OBESITY’S IMPACT ON HEALTH AND REPRODUCTION

Obesity is a disease of excess body fat that varies by race, gender, age, and individual.  It is becoming increasingly prevalent in our society as well as a major health problem world-wide. 

Obesity is categorized by BMI (body mass index) as follows:

• Overweight - 25-29.9
• Obese - >30 (Class 1 - 30-35, Class 2 - 35-40)
• Extreme (severe) - 40 or higher (Class 3)
• Super - 50 or higher

The reasons for obesity increasing are complex and are an interplay of cultural, economic, and social forces.  It is estimated that the annual cost of obesity related healthcare issues exceeds 1.4 trillion dollars which is twice what the U.S. spends on defense.  Surprisingly, only 1/3 of obese individuals receive advice from their healthcare providers to lose weight!

Not only does obesity lead to early mortality, cardiovascular disease, diabetes, dyslipidemia, stroke, and cancer, but for REPRODUCTIVE AGE WOMEN  it is associated with:

• Menstrual cycle irregularities
• Ovulatory dysfunction - 3 times more likely to be anovulatory
• Higher doses of ovulation induction medications needed to induce a response
• Slower ovarian/follicular response to ovulation induction medication
• Higher cancellation rate of stimulated cycles, fewer number of oocytes, and lower estradiol levels
• Lower clinical pregnancy rates
• Linked to increased risk of abnormal chromosome karyotype in offspring
• Shown to increase spontaneous miscarriage rate
• Linked to abnormal gene expression in the endometrium thereby decreasing implantation rate.

Obesity in pregnancy leads to:

• Gestational Diabetes
• Pregnancy induced hypertension
• Stillbirth
• Higher incidence of instrumental deliver
• Higher incidence of C/Section
• Higher incidence of post C/Section complication

Fetal complications for maternal obesity:

• Fetal death
• Preterm delivery
• Heart defects
• Neural tube defects

Written by: Linda Ward, LVN, IVF Nurse Coordinator, TexasIVF