Obesity has also been associated with an increased risk of early pregnancy loss after IVF (In vitro Fertilization), decreased pregnancy rate, decreased fertilization, higher gonadotrophins requirements, as well as an impaired response to gonadotrophins. The cause of a poor IVF treatment outcome from a Fertility Clinic may be due to poor oocyte quality with subsequent lower fertilization and /or implantation defects caused by a qualitatively poor endometrial milieu. Finally, there are a number of endocrine changes that are associated with being overweight or obese. Please consult with your Fertility Doctor or local Fertility Clinic.
The conventional approach in the past has been to carefully monitor fertility patients who have high risk pregnancies; e.g. gestational diabetes, multiple gestations, etc. Based on more recent data, it seems that overweight/obese individuals represent another high risk group. Yet, widespread routine high risk screening of obese infertility patients has not become the standard of care.
Therefore, treatment of the infertile, overweight/obese patient should include a multidisciplinary approach to weight management that fosters lifestyle change through proper diet, exercise, behavior modification and stress reduction in concert with pharmacologic approaches (e.g. Metformin) when indicated. Once pregnant, it may be prudent to follow these patients closely due to their propensity to becoming high risk.
By providing a more holistic approach to obesity and reproductive health preconceptually, we may be able to have a powerful impact on infertility by improving their chances of conception, achieving a healthy obstetric outcome and possibly enhancing their overall health.