Many people are surprised to learn that doctors are uncomfortable discussing certain issues with their patients. One subject that many obstetricians and gynecologists (OB-GYNs) find uncomfortable is the issue of excess weight when a patient is having difficulties conceiving. The subject is so important, however, that a leading medical group is urging doctors to prescribe a weight loss regimen before attempting conception. They say losing weight will significantly increase the odds of success for many women facing the dual challenges of weight and fertility.

The American College of Obstetricians and Gynecologists isn't suggesting that OB-GYNs get into the weight-loss business but it does stress the importance of patient education. In a recent study, more than 3,300 women responded to survey questions on the subject. A surprising one-third of them either didn't believe or expressed uncertainty as to the effect a woman's weight has on her chances of conception.

Excess weight disrupts the balance of hormones required for conception. It makes ovulation more difficult and irregular. Estimates indicate about 30% of the obese women in the US experience no difficulties getting pregnant but others turn to fertility specialists to overcome infertility issues.

According to the American Society for Reproductive Medicine:

  • 6% of infertility is caused by obesity
  • 6% is caused by being underweight
  • 70% of these women will conceive naturally once they lose or gain enough weight to attain a healthy body mass index (BMI)

Conception difficulties aren't the only reproductive challenges faced by women of excess weight. Once pregnancy is accomplished, the risk of certain complications are higher than they'd be for a woman of healthy weight and the children born to obese women are at increased risk for medical problems, too.

During pregnancy, extra weight increases the risk for gestational diabetes, hypertension that could escalate into preeclampsia, miscarriage, premature delivery, and stillbirth. Weight affects the likelihood of cesarean-section delivery, too:

  • 21% for women of healthy weight (BMI less than 30)
  • 34% when BMI is greater than 30
  • 47% when BMI is greater than 35

Children born to obese mothers have a greater risk of neural tube defects, including spina bifida. They are also more likely to become obese themselves.

One reason doctors are reluctant to discuss weight issues with overweight women seeking fertility treatments is that many have battled with weight all their lives. When fertility issues are attributed to the weight battle, many women will turn to food for comfort and to cope with the added stress.

A woman's age is another cause for reluctance. Many women seek fertility treatments when they are reaching the end of their reproductive lifespan. Their biological clock is ticking to an end. The time it takes to lose the weight that hinders conception delays fertility treatments even though it improves the chance of success. Many women don't want to wait any longer.

Source: Richards, Sarah Elizabeth. "The Obesity Pregnancy Dilemma." TIME Health / Pregnancy. Time Inc. Mar 14, 2014. Web. Mar 20, 2014.