WILL LOSING WEIGHT REALLY HELP ME FALL PREGNANT?
Q: I’ve been trying to conceive for a year now, but my doctor just tells me to lose weight and then it will happen. Surely it can’t be that simple – my period isn’t regular so I think the cause of my inability to conceive must be something else, not the extra 15kg I’m carrying! Could it be PCOS? A: Dr Nedic answers: Obesity affects fertility by causing hormonal imbalances and problems with ovulation. Insulin resistance, which usually presents with stubborn belly fat, is associated with polycystic ovary syndrome (PCOS), a complex hormonal disorder affecting young women at a reproductive age. While obesity, hypertension and insulin resistance are a few of the symptoms of PCOS, it is also the leading cause of infertility. In an article published over 10 years ago in the BMJ (formerly known as the British Medical Journal) it was already found that PCOS was accounting for 90-95% of women who attend infertility clinics with anovulation. In some menstrual cycles, an egg does not mature, and a woman does not ovulate, which is referred to as anovulation. A weight loss of as little as five to 10 percent can improve a woman’s chance of falling pregnant. In fact, in the world’s first comprehensive study on weight and its effect on fertility, researchers found that losing even five percent can have a significant effect on a woman’s chances of conceiving. The study involved 23 fertility centres, and was carried out by the University Medical Centre in Groningen in the Netherlands. The study found that weight loss following a lifestyle intervention improved conception rates among obese infertile women who experienced irregular menstrual cycles. More specifically, obese infertile women who had just completed a sixmonth lifestyle intervention were more than four times as likely to naturally conceive compared with women who were given fertility treatment alone. Studies have also shown that overweight and obese women with PCOS may have a greater chance of becoming pregnant if they lose weight before beginning fertility treatment. A hormonal imbalance is the main difficulty with PCOS. In women with PCOS, the body manufactures more androgens than normal. Androgens are male hormones which females also produce. High levels of these hormones affect the development and the release of eggs during ovulation. Increased levels of androgens in a woman’s body are responsible for the majority of symptoms, however many symptoms are coming from an underlying insulin resistance. In fact, insulin resistance seems to be particularly detrimental for modern PCOS epidemics. PCOS has a variety of signs and symptoms, which do not necessarily include having identified cysts in the ovaries in order to diagnose this disease.
PCOS symptoms and signs
• Irregular or absent menstrual cycles • Infertility or recurrent miscarriage • Hirsutism (excessive facial hair and body hair) • Oily skin/acne • Obesity/abdominal fat • Male pattern baldness • Insulin resistance • Dyslipidaemia (unhealthy levels of one or more kinds of lipid – or fat – in the blood) • Hypertension • Depression and/or anxiety • Sleep apnoea Statistics show that half of these women, if left untreated, can develop type 2 diabetes by the age of 40. Meanwhile, their chances of suffering from a cardio-metabolic syndrome, heart attack or cerebrovascular insult is 5 to 7 times higher, while the risk of contracting endometrial cancer is also increased threefold. In one study, 187 obese and overweight women with PCOS were immediately treated with a drug that induces ovulation. In the other study, 142 women with PCOS began a weight-loss programme, which consisted of a lower calorie intake, exercise, and anti-obesity medication before starting the fertility treatment. Women who were treated with the treatment alone had an ovulation rate of 44.7 percent and a live birth rate of 10.2 percent. The women who received the treatment after the weight-loss programme had a 62 percent ovulation rate and a 25 percent live birth rate. Medical research has shown that there is strong and consistent evidence that overweight and obese patients in welldesigned programmes can achieve weight loss as much as 10 percent of their baseline weight. Prescription medication, together with a healthy eating and exercise plan, can help kick start a weight-loss journey, or can help someone get back on track. Speak to your doctor or go to ilivelite.co.za or 8thsense.co.za for more info.