The most beautiful gift that nature has provided to us is the gift of making a new living being, a new living body out of the body we have.
It indeed is a very precious thing and it is a very well-known fact that all pregnancies are not successful. Many-a-times, parents have a very hard time conceiving.
There are many conditions nowadays that lead to difficulty in conceiving. There can be diseases and disorders, some genetic, and some even related to lifestyle.
There has been a sudden rise in the number of infertility clinics that you find in your city. Isn’t it? Is it a disease that is affecting women? Or is there a common factor at play? In more than half of the cases, the lifestyle is to blame, or, the diet.
Obesity has made its way to obstructing not only people’s self-esteem and happiness, but also fertility.
Obesity has affected millions of people worldwide. Every one in four women is found to be obese and subsequently trying hard to carry on with a pregnancy. However, it is not only the women, that have been affected by the maliciousness of obesity.
It is also men, those struggling with their weight, that have been found struggling with fertility.
Unwanted fat undoubtedly plays havoc with the body. It can cripple people’s hopes. How do these complications occur? Is there anything that can be done to prevent these?
How Does Obesity Affect Fertility?
A person who has their BMI (body mass index- which is a measure of fat in the body) over 30 is considered to be obese. This has a negative impact on the overall health. It puts the person at a very high risk of cardiovascular diseases as well as sleep apnea and type-2 diabetes.
Obesity can be encountered by people for various reasons. It can be due to their genetics, that make the more susceptible to obesity, their diet, lifestyle and a lack of physical activity also contributes to obesity.
Fertility refers to the capability to conceive or cause a pregnancy. If the couple does experience infertility, it can take a long time to identify a cause, which can vary from ovulation disorders and damaged or blocked fallopian tubes in case of females, and poor sperm quality or low sperm count in case of males.
Excess body fat poses problems in reproduction, regardless of gender. Obesity has a direct impact on hormones. In case of males, it targets oestrogen and also lowers testosterone levels which increase the fat deposits.
An increase in oestrogen levels hinder fertility as the level of androgen goes down.
If women are obese, there are many conditions that can lead to infertility, such as irregular menstrual cycles, ovulation problems, increased rates of miscarriages and polycystic ovarian syndrome.
When excess fat gets deposited around and in the abdominal area, the androgen production is increased (hyperandrogenism). Insulin resistance is another condition that may be encountered.
Insulin is responsible for the regulation of the production of sex hormones. However, when the levels are disturbed, it can elevate the production of androgens which in turn lead to the formation of follicles and cysts in the ovaries.
What does this mean?
Obesity can hinder fertility by causing havoc with the hormones, increasing the BMI and leading to various metabolic disorders such as insulin resistance, hyperandrogenism, cysts in the ovaries and even type-2 diabetes.
Do Men Encounter Fertility Problems Due To Obesity?
A study published in “Biochemical and biophysical research communications” in 2017 reported that animals with high levels of glucose, cholesterol, triglycerides and morbid obesity were found to be infertile.
When changes were made to the diet of these animals and the triglycerides were replaced, the spermatogenesis (formation of male germ cells, that is, sperm) as well as the motility of the sperm was enhanced.
In case of paternal obesity, the expression of the genes is also altered throughout the placenta (as genes from the father also help in the buildup of the placenta) which is capable of affecting fertility.
It can also have a negative impact on the health of the offspring.
The BMI (Body Mass Index), if increased, also has a negative effect on fertility. It was found that with increasing BMI, the sperm volume and concentration was decreased. This could affect male fertility.
Azoospermia is a condition where the male is unable to produce sperm and oligozoospermia is another condition where the sperm concentration is less. Males who were overweight or obese were the ones who suffered from these problems, according to a study.
However, there was a limitation to this study as well, because the subjects who participated in this study were from infertile couples as well as general population, hence more studies are required for further evaluation in relation to these parameters.
Obese men had sperm with damaged DNA and had a low total sperm count as compared to men with a normal weight and BMI.
Besides that, the testosterone levels were less and the estradiol (female hormone) levels were high. This affected the reproductive potential of obese men in a negative manner.
What does this mean?
Obesity leads to a decrease in total sperm count, concentration, motility and hormonal imbalance which lead to infertility.
What are the fertility problems encountered by females due to obesity?
Obesity can cause insulin resistance, as mentioned above. This can result in a phenomenon known as “anovulation”, which means that a woman may fail to produce an egg in each ovary every month. The levels of androgens are also increased.
These unfortunate events are a result of an underlying condition known as Polycystic ovarian syndrome (PCOS).
Other symptoms of PCOS include hirsutism (male-like hair growth patterns, such as facial hair), hair loss, acne, high cholesterol levels and a higher risk of developing cardiovascular diseases.
Environmental factors and lifestyle contribute to the development of obesity, and in turn to PCOS.
Obesity has been found to worsen the problems associated with this syndrome. These problems include insulin resistance, glucose intolerance and menstrual irregularities.
The onset of PCOS has been linked to infertility. The exact cause of PCOS is unknown, however it has been linked to obesity, and can be multifactorial. Patients suffering from it develop glucose intolerance and a higher susceptibility to type-2 diabetes.
PCOS has also been linked to the prevalence of endometrial disorders. The endometrium is the inner lining of the uterus. Due to PCOS, there is an over-expression of androgens in the endometrium.
The implantation of the embryo becomes difficult. The insulin resistance hinders with the normal processes of the endometrium. This increases the chances of miscarriages, infertility and endometrial cancer as well.
