Handling Obesity and PCOS in Situations of Infertility

Obie Editorial Team

When an old friend of mine was getting married, it was not the wedding she was anticipating with such excitement. Instead, it was getting pregnant after the wedding that had her filling notebooks with plans and bubbling over with joy every time we talked. She had been thinking about babies since she met her fiancé and couldn’t wait to have one, but there was a problem. Already in her thirties, she suffered from polycystic ovary syndrome and was nearly 100 pounds overweight. Her doctor had already discussed with her the challenges she would face in her attempts to get pregnant. With all of these factors combined, she had little chance of getting pregnant, and if she did get pregnant, it would be difficult for her to carry her baby to term. It became obvious that if she wanted a chance to have the child she imagined, she would have to do what it took to handle her problems effectively.

Levels of obesity are increasing globally, with the number of women in their childbearing years that are obese reaching the highest it has ever been. Along with the many other problems associated with obesity, overweight and obese women are at sharply increased risk of infertility, pregnancy complications, and birth complications. All of these can make becoming pregnant, carrying a healthy baby to term, and delivering it safely a nearly insurmountable challenge. These challenges are only increased when a woman suffers from PCOS. Studies have indicated that women who have polycystic ovary syndrome, are overweight, and who choose to undergo therapy to stimulate ovulation are at far greater risk of miscarriage.

Women with PCOS who desire a child are often prescribed medications aimed at stimulating ovulation. This medication is taken for only a short duration but can prove highly effective in reestablishing a pattern in women who have coped with amenorrhea due to their condition. Research has been conducted to evaluate the effectiveness of this type of medication in both lean and obese women. Obese women required much higher doses of the medication to achieve ovulation, but once ovulation was achieved, both groups were able to conceive at least one pregnancy. The proportion of miscarriages, however, was dramatically higher in the obese group than in the lean group. Medical professionals caution women with PCOS to lower their weight to a healthy level before beginning medication to achieve pregnancy.

Source: Hamilton-Fairley, Diana et al. Association of moderate obesity with a poor pregnancy outcome in women with polycystic ovary syndrome treated with low dose gonadotrophin. BJOG: An International Journal of Obstetrics and Gynaecology, Volume 99, Issue 2, pp 128-131, February 1992.