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Can Obesity cause infertility in women? – How Weight Loss Can Improve Fertility

Can Obesity cause infertility? How weight loss can improve fertility

Can Obesity cause infertility in women?

Obesity makes it difficult for women to get pregnant. If they get pregnant, then there is higher risk of losing it. Hormonal levels are also altered in obese women.

Obesity related complications in pregnancy (BMI >35):

Preeclampsia (5 times)
Stillbirths after 28 weeks gestation (3 times)
Early neonatal death (3.5 times), large-for-gestational-age infants (4 times)
Gestational diabetes (8 times).

Obese women may also have lower success rate with infertility treatments including IVF. Obesity is a life-long, progressive, life-threatening, genetically-related, multi-factorial disease of excess fat storage. BMI (Body Mass Index) = Weight in Kg / Height in M2. For Asian populations, classifications remain the same as the international classification, but public health action points for interventions are set at 23, 27.5, 32.5 and 37.5. Obesity has reached epidemic proportions in India in the 21st century, affecting 20% of the country’s population and another 20% being overweight. 1.5 million deaths were reported due to obesity in 2000 and 20 million deaths due to obesity in 2010.

How weight loss improves fertility?

Excess fat in the body can contribute to hormonal imbalance and metabolic problems and weight loss is advised to resolve metabolic issues. Metabolic Syndrome is a condition in which excess body fat is accumulated to such an extent that health may be negatively affected and the life span is shortened. It is a group of diseases where increased abdominal girth more than 90 cm in males and more than 80 cm in females generally associated with increased BMI, diabetes, dyslipidemia, hypertension, polycystic ovarian disease, sleep apnea and non-alcoholic steatohepatitis.

Weight loss can significantly improve fertility in both women and men. It helps in restoring hormonal balance, improve ovulation, improve polycystic ovarian syndrome (PCOS). Even a 5-10% reduction in body weight can contribute to normalizing the hormone levels, improving ovulation, restoring regular menstrual cycles, and even increase pregnancy rates. Weight loss also can contribute to reduction in pregnancy related complications such as gestational diabetes, high blood pressure, preterm delivery, or miscarriages.

How can I lose weight?

Weight loss can be achieved by following a healthy lifestyle, having a balanced diet, regular exercise and managing stress and having adequate sleep. However, in obese or overweight patients who find it difficult to achieve the desired weight loss, medications, Bariatric surgery or Intragastric Balloon Placement would be an ideal option to consider for adequate weight loss.

Medications for Weight Loss

Orlistat, Semaglutide (oral / injections), Tirzepatide (1 week injection) are some medications that aids in weight loss.

Intragastric Balloon Placement for Weight Loss

It is placing a deflated balloon in the stomach using endoscope and then filling it to decrease the amount of intragastric space. It can be left in the stomach for a maximum period of six months. Intragastric Balloon placement results in average weight loss of 10 to 15 kg. It may be used in patients with overweight who are not suitable for Metabolic Surgery

Bariatric Surgery for Weight Loss

Bariatric surgery is effective in young infertile obese women who wish to become pregnant. The term “bariatric” surgery is derived from the Greek word baros for weight; defines surgical procedures designed to produce substantial weight loss.

There are different types of Bariatric Surgery:

Laparoscopic Sleeve Gastrectomy
Laparoscopic Gastroplasty
Roux-en-Y Gastric Bypass
Mini Gastric Bypass

Laparoscopic Gastroplasty is another Weight Loss procedure and the results are sustained even after many years. No chance of bleeding as there is no cutting involved. No leak as the stomach is not resected. Less expensive. Less duration of anesthesia. Early return to normal life. The procedure is reversible if patient desires.

Laparoscopic Sleeve Gastrectomy is a surgical procedure for weight loss. Sleeve gastrectomy is also known as a vertical sleeve gastrectomy or gastric sleeve procedure. In this procedure, the outer margin of the stomach is removed to restrict the amount of intake of food leaving the size of the stomach to about 15% of the original size of the stomach.

Gastric Bypass or Roux-en-Y Gastric Bypass is another surgical weight loss procedure for treatment of morbid obesity. In this procedure the stomach is divided into a small upper pouch and a large lower pouch. The small intestine is then reattached to the pouch that creates a bypass for food, which results in absorption of less calories and nutrients.

