Does excess weight affect fertility? How can bariatric surgery help?
Infertility is a medical condition. It can affect both men and women, which makes pregnancy difficult. There are many risk factors for infertility, and most of them are related to genetics, the environment, or lifestyle. Being overweight or obese can significantly lead to various health problems, and infertility is one of them. It is caused by hormonal imbalances, which affect both men and women.
Infertility in obese women
Many studies by experts say that conceiving can be challenging in women who are overweight or obese compared to women who are normal-weight. Though obese women conceive, the risk of miscarriages is high.
Excess weight, especially around the abdominal area, can lead to insulin resistance and reduce SHBG (sex hormone-binding globulin) levels. SHBG is an important protein that regulates the androgen and oestrogen.
These abnormal hormonal issues interfere with the reproductive process; they negatively influence ovulation and sperm production.
Especially in obese women, it can lead to overproduction of insulin, which may result in ovulation problems. Moreover, excess insulin production can lead to an infertility condition known as polycystic ovarian syndrome (PCOS). It is associated with irregular menstrual cycles, anovulation, and increased male hormone levels.
Infertility in obese men
Obesity can negatively impact the fertility of men, as many studies have demonstrated. Men with excess weight are at higher risk of infertility compared to healthy-weight men. According to the National Institute of Environmental Health Sciences (NIEHS), the risk of infertility increases for every 10 kg increase in body weight above BMI.
Hormonal imbalance in men can negatively impact testicle stimulation, which interferes with sperm production. Excess fat in obese men converts testosterone (male hormone) into estrogen and higher estrogen levels reduce the testicular stimulation. Studies suggest that men with high BMI have 24% to 26% lower testosterone levels compared to men with healthy weight. Studies show that men with higher BMI often have abnormal semen analysis.
The production of gonadotropin-releasing hormone (GnRH) is reduced by excess body fat. GnRH plays an important role in reproduction; in women, it promotes regular ovulation, and in men, it promotes healthy sperm production. Especially, it triggers the pituitary gland to release luteinizing hormone (LH) and follicle-stimulating hormone (FSH), both of which are important hormones as they play crucial roles in the development of eggs and sperm.
How can bariatric surgery help to improve fertility?
Bariatric surgery is an advanced surgical procedure specially designed to help obese people who want to lose weight loss. Multiple bariatric procedures are available, which include gastric bypass, sleeve gastrectomy, adjustable gastric banding, etc. Almost every bariatric procedure works by making changes to the digestive system, which intends to limit food consumption and improve metabolism.
By now you may understand that excess weight has a negative effect on reproductive health, which leads to infertility. However, bariatric surgery can be a life-changing option that helps to treat obesity-related fertility issues in both men and women. Reproductive functions improve after bariatric surgery, which eventually increases the chances of conception.
Hormonal imbalances are the reason for fertility issues, which are caused by excess body weight. After bariatric surgery, the hormonal levels will be restored, which favours regular menstrual cycles in women and improves the quality of sperm in men.
Many obese women experience anovulation (reduced or no ovulation), which is caused by insulin resistance and hormonal fluctuations. However, weight loss gained after bariatric surgery reduces insulin resistance, which regulates ovulation better and improves menstrual cycles, particularly in women with PCOS problems.
Pregnancy in obese women has many complications, like gestational diabetes, preeclampsia, and miscarriage. However, post-bariatric surgery, one can achieve a healthier weight, which improves the chances of a safer pregnancy by minimising the likelihood of complications.
In men, hormonal issues caused by weight gain reduce sperm count and affect motility. However, bariatric surgery helps to lose weight quickly and elevates testosterone levels, which improves sperm production and health.
Weight loss after bariatric surgery lowers chronic inflammation and improves insulin resistance. Thus, it creates a healthier reproductive environment that is favourable to conception.
Tips to improve reproductive health following bariatric surgery
To ensure a healthy pregnancy after a bariatric procedure, it is recommended to wait 12 to 18 months before trying to conceive. During this time, your body tries to rebalance itself in many ways, like restoring hormone levels and improving nutrient absorption and metabolism.
Nutrient deficiencies are one of the common problems with bariatric surgery due to rapid weight loss. Your body may not receive sufficient nutrients (iron, vitamin B12, folic acid, and calcium). So it is suggested to take nutritional supplementation and monitor their levels regularly so that you can prevent complications.
After any weight loss surgery, you may not be able to eat much, so adopting a well-balanced diet rich in proteins and minerals is very important. It helps to stabilize and maintain your hormonal levels and promotes reproductive health. After surgery, consult a dietitian for the best nutrition plan.
To maintain a healthy body weight, engaging in regular physical activity is very necessary. Exercising regularly also reduces stress, which is vital for fertility. Consult a physical therapist for a tailored exercise plan, and you start with walking, yoga, and light strength training activities.
As you are planning to conceive, consult an endocrinologist and gynaecologist regularly after surgery, as they can help you track your hormone levels and overall reproductive functions.
Bariatric surgery can improve obesity-related infertility by enhancing reproductive functions. If you are obese and looking for the best weight loss solutions, consult Dr. Venugopal Pareek, one of the best bariatric surgeons in Hyderabad. Call +91 91777 77715 for an appointment booking.
