HealthONE - November 19, 2019

What you need to know about the effect obesity has on your ability to get pregnant

People who are obese or morbidly obese and struggling to get pregnant should take a closer look at bariatric surgery before spending money on IVF or another assisted reproduction technology.

"One of my major referral sources is fertility doctors," said Michael Snyder, MD, FACS, PC, the medical director of the Bariatric Surgery Program at Rose Medical Center. "They must think losing weight will help, and it does."

According to the World Health Organization, 60 percent of women in the U.S. are overweight, and of those, 30 percent are obese (with a BMI over 30) and 6 percent are morbidly obese (100 pounds over his or her ideal body weight or a BMI over 40).

Women who are obese are less likely to get pregnant and more likely to suffer a miscarriage. There's an increased risk of pregnancy complications and live birth rates decrease in obese women. Women who are overweight have a higher risk of menstrual dysfunction and anovulation (not ovulating).

At his practice, Denver Center for Bariatric Surgery, Dr. Snyder sees people every day who have surgery just so they can increase their fertility potential.

"If you have morbid obesity and are infertile, until proven otherwise, it is related to your weight," said Dr. Snyder.

But while the spotlight on obesity and infertility is often pointed at women, men are highly affected as well. Obesity is linked to a drop in testosterone in men, leading to infertility.

"Male fertility is severely impacted by weight issues as fat is a hormonally active substance," said Dr. Snyder. "It's a two-person show."

The office sees so many women who are hoping to get pregnant that Nurse Midwife/Nurse Practitioner Kim Delamont is part of the practice; clearly, an added value for patients with this specific goal.

There isn't one type of bariatric surgery over another that Dr. Snyder recommends for women who hope to conceive in the future, either. He performs all of them -- gastric band, gastric bypass, gastric sleeve, duodenal switch and more.

"It doesn't matter which procedure, really, it just depends on which one is right for you," Dr. Snyder said. "None of them are incompatible with getting pregnant or carrying a pregnancy."

Dr. Snyder does have one recommendation though -- to wait at least a year after bariatric surgery before trying to conceive.

"Wait at least a year and focus on yourself, not the baby," he said. "Get as healthy as you can because that first year is where you're going to make most of your traction with weight loss," he said.

It's during that 12-month period that women tend to find their "new normal."

"They're more active, they're eating better and their weight is down. That's the best time to get pregnant -- when life is going really well," he said.