Fertility in Obese Women: Benefits of Weight Loss

Summary and Comment |
May 18, 2016

Fertility in Obese Women: Benefits of Weight Loss

  1. Robert L. Barbieri, MD

In a randomized trial, reduced calorie intake and increased physical activity raised the odds of natural conception in obese infertile women.

  1. Robert L. Barbieri, MD

High body-mass index (BMI) and sedentary lifestyles decrease fertility potential. To test the efficacy of weight loss and increased activity on augmenting fertility, Dutch investigators randomized 574 infertile women (BMI ≥29 kg/m2; median, 36 kg/m2) to a 6-month lifestyle intervention followed by infertility treatment or to immediate treatment (control). The intervention consisted of reduced caloric intake (to lower BMI by ≥5%) and increased activity (10,000 steps daily plus 30 minutes of moderate exercise 2–3 times weekly).

Women in the intervention and control groups lost a mean of 4.4 kg (9.7 lb) and 1.1 kg (2.4 lb), respectively (P<0.001). Natural conception was achieved by 26% of women in the intervention group and 16% of those in the control group (rate ratio, 1.6). However, 22% of women in the intervention group discontinued participation within 3 months — and, overall, only 38% of those in the intervention group achieved weight loss of ≥5%. Within the 2 years after randomization, ongoing pregnancy was achieved with fertility treatments in 28% and 43% of women in the intervention and control groups, respectively. Treatments included ovulation induction, intrauterine insemination, and in vitro fertilization. Ovulation induction resulted in the greatest number of pregnancies in either group.

Comment

The chances of natural conception can be augmented by achieving an optimal BMI; thus, for young infertile women with high BMI, modest weight loss and increased exercise should be considered and encouraged before initiating resource-intensive fertility treatments. This study shows that such lifestyle intervention makes natural conception more likely, thereby helping to obviate the need for fertility interventions. However, achieving the target goal of ≥5% weight reduction was difficult for most participants (despite guidance and coaching). In the real world, more-effective intervention strategies are clearly needed.

Editor Disclosures at Time of Publication

  • Disclosures for Robert L. Barbieri, MD at time of publication Editorial boards UpToDate (Editor-in-Chief, Obstetrics/Gynecology and Women’s Health); OBG Management (Editor-in-Chief)

Citation(s):

Reader Comments (1)

Profesor Izzi Blitz Physician, Endocrinology, Hospital Universitario....Maracaibo Venezuela

Very important that Publication.....You can toch the Obese Woman,,,the Prediabetic, The woman with SPO, or with Hypotiroidism......With treatment and Diet....you can have excellent answers....taking Down the BMI....and having excelent results.....Ths is my area where I Work....Thanks...

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