Weight Loss and Fertility
Did you know that weight issues in women, both underweight and overweight, are a major contributing factor of infertility?
Being underweight or overweight can significantly disrupt the reproductive system. It can cause menstrual dysfunction leading to anovulation and infertility (1).
A decrease or increase of adipose tissue (body fat) in underweight/overweight women may disrupt the regulation of the reproductive system through the Hypothalamic-Pituitary-Gonadal (HPG) axis.
How can underweight influence fertility?
Leptin is a hormone produced primarily by adipose tissue in the fat cells. It plays an essential role in weight regulation. Leptin travels to the hypothalamus via our circulatory system. It communicates to the brain when the body has enough stored fat, which then decreases appetite and therefore, food intake.
Leptin levels can alter the HPG axis and consequently, the hormones in the reproductive system. When we diet extensively and lose a lot of weight or become even underweight, Leptin levels drop significantly. As a result, this drop can lead to a decrease of two crucial hormones for ovulation: luteinising hormone (LH) and follicle-stimulating hormone (FSH) (2).
Underweight women may also not produce enough oestrogen to support ovulation and maybe lacking the nutrients required for a healthy cycle. They are likely to experience anovulation, irregular cycles, or amenorrhoea (absence of a period) (1). By putting on weight to reach a healthy BMI, there is a much higher likelihood of falling pregnant; it might even be just a few kilograms that makes the difference!
How can overweight influence fertility?
At the other end of the scale, an excess of fatty tissue can cause insulin resistance, inflammation, hypertension, and hormone dysregulation (3). A high body mass index (BMI) is responsible for 25-50% of female infertility (1). Causes might be impaired reproductive function or impaired endometrial implantation, as well as an increased risk of complications, including an increased miscarriage rate. Also, anovulation is detected more frequently in overweight women than in average weight (1).
A high BMI also comes with a risk of comorbidities, including high blood pressure, diabetes type II, cardiovascular disease, all of which have an impact on fertility. Abdominal obesity is associated with elevated insulin and insulin resistance which can stimulate androgen production in the ovaries and cause hormonal imbalance (2). Losing 5-10% of your body weight can significantly increase your chances of conception.
Lifestyle modification and weight management can provide potent solutions to the problem.
If you have been struggling to conceive or need help to manage your weight, you can make an appointment with us through our online booking system, or give us a call on 3371 0100. Our practitioners can help you with nutritional advice, lifestyle medicine and the tools of acupuncture and herbal remedies.
- Giviziez C, Sanchez E et al. 2016, ‘Obesity and anovulatory infertility: a review’, JBRA Assisted Reproduction, vol. 20, no.4, pp. 240–245. <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5265624/>
- Dhillo, W and Sam, A 2010, ‘Endocrine links between fat and reproduction’, The Obstetrician & Gynaecologist, vol.12, pp. 231-236. <https://obgyn.onlinelibrary.wiley.com/doi/pdf/10.1576/toag.22.214.171.124614>
- de Pergola, G, Loverro, G, et al. 2018, ‘Obesity as disruptor of the female fertility’, Reproductive Biology and Endocrinology, vol. 16, no. 22, <https://link.springer.com/article/10.1186/s12958-018-0336-z>