Starting a family or adding a new member to your family is a wonderful experience. However for many couples, it can be a difficult journey both physically and emotionally.

Weight is an important consideration for either partner while trying to conceive. Being overweight or obese can have wide-ranging detrimental effects on fertility and cause complications during pregnancy and childbirth. The physiological effects of obesity can be detrimental to natural conception, IVF success rates, pregnancy and childbirth.  Whilst the mechanisms are varied – as a woman’s BMI increases, so too does the risk of unsuccessful pregnancy or pregnancy complications such as miscarriage, diabetes or premature birth.

Reaching a healthy weight will give you the best chance to achieve your dream of starting, or continuing your family. A recent systematic review reported an average weight loss of 5 kg in women who were aiming to conceive who were enrolled in diet and exercise studies. In these women, there was a significant increase in the likelihood of falling pregnant, as well as an increase in the number of babies born, compared to those who didn’t undergo the lifestyle program (Hunter et al, 2021).

Risks from obesity during pregnancy

Being obese during pregnancy increases the risk of various pregnancy complications, including:

• Gestational diabetes. Women who are obese are more likely to have diabetes that develops during pregnancy (gestational diabetes) than women who have a normal weight.
• Preeclampsia. Women who are obese are at increased risk of developing high blood pressure and protein in the urine after 20 weeks of pregnancy (preeclampsia). The higher the blood pressure becomes, the more dangerous it is to mum and baby.
• Infection. Women who are obese during pregnancy are at increased risk of urinary tract infections. Obesity also increases the risk of postpartum infection, whether the baby is delivered vaginally or by C-section.
• Thrombosis. Women who are obese during pregnancy are at increased risk of a serious blood clots forming (thrombosis).
• Obstructive sleep apnoea. Women who are obese during pregnancy might be at increased risk of a potentially serious sleep disorder in which breathing repeatedly stops and starts (obstructive sleep apnoea). Pregnancy might also worsen existing obstructive sleep apnoea.
• Overdue pregnancy. Obesity increases the risk that pregnancy will continue beyond the expected due date.
• Labour problems.  Labour induction is more common in women who are obese. Obesity can also interfere with the use of certain types of pain medication, such as an epidural block.
• Caesarean section.  Obesity during pregnancy increases the likelihood of elective and emergency C-sections. Obesity also increases the risk of C-section complications, such as delayed healing and wound infections. Women who are obese are also less likely to have a successful vaginal delivery after a C-section (VBAC).
• Pregnancy loss. Obesity increases the risk of miscarriage and stillbirth.

How LifeShape Clinic can help

We know that weight loss of up to 1kg^ per week in women can be achieved through our program. Losses of 1kg per week can add up to 16kg to 20kg within a meaningful time frame. Some people can achieve faster rates – but it’s best to be realistic about what can be achieved and how long it takes. The key is to maintain an energy reduced but balanced diet, control hunger and be active. Importantly those changes should remain as healthy lifetime habits. In addition to weight loss and improved fitness there are a number of important health improvements:

• Blood pressure will fall significantly
• Cholesterol levels fall
• Blood glucose also falls as insulin sensitivity improves
• Reproductive hormones can normalise

All these health improvements can contribute to becoming pregnant and remaining at a healthy weight during pregnancy and after childbirth.

We’d love to help you, or your partner reach a healthy weight to give you the best chance to achieve your dream of starting, or continuing your family. All of our programs are tailored to your individual needs, so wherever you are on your journey to parenthood, the advice we give is carefully tailored to you and your pregnancy. If you are pregnant or are trying to conceive, you can be assured that our medical, dietetic and exercise advice is always in the best interest of you and your baby.

REFERENCES

Hunter E, Avenell A, Maheshwari A, Stadler G, Best D. The effectiveness of weight-loss lifestyle interventions for improving fertility in women and men with overweight or obesity and infertility: A systematic review update of evidence from randomized controlled trials. Obes Rev. 2021 Aug 13:e13325. doi: 10.1111/obr.13325.