As one of several causes of infertility, Polycystic Ovary Syndrome (PCOS) is considered the most common reproductive disorder experienced by women. Views differ on whether obesity causes PCOS (or vice versa), but there is a clear correlation between PCOS and obesity — as well as increased risks such as dyslipidemia, cardiovascular risks, glucose intolerance and type 2 diabetes.
For the 12 percent of couples unable to become pregnant within a year, infertility can be devastating, affecting both physical and mental health. Ovulatory defects and other unexplained causes of infertility impact more than 50 percent of couples, and infertility — in both women and men — in many cases can be linked directly or indirectly to obesity. If both partners have obesity, the likelihood of infertility increases, even when fertility treatments are used. (Click here to learn more in a free white paper, Understanding How Obesity Affects Infertility.)
Many women with PCOS remain undiagnosed, in part due to patients’ presentation of symptoms, as well as differences in diagnostic criteria. PCOS also has been diagnosed in prepubertal girls, though less frequently, suggesting possible fetal or early postnatal influence. Beyond PCOS, women with obesity are also more likely to experience other fertility issues such as anovulation, menstrual dysfunction and miscarriage.
Fortunately, PCOS and many other fertility issues can be treated and reversed. Research consistently supports preconception weight loss as the best course of action for women who are overweight or obese and trying to become pregnant. Lifestyle change, specifically weight reduction and limited carbohydrates, are recommended to counter PCOS and other challenges to fertility. Exercise also helps lower blood sugar levels, which could help prevent diabetes.
Preconception weight loss also can lead to more regular menses and ovulation, increasing the chances of becoming pregnant, and weight loss of even ten percent can increase pregnancy and live birth rates. Because higher body mass index in the mother can lead to a more difficult pregnancy, additional weight gain and higher likelihood of obesity in her child, optimizing weight prior to conception offers immediate and long-term benefits.
Greater awareness of PCOS and fertility issues can increase recognition of symptoms in mothers-to-be so that they can seek care and increase their likelihood of conceiving. For women with obesity, weight loss prior to becoming pregnant offers greater health outcomes for themselves and their child, with benefits that can extend beyond pregnancy.