Are obese women less likely to become pregnant

Obese women may indeed face a higher risk of infertility. Obesity mainly affects fertility through mechanisms such as disrupting endocrine balance, affecting egg quality, inducing polycystic ovary syndrome, increasing the probability of pregnancy complications, and reducing the success rate of assisted reproductive technologies.

1. Endocrine imbalance

Excessive secretion of hormones such as leptin by adipose tissue can disrupt the function of the hypothalamic pituitary ovarian axis. This endocrine disorder may lead to abnormal menstrual cycles, and some obese women may experience infrequent ovulation or anovulation. Increased aromatase activity in adipocytes can also promote the conversion of androgens to estrogens, further exacerbating hormonal imbalances.

2. Decreased Egg Quality

Oxidative stress and chronic inflammation caused by obesity can damage mitochondrial function in oocytes. The increase in fatty acid concentration in follicular fluid may alter the maturation environment of eggs, and clinical data shows that the rate of obtaining high-quality embryos in obese women undergoing in vitro fertilization treatment is significantly reduced. This type of egg quality defect can directly affect fertilization and embryonic development potential. About 60% of polycystic ovary syndrome patients are accompanied by overweight or obesity. Insulin resistance and hyperandrogenism form a vicious cycle, leading to the stagnation of follicular development. Ultrasound examination of such patients often shows an increase in ovarian volume, with multiple small follicles arranged in the periphery, but lacks the selection of dominant follicles, resulting in a significant decrease in the probability of natural conception.

4. Pregnancy complications

Obese pregnant women have an increased risk of gestational diabetes and pre eclampsia. These complications not only threaten maternal and infant safety, but may also cause placental dysfunction. Research shows that the miscarriage and premature birth rates of obese women are higher than those of the normal weight population, and the live birth rate is correspondingly reduced.

5. In the treatment of assisted reproductive restriction

in vitro fertilization, obese patients require higher doses of ovulation inducing drugs, but the number of retrieved eggs may actually decrease. Endometrial receptivity can also be affected, with lower embryo implantation rates and clinical pregnancy rates compared to those with normal weight. Some reproductive centers may set treatment restrictions for patients with excessive body mass index.

It is recommended that obese women planning to conceive undergo weight management in advance, by controlling their body mass index within a normal range through proper diet and moderate exercise. Increase the intake of vegetables, fruits, and whole grains in diet, and reduce refined sugars and saturated fats. Maintain moderate aerobic exercise and resistance training every week to gradually reduce weight. Before preparing for pregnancy, reproductive hormone tests and ovulation monitoring can be performed, and if necessary, medication to improve insulin sensitivity can be used under the guidance of a doctor. Even with assisted reproductive therapy, moderate weight loss can significantly improve the success rate of treatment.