The complications for obese women to conceive and deliver a healthy baby are often discussed while the outcomes of being underweight and the connection between obesity and male infertility are neglected. The concept of weight management in respect of fertility is strictly subjective and unique for each couple which is why a thorough assessment of both partners and opinion of your consultant are significant.

Overweight or Underweight?

It is no secret that obesity is a hurdle for couple who is trying to conceive a baby. An obese body has a set of challenges that are not favourable for conception. However, being lighter than one should be is also a hindrance.

Unstable Hormones

Those extra pounds in the female body is going to negatively influence the hormone production which is key to the whole reproductive system. The fat cells cause excessive production of oestrogen and this will block production of other hormones such as LH (luteinizing hormone) and FSH (follicle-stimulating hormone) which triggers ovulation. Overweight women are likely to produce excess insulin as well which will induce reproduction of male hormones in ovaries resulting in ovulatory dysfunction. These patterns are obstacles enough and they are also capable of leading to PCOS.

No Exception for Men

Men are also subjective to a number complications raised by being overweight and underweight. Hormone imbalances caused by obesity will affect the production and quality of sperm such as count and motility. Underweight men are more likely to have low sperm count which hinders pregnancy.

Look Out For PCOS

While the connection between PCOS and weight gain is not crystal clear, there is no denial that these two are linked. PCOS causes excessive production of insulin which eventually leads to weight gain. The hormonal imbalance due to obesity can also cause PCOS. And it is next to impossible for an overweight woman with PCOS to lose weight. However, it is clear that obese women are at higher risk of PCOS which is not a good news if you are trying to conceive.

After Crossing the Hurdles

If you managed to overcome all the biological hurdles and conceived, it is only going to get more complicated from here on. The risk rate is high for an obese mother and her foetus. The possibilities of high blood pressure, pre-eclampsia, gestational diabetes, blood clotting and even miscarriage are not vague.

The chances of the foetus being larger than average are high which narrows the chances of a normal delivery. Imbalanced hormones might not induce a natural labour which can also demand a caesarean section. A highly complicated delivery can even result in the birth of an unhealthy child or even stillbirth.

What Happens To Your Baby?

The baby’s health is influenced by the conditions under which the sperm and egg is developed. Excess body fat is not a favourable condition for the development of healthy sperm and egg.

An obese mother’s new born is at risk of childhood obesity and long term health problems as well. On the other hand, underweight woman should be concerned about the poor health of her child. Your lack of nutrition might cause an early delivery of an underweight premature baby with several health issues which will be followed by an unhealthy childhood.

Find Your Ideal Weight

Your ideal weight is defined by BMI (Body Mass Index) which is the ratio of your height to weight. A person’s optimum BMI is 18.5-25. A person with Body Mass Index lower than 18.5 is underweight and likely to have weak body. A BMI higher than 25 leads to obesity and problems related to it.

A BMI of 30-35 is considered as class I obesity which has relatively lower risk rate. Class II obesity which is indicated by BMI of 35-40 and it comes with moderate risk during pregnancy. But anything higher than a BMI of 40 indicates class III obesity and it comes with high health risks.

BMI Chart

Height (cm) Weight (kg) BMI Analysis
140 36 and less 18.4 and less Underweight
140 40 – 48 20.4 – 24.5 Normal
140 49 – 58 25 – 29.6 Overweight
140 59 and more 30.1 and more Obese
150 41 and less 18.2 and less Underweight
150 42 – 56 18.7 – 24.9 Normal
150 57 – 67 25.3 – 29.8 Overweight
150 68 and more 30.2 and more Obese


Normal BMI and IVF Success Rate

Optimum BMI has been proven to be supportive to IVF treatments because hormones and other bodily functions are normal at this point. Women with higher BMI and lower BMI shows lower response rate to medication given to initiate or regulate ovulation. Eggs retrieval, anaesthesia and embryo transplant are also difficult with obese women. Even after conceiving, they are more prone to miscarriage.

Obesity – How to Deal With It?

A couple planning to have a baby should start working on their ideal BMI at the earliest. It will not be a mountain task with a healthy diet and a work out plan along with suggestions of a health professional. Be sure to eliminate your disadvantageous habits such as sugary drinks and alcohol along with filling half of your plate with veggies and fruits at lunch as well as dinner to cleanse your body.

It is not necessary that you sweat it out in the gym. A morning/ evening walk with few simple exercises at home will do the trick. Walking few a kilometres instead of hiring an auto or taking stairs instead of elevator will also help you shed some of those extra pounds.

It is important to set a realistic goal and no matter how little weight you lost, it does count. Every ounce of fat you lose will help to get closer to your pregnancy. Having a friend or your partner on this journey will be motivational and you might even end up having a fun while developing a healthy habit.

About the Author

Dr. Parasuram Gopinath is the Senior Consultant & Scientific Director at CIMAR Fertility Center with branches in several parts of Kerala. Tamil Nadu & Dubai. After Dr Parasuram completed his post-graduation in Obstetrics and Gynecology, his work has been mainly focused on infertility and embryology. He had undergone further training in Advanced Reproductive Techniques like Oocyte Cryopreservation, IMSI, IVM etc. from several centers in Singapore, Germany & Canada. He has personally done over 3000 ICSI procedures and was instrumental in introducing the technique of IMSI in South India. He is an Invited speaker at Several National conferences on Infertility and do also have several publications to his credit.

Dr. Parasuram Gopinath

Dr. Parasuram Gopinath, MBBS. MS(OBG)

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