will help.”
Increased Weight Reduces Chances of Conception
Doctors have known for a long time that women with a condition called Polycystic Ovarian Syndromeor PCOS can improve their fertility by losing weight. PCOS is caused by hormonal imbalances that prevent ovulation. The woman’s body produces too much of some hormones and not enough of others. This imbalance also contributes to weight gain in many women with PCOS. However, when these women start a specific nutrition and exercise routine, many of them begin to ovulate again. Even those that need medication to ovulate still dramatically improve their chances of conception with weight loss.
It turns out that women without observable hormonal imbalances like PCOS may also be helped by losing excess weight. “We’ve found that even women with normal cycles whose BMIs are higher than normal can be infertile or subfertile,” says Dr. McKeeby. “There’s no way to definitively say that the excess weight is the cause of their infertility, but we can say with confidence that losing weight can improve their fertility.”
One study showed that as a woman’s BMI went over 29, her chances of conceiving went down by 4% compared to women with a normal BMI of 25. “Each point over a BMI of 29 caused an additional 4% decline in success,” says Dr. McKeeby, “so you can see how bringing down your BMI, even by a few points, can increase your odds of success.”
Weight Also Matters to Fertility Treatment and Pregnancy
Weight continues to be a factor when couples start fertility treatment. “Studies have shown that weight can have a significant impact on the success of fertility treatment and resulting pregnancies,” says Dr. McKeeby. “It’s so important that we won’t start treatment with patients with BMIs that are over a certain level.”
Shady Grove Fertility follows guidelines based on BMI for women undergoing different treatment options. For patients undergoing Intrauterine Insemination (IUI), their BMI must be below 44. For In Vitro Fertilization (IVF)patients, their BMI must be below 40.
“We’re not trying to exclude anyone from treatment, but as healthcare professionals, we have an obligation to make treatment as safe as possible and not to take unnecessary risks,” says Dr. McKeeby. “We also want your subsequent pregnancy to be as safe and successful as possible.”
For patients undergoing IVF, a higher than normal BMI can make it more difficult to get to the embryo retrieval stage because they may not respond as well to fertility medication which can lead to cancelled cycles. Also, during the egg retrieval procedure, it can be technically difficult to reach all the eggs, so that consequently, chances of conception are decreased. In addition, one study showed that women whose BMIs are either above or below the normal range are more likely to produce immature eggs during their treatment cycles, leading to lower success rates.
When it comes to pregnancy, excess weight can cause several complications. These include an increased risk for gestational diabetes, high blood pressure, more difficulty with vaginal deliveries, and even an increased rate of miscarriage.
Here, again, losing some weight was shown to improve outcomes dramatically. A review of 33 published studies evaluating the effect of BMI on IVF treatment outcomes found that moving from the overweight to the normal BMI category reduced miscarriage rates by 13% and increased the chances of delivering a baby by 10%.
Underweight Can Also Impact Fertility
Patients with a BMI lower than the normal range can have just as much trouble conceiving as those with a higher BMI. Underweight patients can experience hypothalamic amenorrhea, a condition in which menstruation stops for several months due to a problem affecting an area of the brain called the hypothalamus. This leads to an inadequate response to fertility medication and treatment.
“When we see patients who are underweight, they are also encouraged to focus on increasing their weight,” says Dr. McKeeby. “Again, we know that they will be more responsive to fertility treatment and have a better chance of success when they are closer to a normal BMI.”
It’s Not Just About The Ladies… His Weight Matters Too!
You don’t hear much about it, but studies have shown that excess weight can affect a man’s fertility as well. Research has proven men with BMIs over 30, which is considered obese, have a lower sperm count and negatively impacted fertility over all.
“Sperm counts actually decrease as a man gains weight,” says Dr. McKeeby. “They may have more estrogen because of the excess weight or their body temperature may be higher which can impact sperm count. Whatever the reason, losing weight can help men boost their fertility as well.”
Shady Grove Fertility Can Help When Weight Might Be the Issue
“It is always difficult for physicians to talk to patients about their weight,” says Dr. McKeeby, “but believe me, we are sympathetic or I should say, empathetic, since many of us have struggled with our weight just like everyone else.”
BMIs are always considered in testing and treatment plans at Shady Grove Fertility. Our physicians encourage all patients with a BMI over 30 to work on weight reduction. Each physician and office will have unique resources to offer patients for support. “In general, though, we want our patients to take a holistic approach to their fertility,” says Dr. McKeeby, “so we want them to lose weight in a way that is nutritionally sound and also to increase their physical activity.”
The physicians at Shady Grove Fertility recommend working with a dietitian or joining a proven weight loss program such as Jenny Craig or Weight Watchers. For patients with PCOS, there are specific diets that can target their unique issues. Pulling Down the Moon located in Rockville, MD is a holistic treatment center specializing in complementary therapy services for fertility patients. Along with accupuncture and yoga Pulling Down the Moon offers nutrition services for both men and women seeking to lose weight. In additon they also provide a PCOS focused program. Patients who have a significant amount of weight to lose may be referred to a physician to be evaluated for bariatric surgery.
“Women with high BMIs shouldn’t put off seeing a fertility specialist,” says Dr. McKeeby. “Weight may not be the only factor causing infertility. A complete diagnostic work-up is always recommended to optimize your change of pregnancy.
Make This Your Year
We know every couple is looking at the calendar and hoping that this is the year that brings them their baby. When you come to Shady Grove Fertility our fertility specialists work with you to evaluate how weight and other factors are impacting your fertility. We work together, with our patients, to develop an individualized treatment plan to help make your dreams a reality.
By scheduling your new patient appointment today you are one step closer to the family you have always wanted.
For more information or to schedule an appointment with one of our physicians, please speak with one of our friendly New Patient Liaisons by calling 888-761-1967.