With in vitro fertilization, the conception process occurs “by externalization.” But that doesn’t mean you can’t be influenced. Weight normalization is a serious way to increase the chances of success. And this applies to both women and men. We talked about this topic with obstetrician-gynecologist and reproductive specialist Elena Mladova.
obstetrician-gynecologist, reproductive specialist, general director and chief physician of the REMEDI clinic
Adipose tissue is hormonally active. This means that it produces hormones that, among other things, affect how the reproductive system works. In addition, the lack and excess of body weight have similar consequences: the process of maturation of the ovum is disrupted, up to the complete disappearance of ovulation. In a word, weight problems themselves can cause infertility, and correcting body weight by just 5-10% can lead to a desired pregnancy.
Very simple: calculate your body mass index. This is the accepted method of weight assessment throughout the medical community. The optimal range of values is from 18.5 to 25 units. What do the numbers outside of it mean?
If a woman has a body mass index less than 18.5 and is not ovulating, the fertility specialist may refuse to treat the infertility until the patient gains weight. First, it is worth improving, and the problem may go away by itself. Second, low birth weight is a risk factor for preterm birth and low birth weight.
It is more difficult with him: formally, a BMI above 30 is considered obesity, however, indicators of 25 units already affect the reproductive system. Even if a woman does not ovulate, the chance of spontaneous conception with each BMI decreases by 5%. In some countries, such as the UK, the insurance company does not pay for IVF procedures for women with a BMI over 25. In Russia, there are no such restrictions, but a reproductive specialist will certainly recommend losing weight before starting the program.
Most of the time we have to deal with overweight patients. Before starting the IVF procedure, we always recommend losing weight, many times this process takes 6 months. In addition to diet and exercise, medication support may be recommended for the patient. Very simple: Calculate her BMI. This is the accepted method of weight assessment throughout the medical community. The optimal range of values is from 18.5 to 25 units. What do the numbers outside of it mean?
The ovaries respond worse to hormonal drugs and the follicles grow slowly. The probability of canceling the cycle increases, or few eggs are obtained “on the way out”.
It is difficult to make a puncture – a fence of mature follicles. The procedure is complicated by inconvenient access to the ovaries and increases the risk of anesthetic complications.
With obesity, conception time doubles.
This does not mean that pregnancy will not occur. But it is possible that further IVF procedures will be required, and this is time, nerves, money and health risks.
There is absolutely no need to eat “for two”. Overweight women should especially monitor weight gain. It should not exceed 11 kg (compared to 16 kg in women with normal weight).
Obesity is a risk factor for many pregnancy complications. Multiplies (1.5 times on average) increases the risk of developing obstetric complications (for example, gestational diabetes mellitus), which negatively affects the health of the mother and the fetus. The threat of miscarriage, preeclampsia, weakness of labor, premature birth, large fetal birth weight and its intrauterine death are also increasing.
Separately, it is worth mentioning such a pathology as a defect in the neural tube – the structure from which the child’s brain and spinal cord develop. Folic acid is essential for its correct formation. However, overweight women often experience a severe deficiency of this trace element, and the risk of serious malformations in the child jumps. Therefore, obese women should take folic acid in a higher dose.
In men, the same hormones are involved in spermatogenesis as in women – in the formation of eggs. Consequently, adipose tissue also negatively affects fertility. In addition, all indicators are deteriorating: both the number of sperm and their quality. Every 9 kilos of more increases the probability of infertility by 10%.
As with women, even a small amount of weight loss can lead to impressive results, and quite quickly: the sperm turnover cycle lasts two and a half months. Another argument in favor of proper nutrition is the health of future generations: children of obese parents are more likely to develop diabetes and metabolic disorders.