Weight & Fertility

Frequently Asked Questions regarding weight and fertility – Responses by Lisa Farah-Eways, MD.

Dr. Farah-Eways, is there a connection between weight and fertility?

Excessive weight decreases fertility in women and men, and raises the pregnancy risks for mother and baby. In general, these risks increase with rising weight. According to the American Society of Reproductive Medicine, weight loss of 5% to 10% may dramatically improve ovulation and pregnancy rates.

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What amount of weight is considered excessive?

Obesity is defined as a body mass index (BMI) of 30 and above.

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How do I calculate my BMI?

Centers for Disease Control and Prevention have a BMI calculator. See the link below:
http://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/english_bmi_calculator/bmi_calculator.html Click here.

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What are some of the fertility issues that can arise when a patient is obese?

  • Irregular or infrequent menstrual cycles
  • Increased risk of infertility
  • Increased risk during fertility surgery
  • Increased risk of miscarriage
  • Decreased success with fertility treatments (as specifically related to IVF, this could include a difficult oocyte/egg retrieval and/or a difficult embryo transfer)
  • Increased risk of insulin resistance (decrease in the body's response to insulin), which can lead to ovulatory problems and miscarriage

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What are some of the risks associated with being excessively overweight while being pregnant?

  • Increased risk of high blood pressure
  • Increased risk of diabetes (excess blood sugar) in pregnancy – Diabetes may lead to additional complications, such as an excessively large baby who may have breathing problems, suffer birth injury, and who may be afflicted with obesity and possibly diabetes later in life
  • Increased risk of birth defects
  • Increased risk of Cesarean section
  • Increased risk of miscarriage – The risk of miscarriage before 20 weeks is 15-20% for women with normal weight and may be increased to 20-30% for overweight women. For women with a Body Mass Index (BMI) over 35, especially those having their first baby, these risks may be even higher

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If I have a BMI of 40, can I try to lose weight while getting pregnant?

"Dieting" is not recommended during pregnancy. However, weight loss before conception is recommended to minimize the risks.

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What advice would you give your patients who are overweight but want to start IVF right away?

I recommend weight loss for all my infertile patients with a BMI of greater than or equal to 30. As stated above, a weight loss of just 5-10% can increase the pregnancy rate and decrease pregnancy complications. The difficult situation arises when older women (namely women around the ages of 38 or greater) have a BMI greater than or equal to 40. In this situation, I always recommend weight loss even in the older patient because I consider IVF an elective procedure and it is not without risk. I tell patients that I feel that the risks of the procedure generally outweigh the benefits.

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Is there such a thing as a fertility diet?

There have been many books written about fertility diets. I generally feel that eating a well-balanced diet is all one needs for general well-being. I would recommend a healthy diet rich in water, proteins, vegetables and whole grains.

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Are there foods that boost fertility?

There have been foods that have been reported to increase fertility. For example, full fat milk, yogurt and even ice cream have been shown to decrease ovulatory problems. Dairy also contains calcium, which is important in fertility functions. However, it is important not to overdo consumption of these products as that may increase the risk of weight gain. Therefore, enjoying these products in moderation is important (so compensate for the increased caloric intake elsewhere in the diet).

Whole grains are important in helping to regulate glucose (sugar) and insulin levels in the body. Insulin is important in reproductive function.

Fruits and vegetables are important sources of antioxidants, which are not only important in reproductive health (for women and men), but they are also important for general health. In addition, citrus fruits, strawberries and green leafy vegetables are high in folate, which is an important nutrient to have pre-pregnancy to help reduce the risk of certain birth defects.

Monounsaturated, polyunsaturated and omega-3 fatty acids are the essential fats to eat prior to pregnancy and for overall good general health. These fats reduce inflammation and increase insulin sensitivity. Some sources for these fats are nuts, avocado and salmon.

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Read more about Dr. Lisa Farah-Eways.

Please speak to your personal infertility doctor about any questions or concerns not addressed here.

To schedule an appointment with your doctor or for more information, please call (888) 331-5601 for our Fremont office — or (888) 381-0627 for our Sacramento Office.