OBESITY AND INFERTILITY
Obesity is a rising epidemic affecting millions worldwide. There is a great concern at the high prevalence and increasing trend to obesity all over the world.
Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health.
Body Mass Index is calculated and classified as normal, overweight, obese or morbid obesity.
BMI is calculated by dividing weight in KG by height in m2
Wt in kg
Ht in m2
BMI- 18.5-24.9 – Ideal BMI
25-29.9 – Overweight>30 – Obesity
Obesity is defined as an abnormal accumulation of body fat usually 20% or more, over an individual’s ideal body weight. It is often described as BMI >30.
- Excessive high calorie food intake.
- Sedentary life style.
- Endocrine disorders like thyroid disorders, diabetes.
- Genetic susceptibility
- Medications (Antipsychotics)
Obesity and Fertility
Obesity influences the reproductive cycle by impaired estrogen metabolism, changes in the concentration of sex hormone binding (SHBG) globulin, hyperinsulinaemia, and probably also leptin levels.
Obesity causes anovulation, menstrual irregularities, subfertility, decline in oocyte quality, decrease in pregnancy rates and increased risk of miscarriages.
PCOS is a very common endocrine disorder among obese women in reproductive age group.
PCOS is associated with obesity or overweight along with symptoms of high male hormone secretion(hyperandrogenemia) such as acne, hirsutism,anovulation, high cholesterol levels & insulin resistance.
Obesity in Men
In men, obesity leads to low testosterone and low oestrogen levels. This can lead to low sperm count and quality,(oligoasthenospermia)in obese men. It can also cause erectile dysfunction.
Other risks associated with Obesity.
Cardiovascular disease, type 2 diabetes, osteoarthritis, obstructive sleep apnoea syndrome, asthma, hypertension (High blood pressure) cancer, fatty liver.
Obesity has been found to reduce life expectancy.
Prevention of obesity is very important in the present scenario. Inculcating healthy life style and healthy diet plays a very important role in reducing obesity. Diet should include natural fruits & vegetables. To avoid high calories, processed and preserved food. Daily exercise and healthy food habits to be recommended from adolescent age group.
By following healthy diet and life style activities obesity and lot more diseases associated with it can be prevented.
Only 5% reduction in body weight can increase ovulation rates, and reduce hormonal and biochemical abnormalities.
1 Reduction of calorie intake along with increased physical activity is advised.
2 Medications for PCOS associated with infertility
- T.clomiphene citrate – This is the most common treatment for infertility in women with PCOS.
- ACOG recommends that clomiphene should be the primary medication for PCOS patients with infertility.
3. Metformin – It is used as an adjunct to regulate ovulation in women with PCOS.
4. Gonadotrophins –Next line of treatment for PCOS women with anovulatory cycles.
5. Ovarian drilling- In severe cases who do not respond to medications.
6. Medications like orlistat and sibutramine are prescribed for weight loss for people with BMI over 30
7. Bariatric surgery for obesity is recommended when BMI >35-40
World obesity day is observed globally on October 11 to help find practical solutions and support people to achieve and maintain a healthy weight.