Lose Weight, Gain a Baby

Lose Weight, Gain a Baby
Carrying excess pounds can make conception a lot more difficult.

By Claire Sykes

June 2008

When it’s so in to be thin, being anything but carries a stigma, in addition to increased risks of serious illness. As if that’s not enough, it now appears that infertility—defined as 12 months of unprotected intercourse that doesn’t result in a pregnancy—is also related to obesity.

For women the main obstacle lies with lack of ovulation, when the body refuses to release an egg every month. Too much abdominal fat stores an excess of estrogen, maintaining a steady flow of this hormone instead of the fluctuation that’s needed for ovulation to occur. Meanwhile, levels of male hormones rise. All that estrogen and testosterone sends the wrong message to a woman’s brain, where the pituitary gland, which controls ovulation, lies. How can anyone get pregnant with that going on?

Problems for Her—and Him
     Linda Dement of Seattle couldn’t. With only two periods a year and lugging 265 pounds around on her five-foot-two-inch frame, the 34-year-old accountant assumed she was at fault for her infertility. Then she and her husband found out that his vas deferens, the ducts that sperm whiz through on their way to the outside world, were missing.

“When a couple is having trouble conceiving, evaluation by a fertility specialist is a good idea,” says Clarisa Gracia, MD, MSCE, assistant professor of obstetrics and gynecology at the University of Pennsylvania. It’s pretty easy to count and evaluate sperm, so “rule out any male
problems, first. When a woman has irregular menstrual cycles, look for signs of hormonal imbalances, such as abnormal body hair, indicating an excess in testosterone.” Testing may reveal polycystic ovarian syndrome (PCOS), marked by many cysts on the ovaries, hormonal imbalances and ovulation problems. But if his sperm and both partners’ hormone levels are normal, and if the woman doesn’t have blocked fallopian tubes or poor thyroid function, then the problem may be caused by too much weight.

“Obese people usually have some medical problems already. Infertility is just another hit,” says Michael R. Soules, MD, managing partner of Seattle Reproductive Medicine. “Studies have shown that just a 5% to 10% loss of your current weight often will get your ovaries working again on their own. It’s impractical to suggest a normal weight because it’ll take too long and meanwhile, the ovaries are aging.” Of course, Soules means that you shouldn’t wait until you reach your ideal weight before trying to conceive—definitely keep dropping pounds for the sake of your overall well-being.

Your partner may want to get fit with you: A Danish study has found that conception can be difficult when both partners are overweight or obese (Human Reproduction 6/07). Obese men can have problems with poor sperm counts or quality, in addition to weight-related hormonal imbalances. As a result, they’re twice as likely to be infertile than men of normal weight, according to the National Institutes of Health. Dads-to-be may also want to take folate, a B vitamin long recommended for women to reduce the risk of birth defects. UCLA researchers have found a link between low folate levels and an increased risk of defective sperm (Human Reproduction 3/08).

Finding Fertility Naturally
     Dement “wanted a child so desperately,” so she began shedding the pounds three years ago. “Sure, I sometimes crave pizza, but I’ve learned that I can be happy with some fish, and rice and vegetables, instead.” Along with eating a healthful, balanced diet, she quit smoking and has kept up a daily, three-mile walk.

What about herbs and supplements? “If you’re obese, they may help you get pregnant, but weight loss is paramount,” insists Laurie Cullen, ND, of Bastyr University in Seattle. “My protocol to encourage ovulation, whether you’re obese or not, is through a weight-loss or weight-maintenance program; beta-carotene, a nutrient for ovarian function; and chaste tree berry (also known as vitex), for its hormonal effects of optimizing ovulation.” Cullen says that her program has had a success rate of at least 50%. While such fertility aids as in vitro fertilization result in a live-birth rate of more than 82%, according to the US Centers for Disease Control, only 55% of those births are single babies.

By this past February, Dement had reduced her weight to 200 pounds and started having regular periods again. Her blood sugar level dropped 49 points, her cholesterol 39 points—and her dress size from 24 to 14-16.

But Dement didn’t accomplish all this just so she could try to conceive. If she’s fortunate to get pregnant and steer clear of obesity, she’ll also more likely avoid gestational diabetes, the kind that strikes pregnant women, and hypertension, as well as premature delivery and miscarriage. In addition, she’ll have a much easier time giving birth, and doing so to a healthy baby.

“I want my child to live a healthy, happy life,” Dement says. “I also want to be a physically fit mom who can play with her kids.” If she continues to eat well and exercise, she will be—all through their lives.

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