Obesity & Fertility
If you’re trying to conceive, weight can play a bigger role than many people realise.
Obesity can disrupt the delicate hormonal balance that controls the reproductive system — in both women and men.
In women, excess weight may lead to irregular menstrual cycl35es, polycystic ovary syndrome (PCOS), problems with ovulation, or reduced success with fertility treatments. In men, it can affect testosterone levels, sperm count, and sperm quality.
These issues can make it harder to get pregnant — and can also increase the risk of complications during pregnancy, including gestational diabetes, high blood pressure, and birth complications.
But there’s hope.
Losing weight can improve fertility — naturally and safely.
4.9.1 Bariatric/metabolic surgery could be considered to improve weight loss, hypertension, diabetes (prevention and treatment), hirsutism, irregular menstrual cycles, ovulation and pregnancy rates in women with PCOS.
4.9.2 Bariatric/metabolic surgery in women with PCOS should be informed by general population guidelines.
4.9.3 PCOS is a metabolic condition and could be considered an indication at a lower BMI threshold for bariatric/metabolic surgery similarly to other metabolic conditions including diabetes.
4.9.4 Women should be strongly counseled on the likelihood of rapid return of fertility and the need to commit to effective contraception, ideally prior to surgery. Even when pregnancy is desired, contraception should be continued until a stable weight is achieved, usually after one year, to avoid significantly increased risk of growth restriction, prematurity, small for gestational age, pregnancy complications and prolonged hospitalisation of the infant.
For IVF patients, there are significant higher risks of cycle cancellation, treatment and pregnancy failure with increasing obesity.
Both sleeve gastrectomy and gastric bypass (RYGB) are effective and safe in improving fertility, achieving significant weight loss and supporting favourable pregnancy outcome.
After achieving sustained weight loss, over 70% of patient with primary infertility managed to conceive.
100% patients with secondary infertility managed to conceive.
(ASMBS: American Society for Metabolic and Bariatric Surgery)
(IFSO: International Federation for the Surgery of Obesity and Metabolic Disorders)
“Obesity is associated with diseases affecting nearly every organ system. They include …reproductive system (polycystic ovary syndrome, infertility) … “
For patients with Class I obesity (BMI <35), surgery “should be considered for suitable individuals” with polycystic ovarian syndrome or infertility if attempts with nonsurgical therapy have not been effective.
