Fertility challenges can be a deeply personal and emotional struggle for many individuals and couples trying to conceive. While many factors can influence your ability to conceive, one significant yet often overlooked factor is body weight. You’re 30% more likely to struggle with infertility at some point in your life if you’re overweight. Whether you’re trying to conceive naturally or through assisted reproductive technology, maintaining a healthy body weight can have a profound impact on fertility outcomes.

Bariatric surgery experts Dr. Kyle Thompson and Dr. John Raheb from the Denver Midtown Clinic – Weight Loss Center, provide insights into the connection between fertility and weight and how weight loss methods can aid your fertility journey.

The Link Between Weight and Fertility

Excess weight can impact fertility in several ways. For men, lower testosterone levels reduce sperm production and quality. For women, obesity can have numerous negative and complex impacts on fertility.

Hormonal Imbalances

A lot of conception and fertility relies on the alignment of your hormones. According to the National Institute of Health, obesity can seriously affect hormone levels, leading to imbalances, often due to overproduced estrogen. Imbalanced hormones disrupt ovulation and menstrual cycles, leading to irregular or absent periods, making it more difficult to track and monitor fertility.

“Infertility may be due to abnormalities in oocytes (immature eggs) or ovulation arising from decreased luteal hormones in the hypothalamic-pituitary-ovarian axis of eumenorrheic overweight women,” says Dr. Raheb.

Besides irregular periods and weight gain, other signs of hormone imbalance might include:

• Chronic fatigue
• Sleep problems
• Low libido
• Hair thinning or loss
• Mood swings or depression
• Acne
• Digestive issues
• Breast tenderness
• Night sweats and/or hot flashes
• Brain fog or memory loss

If you think imbalanced hormones are causing your weight gain, fertility issues, or any other problems, talk to your primary care doctor.

Increased Risk for Polycystic Ovarian Syndrome and Other Conditions

Due to hormone imbalances caused by excess weight, women who struggle with their weight are at a higher risk for Polycystic Ovarian Syndrome (PCOS). PCOS occurs when your body develops small, fluid-lined sacs around your ovaries, leading to irregular and/or extremely painful periods and inconsistent ovulation. While the exact cause of PCOS is unknown, it’s the number one cause of infertility in women.

“Obesity can negatively affect women’s fertility via menstrual and ovulatory disorders,” Dr. Raheb says. “Such disorders include PCOS, the most common cause of female infertility, affecting 6% to 10% of women of child-bearing age.”

PCOS isn’t the only disease that can affect fertility if you struggle with your weight. According to the National Institute of Health, you might be more prone to insulin resistance, high-risk pregnancies, hypertension, and even certain types of cancers, which could affect your fertility and the health of your current or future pregnancy.

“Obesity and its related comorbidities decrease fertility, impact the health of a mother during pregnancy, and the health of the baby,” Dr. Thompson says. “Overall, obesity negatively impacts a woman’s health and reproductive system and leads to increased rates of cancer in reproductive organs such as the uterus.”

How Weight Loss can help you on your Fertility Journey

Weight loss is a journey as personal and emotional as your fertility journey. The first step is to determine why and how you’re struggling with your weight by making an appointment with your primary care doctor.

If you’re suffering or think you may be suffering from a hormonal imbalance, PCOS, insulin resistance, or any of the other disorders listed above, weight loss can be a tremendous help.

Keys to Losing Weight:

• A healthy, portion-controlled diet focused on whole grains, fruits, vegetables, and lean protein.
• A cardiovascular-based exercise you enjoy, such as swimming, walking, biking, or jumping rope.
• Drinking plenty of water.
• Getting healthy, adequate sleep.
• Receiving support from friends, family, and medical professionals.

However, if you find these changes to be making little difference, you may be a good candidate for surgical intervention.

Is Bariatric Surgery Right for Me?

Most insurance plans which cover bariatric surgery offer surgery to those with a BMI of 40 or higher or those with a BMI of 35 or higher with an obesity-related medical condition. After receiving a referral from their primary care doctors, patients will sit down with a bariatric surgeon to determine which American Society for Metabolic and Bariatric Surgery (ASMBS)-endorsed surgery is right for them.

Dr. Raheb says that patients who struggle with obesity-related diseases see significant improvement in their conditions. Those who may have been prone to obesity-related conditions prevent their onset entirely.

“Metabolic surgery, also known as weight-loss and bariatric surgery, is the most effective and durable treatment for severe obesity, producing significant weight loss and preventing, improving, or eliminating many related diseases,” Dr. Raheb says.

If you’re considering bariatric surgery for fertility improvement purposes, both doctors recommend that you wait at least 12 months before trying to become pregnant after the surgery is performed. However, the improvements in fertility and fetal health in patients who have undergone a bariatric procedure are generally positive.

“In addition to improving fertility, patients who have bariatric surgery have a lower chance of having a post-term pregnancy (pregnancy lasting longer than 42 weeks), less need for induction of labor, fewer complications from epidurals, and less risk of lacerations and bleeding during childbirth,” Dr. Thompson says.

Weight Loss is Not a One-Size-Fits-All Solution

A healthy diet and exercise are the building blocks of weight loss. But for many women, hormonal imbalances, chronic illness, or other issues can make weight loss much more difficult. That’s why it’s important, especially when you’re pregnant or thinking about becoming pregnant, to talk with your primary care provider. They can help you with every step of your journey and connect you with expert fertility, weight loss, or any other care you might need to start your fertility journey.