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Obesity and Infertility

Obesity and Infertility


Infertility, or subfertility (delay in conceiving), is a clinical condition characterized by diminished ability to reproduce and produce offspring. Subfertitiliy is a common condition referred to in clinics. However, it is hard to pin down its source. There are numbers of risk factors for subfertility, which include genetic, environmental, and lifestyle. The most common and significant threat factor for subfertility is obesity. The risk of subfertility is increased three times in obese women compared to women with normal BMI. In addition to many other adverse effects, obesity affects the individual’s ability to reproduce. This is a matter of concern for those individuals trying to conceive.


Subfertility is one of the adverse outcomes of obesity in females. Obesity affects female reproductive health in various ways. In order to understand the pathology, we need to know the normal physiology of female reproduction. Hormones are chemicals that affect the activity of the reproductive cycle. The Hypothalamus, an area of the brain, sends signals to the pituitary gland, which produces hormones that act on ovaries. This hypothalamus-pituitary-ovarian axis (HPO axis) controls ovulation or egg production. Usually, there is one egg maturation every month. The menstrual cycle works side by side with the ovarian cycle. A female menstruates every month for 2-7 days typically, the length of the cycle varying in every individual.

The mechanism by which obesity affects ovulation is that obesity causes increased insulin levels in the body, causing insulin resistance. Insulin resistance disturbs the hormonal balance of the HPO axis. Moreover, it causes anovulation which is no release of an egg from the ovary. This is a mechanism that occurs in polycystic ovarian syndrome or PCOS. High levels of androgens or male sex hormones are the main characteristics of PCOS, making ovulation more difficult.

In addition to its effects on ovaries producing anovulation, obesity also affects adipokines, the hormones secreted by adipocytes or the fat cells. One of the vital hormones secreted by fat cells is called Leptin. Increased levels of Leptin initiate reproductive disturbance. This hormone prevents the average steroid hormone production by both acting on the site of production and the site of action.


Even when pregnancy occurs, there may be complications due to obesity. During early pregnancy, studies have shown that there are increased risks of miscarriages in obese women. Moreover, in later pregnancy, there may be complications like gestational diabetes, or diabetes during pregnancy, hypertension during pregnancy, which may lead to pre-eclampsia and eclampsia in severe cases.


Where excess weight and obesity have undesirable effects on female health; male reproductive health is also affected adversely. Studies have shown that there is 24% less testosterone in overweight and 26% less testosterone in those individuals suffering from obesity. Testosterone is a male reproductive hormone. Testosterone gets converted mainly to estrogen in obesity. This is the reason which is the cause of subfertility in males.


Excess-weight and obesity dramatically influence the general physical appearance of an individual. This is an essential component of a relationship. Being overweight makes an individual conscious of their physical appearance all the time. Individuals suffering from obesity also have difficulty getting pregnant. This is due to the time taken to conceive is doubled when compared to individuals with normal BMI. Subfertility affects the mental health of both partners, and negatively affects their relationship.


One vital thing to note is that both obesity and its adverse outcome subfertility are entirely preventable, curable, and treatable issues. Excess weight can be controlled initially by diet and exercise along with following a healthy and active lifestyle. For individuals who are obese, bariatric surgery is also an excellent option to consider, especially when you are 30 kilograms above your ideal weight or have diabetes or hypertension. Controlling and maintaining weight eliminates the most significant risk factor for subfertility.


Obesity and infertility are closely knit together. According to studies, there is a three-fold increase in subfertility chances in women suffering from obesity compared to those with normal BMI. We can reduce the rates of subfertility in women suffering from excess weight by treating obesity. Bariatric surgery is a modern and efficient way to get rid of obesity. This surgery treats the long-term effects of weight loss, and doing so helps overcome the problem of subfertility/infertility.

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