One of the many reasons that women, and occasionally men, come to see me for weight loss advice is because they want to start a family, but are struggling. Did you know that obesity is a major cause of difficulty getting pregnant - and can increase the risk of miscarriage or problems during pregnancy and childbirth? In fact, there is a significantly greater risk of diabetes during pregnancy if you are overweight - and this can affect the future health of your child as well as you.
Some women end up seeking help with IVF (in-vitro fertilization) or other forms of fertility treatment, but this isn't usually funded unless women are below a BMI of 30 or under the age of 40 - which is why I get women coming to me for weight-loss surgery.
Thinking of starting a family is a great incentive to lose weight, but you have to make sure you do it in a way that is good for you - not by fad dieting which will starve your body of essential nutrients just at the time when you and your unborn child need them most. In fact, some studies suggest that a mother's diet, even before she actually gets pregnant, can affect the health of her child. So instead of crash dieting, treat your body with the care and respect it deserves:
- Fill it with the most nutritious food you can find
- Keep active to ensure you are as fit as you can be
As a result, you'll be rewarded with a slimmer, healthier body, and not only this, you will find it easier to get pregnant too.
I asked top fertility expert and NHS consultant Valentine Akande to give us the lowdown on how obesity affects fertility and pregnancy:
Photo supplied by FertilityBristol.com
Being overweight, obesity and infertility
If you are intending, or trying to get pregnant, being overweight or obese can affect your chances of getting pregnant, having a normal pregnancy and a healthy baby.
Research evidence shows that being overweight can contribute to period problems, hormonal imbalances, lack of ovulation, resistance to fertility treatment and therefore fertility problems particularly in women with polycystic ovarian syndrome (PCOS).
There is a higher risk of miscarriage, higher risk of abnormalities of the baby as well as still birth in women who are overweight. The pregnant overweight mother is also at higher risk of diabetes, high blood pressure and difficult or complicated delivery of the baby by Caesarean or forceps.
Small changes, big results
In women with PCOS who have infertility due to problems with ovulation, even a 10% loss in weight can result in return to normal ovulation. As such, losing weight before trying to conceive will improve the likelihood of ovulation, improve fertility and reduce the risk of problems in pregnancy and improve the chance of having a healthy baby.
In more challenging obesity cases there is evidence that "bariatric surgery" can result in an improvement of the hormonal profile, improve fertility as well as reduce the risk of miscarriage.
It's not all on you...
In men, being obese can cause the following problems: reduced semen volume, a reduced sperm count and increased sperm DNA damage. Losing weight will improve these parameters.
In summary, if you are planning to get pregnant in the next year or few years, healthy eating and regular exercise to maintain a normal weight can boost your fertility and improve your chances of having a healthy baby. If you have challenges losing weight seeking expert help would be of benefit.
Dr Valentine Akande MBBS PhD MRCOG
Consultant Gynaecologist & Fertility Specialist
For further advice and help in starting your long-term weightloss journey, visit our Vavista programme.