Obesity has been linked to a number of health concerns including impaired reproduction. Obesity in women is associated with sexual dysfunction which may reduce sexual desire and frequency of intercourse, ovulation dysfunction, depleted or poor egg quality, uterine lining (endometrium) abnormalities that may compromise implantation, pregnancy loss, and other pregnancy complications.
Obesity among infertile women has been associated with diminished response to ovulation induction and decreased pregnancy rates. Obese women are advised to lose weight to improve their chances of a successful outcome. Some fertility centers do not offer IVF to morbidly obese women (BMI> 40) due to the very low probability of a successful pregnancy.
The mechanisms behind impaired female reproduction in obese women are not well understood. However, weight loss in obese women has been shown to improve the chances of a successful pregnancy in women having IVF.
Guidelines for bariatric surgery (gastric bypass) include a body mass index (BMI) above 40 or a BMI between 35 and 39.9 with a weight-related health problem such as diabetes, hypertension, and failed medical weight loss. Women having bariatric surgery have improved ovulatory function, fertility, and pregnancy outcomes. However, women having bariatric surgery should wait approximately one year following surgery before attempting conception to allow for maximum reproductive benefit.