Obesity Epidemic Is Causing Infertility And Reducing The Success Of Treatments Such As IVF

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Obesity is becoming an increasingly common cause for infertility. Obesity causes problems with ovulation, reduces the success of fertility treatments including IVF, increases the chances for miscarriage and other pregnancy complications. Weight loss is an effective treatment to increase fertility.

I have also been impressed with the results of bariatric or weight loss surgery

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Couples spend thousands of dollars on infertility treatments such as in vitro fertilization. For some, IVF may be the only treatment that will allow them to conceive. Women who are obese, however, have a potentially preventable and correctable form of infertility.

According to the American Obesity Association, approximately 127 million adults in the U.S. are overweight and 60 million are obese. From 1960 to 2002, the average adult female weight has increased from 140 to 163 pounds. In reproductive aged women, the prevalence of obesity has substantially risen in the last twenty years. Obesity immediately brings to mind associations with hypertension, diabetes and heart disease, yet most people are surprised to learn that there is a strong association between obesity, infertility and miscarriage.

According to Dr. Randy Morris, board certified reproductive endocrinologist and Medical Director of IVF1 in Chicago, "Excess weight and obesity can affect fertility in a number of different ways by causing hormonal imbalances that have an impact on ovulation and menstruation. Over the last three years, I have seen the percentage of obese women seeking fertility treatment at my center increase from 9% to 39%. The percentage with morbid obesity went from 0% to 23%."

Morris explains further, "Obese women have a higher incidence of ovulation problems and irregular menstrual cycle. This may be due to a problem called insulin resistance which is the same problem that increases their risk of diabetes. Obese women may also have more uterine problems as estrogen production from fat cells can cause abnormal changes in the uterine lining and in some cases even proceed to cancer." A recent study suggested that obese women may have a 3.5 fold increase in their risk for miscarriage.

Additionally, obese patients have a poorer chance for success with fertility treatments. They tend to have a worse response to fertility medications and as a result may need higher doses. Pregnancy rates are uniformly lower for obese women. This is true even for high tech treatments such as in vitro fertilization. Some IVF studies show a delivery rate for obese women that is one half what it is for thinner women. "If you are going to spend thousands of dollars on fertility treatments, obese women should be advised of their prognosis so they can make a more educated decision," adds Morris.

Obesity may also be the source of many problematic occurrences in women even if they do successfully become pregnant.

1) Excess weight often causes breathlessness, lethargy, increased abdominal pressure, indigestion, heartburn, depression and added physical pressure on the body.

2) Obese women are more likely to have labor complications requiring Cesarean section.

3) There is an increased risk for gestational diabetes and blood pressure problems.

4) Babies born to obese women are at higher risk for birth defects

There is some good news though. Weight loss is associated with an improvement in ovulation and fertility and a reduction in miscarriage risk. However, Dr. Morris stresses that there are no miracle diets. "In fact, there haven't been any good studies showing that one type of diet is better than another for losing weight and improving fertility. The key is compliance. Women need to find a diet that they can stay on for a long period of time." Of course, exercise is also extremely important. "I have also been impressed with the results of bariatric or weight loss surgery," states Dr. Morris. "Although the data is still limited, this may be a good choice for women who struggle with persistent morbid obesity."

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Randy Morris
IVF1
212-213-2003
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