An animal study was suggestive of the fact that imbalance in the lipid levels of the body lead to oxidative stress which increased the risk of infertility and also cause health issues in the baby.
What does this mean?
Obesity can be directly linked to hormonal imbalances in women, such as high levels of androgens and development of cysts in the ovaries which together contribute to infertility.
Can Weight Loss Help Improve Fertility?
Losing weight would mean getting rid of all the extra fat in the body, lowering of the BMI, regulation of the cholesterol and insulin levels. But would these events help with the infertility issues?
Weight loss improved fertility in males
Male obesity has been known to contribute to hormonal and sexual dysfunction that can lead to infertility.
A study was conducted where obese men were subjected to a weight loss program and their reproductive indicators were kept under observation. Semen and blood samples were taken and laboratory tests were carried out while the weight loss program lasted for 14 weeks.
It was observed that, the lower the BMI, the higher was the sperm concentration. Weight loss improved the total sperm count, volume as well as testosterone in those men who had lost the maximum weight.
Obesity has been known to reduce testosterone levels. These result in an increase in body fat and give rise to a number of other metabolic complications. The testosterone levels can be reversed back to normal, as they are not permanent, and this can be achieved by weight loss.
Physically active men were found to have better results in case of semen parameters such as sperm count, morphology and motility.
Weight loss improved fertility in females
It was observed that obese women have a weaker response to fertility treatment. They require higher doses of the hormones required for ovulation.
Even if these women were administered with the required dose, the oocytes (eggs) were found to be less in number. Embryo quality was also found to be impaired.
Weight loss regularized the menstrual cycles and increased the rate of spontaneous ovulation and even conception in obese women. For such reasons, a gradual weight loss was found to be ideal.
Weight loss has been known to have positive effects on the reproductive indicators in women. Obese and infertile women undertook a diet and exercise regimen for a period of 6 months.
Spontaneous ovulation was observed, there was achievement of pregnancies and even a birth. Hence, the miscarriage rate also dropped. This implies that infertility should first be treated with the help of weight loss, as it can be very beneficial, harmless and pose little to no side effects.
Women suffering from PCOS and obesity took up an 8-week dietary plan where they took a low-starch diet. Weight, fasting insulin levels, testosterone levels were found to be reduced. There was improved sensitivity to insulin as well.
When women increased their physical activity, by one hour per week, it reduced the risk of infertility. It was also observed that infertility was attributable to obesity and less to those women who were underweight or over-exerted.
What does this mean?
Weight loss has been proven to decrease the risk of infertility regardless of gender. It reduces the BMI and regulates hormonal levels thereby increasing the chances of conception.
What are the treatment options available to improve fertility in obese individuals?
Apart from weight loss, a few add-on therapies are required to improve fertility in obese individuals.
In case of obese males, testosterone levels are found to be lower, which can lead to a number of negative effects including infertility. Due to hypotestosteronemia, there can be an increase in the fat content of the body.
However, these conditions can be reversed with the help of testosterone therapy. It works best with weight loss. However, it is capable of worsening sleep apnea and may even compromise fertility.
As antioxidants reduce the oxidative stress present in the body, which leads to worsening of obesity as well as acts as a hindrance to fertility, such compounds can be consumed (such as those rich in vitamin C) in order to improve fertility. Proteins and fats in large amounts should be avoided.
Bariatric surgery can be performed, in which the size of the stomach is reduced, usually by the removal of a portion of the stomach which aids in weight loss.
Bariatric surgeries can reverse hirsutism, re-regularize menstrual cycles and regulate the hormones in case of PCOS. Sleep apnea and type-2 diabetes can also be kept at bay.
Bariatric surgery has helped subfertile women achieve a spontaneous pregnancy. It also has a positive effect on the negative events that occur in the endometrium due to obesity and PCOS.
However, bariatric surgery may lead to stillborn or neonatal death and also have a negative impact on the duration of the pregnancy (gestational age).
Assisted reproductive technology
Other options include the ART (Assisted reproductive technology) which include in-vitro fertilization, fertility medication as well as surrogacy.
What does this mean?
While there is testosterone therapy that can help males, bariatric surgery can aid with weight loss for males as well as females, and also help in elevating the chances of fertility. Assisted reproductive technology can also be made use of for females.
How To Target Weight Loss As Well As Infertility?
There are a number of methods we can employ and help both the situations.
- One must avoid trans fats. Hence, one must avoid processed foods as these contribute to weight gain as well as infertility.
- Foods rich in antioxidants can be consumed, such as oranges, chia seeds, walnuts and citrus fruits as they help in the detoxification of the system and help in weight loss. Antioxidants also helped in the improvement of sperm morphology, motility and vitality.
- More of fiber should be consumed as it balances the hormones and regulates blood-sugar levels and reduces food cravings. Fiber was found to reduce infertility in women aged over 32 years.
- One must replace animal protein with protein acquired from vegetables as the proteins present in animal sources pose a greater risk of infertility.
- Participating in physical activity not only helps in shedding those extra pounds, it also improves fertility.
- Alcohol must not be consumed on a very frequent basis or in large quantities as it deteriorates and dehydrates the body hindering weight loss and also poses problems during the achievement of conception.
Losing weight and fertility hence go hand-in-hand. Even if one is treated for infertility, obesity can cause problems when the time comes to see how well the treatment has been and how much could it help.
One must control their sweet cravings and hunger pangs in order to experience more beautiful things in life, such as giving way to a new life through themselves, as well as the achievement of a cleaner, healthier self.