Obesity is a worldwide epidemic that leads to various risks such as cardiovascular disease, Type II Diabetes, sleep apnea and increased risk of cancer. Nearly 20% of women of childbearing age are obese. Studies show that obesity is associated with reduced ovulation, poor ovarian stimulation during assisted conception as well as increased miscarriage. Male fertility can be affected in obese men with reduced ejaculate volume, increased sperm DNA damage in obese men as well as reduced sperm count.
Ultimately these factors result in an increased time to conceive as well as lower pregnancy or implantation rates following either spontaneous or assisted conception in couples where either male or female partner or both are obese. Fertility remains a key issue for many overweight or obese individuals, a problem that much NHS funding of in vetro fertilization restricts who can receive help, typically only giving this funding to women with a BMI of 30 or less.
Many studies show that weight loss helps to improve both fertility and reproduction. Also BMI reductions also help ovulation to occur, sperm counts to increase, improvements in pregnancy and reduce the risk of miscarriages. Ultimately pre-conceptual weight loss is fast becoming important for those having trouble conceiving.
Weight loss surgery where stomach capacity is restricted such as gastric bypass or lap-band or gastric banding have been most successful at helping patients to both achieve and sustain weight loss. Ultimately the number of bariatric surgical procedures has rose since 2003. Lifestyle changes are imperative following weight loss surgery to increase the likelihood of keeping weight off and continuing to receive improved health benefits from the procedure itself.
Women of reproductive age account for just a little under half of all weight loss surgeries. Typically women with a BMI of 40 or more or a BMI of 35 with co-morbidities (cardiovascular issues, joint problems, Type II Diabetes or sleep apnea) qualify for this surgery. Many researchers are wondering if ovulatory subfertility should be considered an associated medical condition or co-morbidities for these surgeries.
Evidence points to fertility and pregnancy outcomes that are more successful after weight loss. Research shows that weight loss can help to restore ovulation, the balance of reproductive hormones and also increases spontaneous conception rates. Also weight loss as a result of gastric banding surgery also helped improve maternal health such as reduced risk of pre-eclampsia or gestational diabetes in mothers.
Many studies found that nutritional restriction does not affect a growing fetus. However it still remains unclear how gastric band should be managed in a pregnancy. A more in-depth study is needed in order to achieve those findings.
Women are typically told to avoid getting pregnancy until at least one year following bariatric surgery. This is because of concerns previous studied showed on dramatic weight loss and a developing pregnancy. However recent data suggests that conception before that one-year mark may be safe, which is great news for those who struggled to get pregnancy prior to surgery.