Does Being Overweight Affect Your Chances of Getting Pregnant?

An expert discusses how excess weight affects ovulation and how to increase fertility

Overweight loving couple in embrace

The stars have aligned. You finally feel like it’s the right time to create a Mini-You. But as the months pass, so does your patience. It seems like everyone around you is starting a family (including that friend who turns up pregnant every time her partner looks at her).

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Could those few extra pounds you’re carrying be the reason? Ob/Gyn Rebecca Starck, MD, breaks down the connection between weight and fertility.

Q. What is a healthy body mass index (BMI) for pregnancy?

A. We use body mass index, or BMI, to determine if a person is overweight. BMI uses height and weight to calculate body fat. It’s a numbers game: A BMI between 25 and 30 is overweight. A BMI that’s over 30 is considered obese.

To optimize your health before — and during — pregnancy, aim for a BMI below 25. But the healthiest BMI for pregnancy is different for everyone.

One woman in the ideal BMI range may have a hormonal imbalance that causes irregular ovulation. Another woman may be technically obese but ovulates every month and has regular periods, giving her more chances to get pregnant. 

Q. Will being overweight affect my ability to get pregnant?

A. Being obese or significantly overweight may make it harder to get pregnant. Why? It’s a complex dance between the hormones that trigger ovulation and your progesterone and estrogen levels. Fat cells often produce higher estrogen levels, which can work against your body when it’s trying to ovulate.

While out-of-balance hormone levels don’t always mean you’ll have trouble getting pregnant, you may experience less regular ovulation and menstrual cycles — which makes it harder to conceive.

Q. Will being overweight affect my ability to get pregnant?

A. Being obese or significantly overweight may make it harder to get pregnant. Why? It’s a complex dance between the hormones that trigger ovulation and your progesterone and estrogen levels. Fat cells often produce higher estrogen levels, which can work against your body when it’s trying to ovulate.

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While out-of-balance hormone levels don’t always mean you’ll have trouble getting pregnant, you may experience less regular ovulation and menstrual cycles — which makes it harder to conceive.

Q. Does it matter where I carry my extra weight?

A. Central obesity, which is around the abdomen, is generally considered the higher risk for cardiovascular disease, diabetes and ovulation difficulties. Women who carry weight more proportionally or in their lower extremities or butt tend to have a little less risk. Those women may be genetically wired to have that body type, while central obesity is usually the result of lifestyle and habits.

Q. How much weight should I lose before getting pregnant to increase fertility?

A. There are all sorts of factors involved. So while there is no magic number, 10 pounds is a good place to start.

To help you reach your goal, focus on making healthy choices every day. That can sometimes be the difference in helping your body ovulate regularly.

Q. Are there any medications that can help increase fertility?

A. Glucophage®, or metformin, is typically used for some women who aren’t ovulating and for women with Type 2 diabetes. It can help, but it’s not a cure-all.

Achieving a healthy body weight has a much better payoff, especially with all the risk factors that come with being overweight and pregnant. A healthy weight can lead to a smoother pregnancy.

Q. How does being overweight affect pregnancy?

A. If you are overweight and pregnant, you are at higher risk for:

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  • Miscarriage.
  • Gestational diabetes.
  • Complications from high blood pressure.
  • Preeclampsia.

Sleep apnea is also more common among women who are obese. And the pregnancy weight gain only makes it worse. All those little periods of hypoxia (lack of oxygen) can impact the pregnancy and slow your unborn baby’s growth.

Your baby could also gain too much weight if you have diabetes or gestational diabetes. A large baby can lead to a more challenging delivery and a higher chance for a cesarean section. Surgery when you are obese comes with an increased risk of infection, blood clots and reduced mobilization after delivery.

Q. What’s the best way to lose weight to increase fertility?

A. I encourage my patients to focus on balancing their diet before trying to conceive. But try not to focus too much on the end goal because that can be overwhelming.

Instead, focus on doing something healthy every day:

  • Eat complex carbohydrates, which you can find in whole grains, beans and vegetables.
  • Eat more protein to sustain you throughout the day.
  • Be more conscious of food labels.
  • Focus on whole and natural foods.
  • Avoid raw sugars and processed foods.

Try to balance those healthy habits with rigorous exercise most days of the week — the kind that gets your heart rate and pulse up. And you don’t have to do it alone. Talk to your doctor or a nutritionist who can help you plan a healthy diet and create a doable exercise plan. Get your partner on board as well by planning menus or signing up for an exercise class together.

I’m also a firm believer in prevention and developing good lifestyle habits at a young age. Women in their 20s who may not be thinking about pregnancy can work on developing healthy diet and exercise habits.

I have been an Ob/Gyn provider for more than 20 years, and there is nothing harder than the yo-yo dieting I see women attempt year after year. A diet will never be as effective as healthy habits. It’s never too early (or too late) to make smart, sustainable lifestyle choices — ones that will keep you (and your future family) healthy and strong.

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