Can Bariatric Surgery Improve fertility?

Bariatric surgery has emerged as the most preferred, highly effective, and safer means to achieve long term resolution of type 2 diabetes and excellent improvement in fertility status.

Around 85 to 90 % of diabetes patients treated by these surgeries get complete resolution of diabetes. Whereas, the rest of them get significant control of diabetes with reduced dose of medication. In addition to diabetic control the other benefits are loss of excess weight and control of triglyceride levels. Sleep apnea, arthritis, cardiac episodes, kidney disorders and cancers are also reduced significantly. Studies show that metabolic surgery is cost-effective and safe.

IFSO Global Registry studied more than 1 lakh bariatric surgeries over 18 countries and has reported a mortality of 0.03%. SOS – Swedish Obese Subject Study (prospective matched cohort study with 15 years follow up) showed excellent results of metabolic syndrome resolution which is sustained even after many years.

Pregnancy after Bariatric Surgery

When can pregnancy be planned? Patients can conceive after 6 months of Bariatric Surgery. Generally, there is no need for any special nutrition or vitamin supplementation to these patients other than what is recommended for a pregnant lady routinely.

Frequently Asked Questions

Can obesity stop pregnancy?

Obesity makes it difficult for women to get pregnant. If they get pregnant, then there is higher risk of losing it.

Can losing weight improve fertility?

Weight loss can significantly improve fertility in both women and men by restoring hormonal balance.

How long after bariatric surgery can I become pregnant?

Patients can conceive after 6 months of Bariatric Surgery

Is bariatric surgery recommended before IVF

Yes, Bariatric Surgery is recommended in very obese patients before IVF as obesity contributes to lower success rate with infertility treatments. IVF may be avoided as post bariatric pregnancy chances are very high.

Does PCOS go away after weight loss?

Weight-Loss surgery resolves PCOS in majority. Most of the improvement in PCOS symptoms occurred during the first 12 months after bariatric surgery.

Dr. Padmakumar is a Senior Bariatric Surgeon in Kerala and also hailed as one of the Best Bariatric Surgeon in India & UAE. He is renowned for new and improved treatment techniques and the first in the World to perform Scarless Bariatric Surgery with Tummy Tuck / Abdominoplasty. He is the CMD of Keyhole Clinic, Center for Obesity and Laparoscopy in Kochi and he is heading MIS Department, VPS Lakeshore Hospital, Kochi, the lone Centre of Excellence in Bariatric and Metabolic Surgery (COEMBS) by OSSI (Obesity & Metabolic Surgery Society of India).

Video Testimonials after Bariatric Surgery

Testimonial	Watch
Ramesh Kumar presents his Bariatric Journey to wellness - From 157 Kg to 102 Kg in 1 year	Watch Video
Weight Loss from 138 Kg to 108 Kg in 3 months. Patient shares his experience from Oman	Watch Video
Weight Loss from 157 kg to 113 kg after Sleeve Gastrectomy. Patient shares experience of Sugar level coming down to normal condition after the surgery. 22 Kg weight loss in the first month itself.	Watch Video
Weight Loss after Bariatric Surgery from 85 Kg to 60 Kg. Cholesterol got normal, leg pain resolved	Watch Video
Weight Loss after Sleeve Gastrectomy - after One Year 130 kg to 80 kg. Had trouble breating, snoring before the surgery due to obesity. After surgery, snoring and trouble breathing has resolved.	Watch Video
Weight Loss after Bariatric Surgery April 2019	Watch Video

Dr. R. Padmakumar is one of the Best Hernia Surgeon in India. He has been changing lives through Keyhole Surgery. He has got more than 30 years of hands-on experience in laparoscopic Surgery in major hospitals across India and has completed more than 7000 cases of Laparoscopic Hernia Surgeries. Dr. Padmakumar has trained more than 300 surgeons from all over the world the art of laparoscopic surgery especially Laparoscopic Hernia Surgery. Dr. Padmakumar is also hailed as one of the Best Bariatric Surgeon in India & UAE. He is renowned for new and improved treatment techniques and the first in the World to perform Scarless Bariatric Surgery with Tummy Tuck / Abdominoplasty. He is also one of the very few thyroid surgeons in India doing Endoscopic Thyroidectomy (scarless thyroid surgery).