How Weight Impacts Pregnancy & Fertility
For years, researchers have seen a strong link between weight and infertility, and as doctors, we often see women struggling with fertility and weight-related issues in our practice.
I recently read an article in the New York Times that brought a personal face to the challenges overweight women face when trying to conceive and wanted to share this story with you. Not all of us look the same or have the same body type and I think it’s important for those who may be experiencing fertility issues to know that they’re not alone. We’re always here to lend a listening ear without judgment and strive to provide compassionate care to all of our patients.
Below is the story of Gina Balzano, as told by the New York Times, which may be of interest to you if you’re in a similar situation.
Gina and her husband, Nick, had dealt with three years of negative pregnancy tests between 2010 and 2013. Balzano had always had very painful periods, so she decided to find out what was going on. While Gina didn’t have any health conditions like high blood pressure, diabetes, or high cholesterol, she was used to being told that weight loss was the answer to her problems and expected this to come up as she considered IVF.
At their first doctor’s appointment, indeed, Gina and her husband were told that she would have to lose weight before being considered for IVF. In fact, the clinic she went to had a policy that prevents patients with a BMI (body mass index) of 45+ from receiving IVF. Gina’s BMI was 51.2. After getting several opinions, Gina did pursue medical support to aid her in losing weight, and in three months, her BMI was 32.1
Gina and Nick Balzano’s son, Anthony, was born in June of 2018, after two rounds of IVF. The doctor that she saw who helped her to get pregnant was not sure that her fertility issues were related to weight, but there are a number of studies that seem to have found a link, going back to 1952.
The Link Between Weight and Infertility
The 1952 study, titled “The Relation of Obesity to Menstrual Disturbances,” surveyed a group of 100 women between the ages of 16 and 40. Each of these women had been given diagnosed with menstrual disorders. This group’s weight was then compared to the weight of a control group, made up of women who had no reproductive health issues. The study found that 43% of the participants with menstrual disorders weighed 20% or more than their ideal weight, compared to 13% of participants in the control group. The authors of the study concluded that this was proof of a link between obesity and “menstrual disturbances.”
Ever since this study, many other doctors and researchers have accepted the idea that there is a link between a high body mass and infertility. And it’s true, there are certain aspects of IVF that are more complicated for heavier women. For example, when retrieving eggs, a doctor may have to go in through the patient’s abdomen rather than her vagina, and they might not be able to retrieve as many eggs.
However, weight loss can take up valuable time in a woman’s life. Gina, for example, was 37 by the time she had completed her weight loss surgery and was ready to start IVF. This meant she had thousands fewer high-quality eggs than when she started tried to get pregnant. Another issue is that crash diets and other forms of weight loss are often not sustainable, and therefore don’t last.
So what does this mean?
At the very least, it means that there is still more work to be done when looking at the potential connection between weight and infertility. At A Woman’s Healing Center, we believe that everyone deserves the best health care, no matter their body type.
What we generally see is that while weight loss may help some women get pregnant, it’s not a one size fits all solution, and there may be other reasons for a woman’s infertility. One common syndrome I, and Dr. Skorberg, frequently see and treat is called Polycystic ovary syndrome (or PCOS).
Polycystic ovary syndrome (or PCOS)
What is PCOS?
Polycystic ovary syndrome impacts 1 in 10 women of childbearing age and is caused by the presence of excess estrogen and an imbalance in reproductive hormones. PCOS disrupts the normal ovulation cycle and thus women with PCOS can find it hard to get pregnant. They also frequently struggle with weight and weight-related health issues.
What are the symptoms of PCOS?
In addition to weight gain or difficulty managing weight, women with PCOS can experience a variety of symptoms, including:
- Irregular menstrual cycle. Women with PCOS may miss periods or have fewer periods (fewer than eight in a year). Or, their periods may come every 21 days or more often. Some women with PCOS stop having menstrual periods.
- Too much hair on the face, chin, or parts of the body where men usually have hair. This is called “hirsutism.” Hirsutism affects up to 70% of women with PCOS.
- Acne on the face, chest, and upper back
- Thinning hair or hair loss on the scalp; male-pattern baldness
- Darkening of skin, particularly along neck creases, in the groin, and underneath breasts
- Skin tags, which are small excess flaps of skin in the armpits or neck area
Preconception Visits and How We Can Help
A Woman’s Healing Center specializes in treating PCOS and other conditions that may make it challenging for women to get pregnant. If you’re considering getting pregnant or have been trying to conceive for some time, we highly recommend that you come in for a “preconception visit.” During this visit Dr. Skorberg or I will talk with you about your plans, will help you to ensure you’re as healthy as you can be before getting pregnant, and can address any fertility concerns you might have.
If you’re concerned about infertility or weight loss, please don’t hesitate to reach out to us. We would be happy to talk to you about your concerns and find a treatment path that’s right for you. You can click here to contact us, or fill out the form below to request an appointment with me or Dr. Skorberg.