Obesity and Infertility

Obesity is a rising epidemic affecting millions globally. There is a significant concern about the high prevalence and increasing trend of obesity worldwide.

Obesity is a medical condition in which excess body fat has accumulated to the extent that it may harm 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

BMI- 18.5-24.9 – Ideal BMI25-29.9 – 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 lifestyle.

• Endocrine disorders like thyroid disorders and diabetes.

• Genetic susceptibility

• Medications (Antipsychotics)

Obesity influence the reproductive cycle by impaired estrogen metabolism, changes in the concentration of sex hormone-binding (SHBG) globulin, hyperinsulinemia, and probably also leptin levels. Obesity causes anovulation, menstrual irregularities, subfertility, a decline in oocyte quality, a decrease in pregnancy rates, and an increased risk of miscarriages.

PCOS is a pervasive endocrine disorder among obese women in the reproductive age group.PCOS is associated with obesity or overweight and symptoms of high male hormone secretion (hyperandrogenemia) such as acne, hirsutism, anovulation, high cholesterol levels & insulin resistance.

In men, obesity leads to low testosterone and low estrogen levels. This can lead to low sperm count and quality, oligoasthenospermia in obese men. It can also cause erectile dysfunction.

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 critical in the present scenario. Inculcating a healthy lifestyle and a healthy diet is vital in reducing obesity. Diet should include natural fruits & vegetables. To avoid high calories, processed and preserved food. Daily exercise and healthy food habits are recommended for the adolescent age group. By following a healthy diet and lifestyle activities, obesity and many more diseases can be prevented.

Only a 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 is the most common treatment for infertility in women with PCOS.

• ACOG recommends that clomiphene be the primary medication for PCOS patients with infertility.

Medications like orlistat and sibutramine are prescribed for weight loss for people with BMI over 307. Bariatric surgery for obesity is recommended when BMI >35-40. Hence, it is necessary to find practical solutions and support people to achieve and maintain a healthy weight.