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 a 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 vitro fertilization restricts who can receive help, typically only giving this funding to women with a BMI of 30 or less.
Research Study
Many studies show that weight loss helps to improve both fertility and reproduction. Also, BMI reductions help ovulation occur, increase sperm counts, and improve pregnancy outcomes to reduce the risk of miscarriages. Ultimately, pre-conceptual weight loss is fast becoming important for those having trouble conceiving.
Evidence points to fertility and pregnancy outcomes that are more successful after weight loss. Research shows that weight loss can help restore ovulation and the balance of reproductive hormones, as well as increase spontaneous conception rates. Weight loss as a result of gastric banding surgery helps improve maternal health, such as the 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 pregnant until at least 18 to 24 months following bariatric surgery. This is because of concerns in previous studies showing 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 pregnant prior to surgery.
Weight Loss Surgery
Weight loss surgery where stomach capacity is restricted, such as gastric sleeve and lap-band (gastric banding), and intestine rerouted to absorb fewer calories, such as RNY gastric bypass and duodenal switch, has been most successful at helping patients both achieve and sustain weight loss. The number of bariatric surgical procedures has risen since 2003.
Women of reproductive age account for just a little under half of all weight loss surgery patients.
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. 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.