This is a tip that is commonly given to overweight women: you have to lose weight to get pregnant. Let's take a closer look at what it is.
Statistically, studies have shown that when the body mass index is greater than 27, the woman is three times more likely to have ovulation problems and therefore to be infertile. When it comes to a simple overweight, that is to say with a body mass index between 25 and 27, the risk becomes very minimal and is only 1.2.
But a decrease in the probability of being pregnant remains a statistic: many women who have had multiple children turn out to be obese, and most women who are obese have been pregnant.
Why this difficulty in having a baby in overweight women?
What is the explanation for this greater difficulty in ovulating women overweight? It is usually explained by hormonal changes. Adipose tissue is indeed a site for the production and metabolism of sex hormones. Overweight thus promotes the metabolism of estrogens and transforms them into 2-hydroxy estrogens, which are less active; On the other hand, obesity is often accompanied by insulin resistance and also modifies the secretion of a glycoprotein called sex hormone binding globulin (SHBG), which is used to transport sex hormones into the blood and inhibits their action. .
Are all forms of overweight to be blamed?
When obesity takes a form called android obesity, that is to say when it is localized at the level of the belly, it is accompanied by an increase in androgenic hormones, which can also increase the difficulty to ovulate of the woman. When obesity and gynoid type, that is to say, localized at the hips and buttocks, we do not observe this effect.
For example, it has been observed that when the waist-to-hip ratio increases, which corresponds to android-type obesity, the design rate by insemination with donor sperm decreases.
Polycystic ovary syndrome: the chicken and egg problem
However, it has also been observed that Stein-Leventhal syndrome, or polycystic ovary syndrome (PCOS), is an important cause of the absence of menstruation, ovulation, and therefore infertility. The causes of this syndrome are poorly understood. The origin of the disorder is located at the level of the pituitary gland and pituitary-hypothalamus axis and there are significant hormonal disorders with an increase in luteinizing hormone (LH). This syndrome is characterized by android-type obesity, insulin resistance, diabetes tendency, and infertility.
A recent study sheds new light on this syndrome. Andrew Wolfe, a researcher at Johns Hopkins University in Baltimore, created transgenic mice with the insulin receptor gene absent in the pituitary gland. Insulin in these mice, therefore, has no effect on the pituitary gland. Transgenic mice, when they have an ordinary calorie diet, do not show a change in fertility. But when they are subjected to a hypercaloric diet and become obese, they prove to be six times less fertile than thin mice. They also become very sensitive to GnRH (gonadotropin-releasing hormone) and insulin, which cause peaks of luteinizing hormone (LH). We, therefore, note the appearance of a table close to polycystic ovary syndrome.
Overall, it seems that PCOS is a major provider of the absence of ovulation and infertility, and one may wonder whether simple obesities, in the absence of this syndrome, and in the absence of resistance to insulin, promote sterility so much.
Lose weight to increase your chances of getting pregnant?
In women with polycystic ovary syndrome, weight loss usually decreases the level of circulating androgenic hormones. A weight loss of between 5 and 15% of the total weight makes it possible to restore ovulatory cycles in half of the cases. The practice of the sport on a regular basis also makes it possible to regulate the levels of sex hormones.
Even in the absence of PCOS, weight loss, accompanied by physical exercise, according to an Australian study, allows an improvement of the cycle and spontaneous pregnancies in 90% of the cases in the obese women. This favorable action is thought to be mainly due to a decrease in insulin resistance.
Yes, but how to lose weight?
Even before thinking of losing weight, in case of overweight and infertility, it is necessary to consult your doctor, to undertake a hormonal assessment, to look for the presence of a polycystic ovary syndrome as well as a resistance to 'insulin. In the latter case, adequate treatment often significantly improves fertility.
Since most women wanting to have a child are always in a hurry, we will be tempted to use brutal methods to lose weight quickly. But slimming diets, which effectively reduce weight quickly, also have the effect of leading to resume it just as quickly. Do we really win? Will not we risk taking all this weight during pregnancy?
It seems to us that it is better to favor the methods that allow perennial weight loss.
We will, therefore, take into account the presence of eating disorders, which will obviously need to be addressed. The cognitive restriction, the loss of control over food and the jolts it causes, the emotional disorders that lead to eating to calm emotions, are all factors that affect fertility.
The Line coaching approach is as follows: you learn to restore a relaxed relationship with your food, to eat according to your food sensations, whenever you are hungry and no more than his appetite tells us. We do not deprive ourselves of anything we like; we take advantage of it without abusing it.
In addition, let's not forget that the unrealized desire to be pregnant also generates all kinds of painful emotions: anxiety, depression, anger. And these emotions often give rise to cravings for emotional eating and loss of control. To want to go too fast, we shoot ourselves in the foot!
The relationships between overweight and fertility are therefore far from simple. It is therefore not necessary to apply simplistic solutions, but for each person, according to their hormonal state, the different diseases and disorders that they may present, the characteristics of their eating behavior, to propose an acceptable and practical solution, aiming at the long term.
Post a Comment