Obesity and pregnancy: Excess weight can make it difficult to conceive – Frederick News Post (subscription)

Weight gain during a pregnancy is inevitable, but beginning the process of getting pregnant, while carrying excessive weight, can be heartbreaking.

Dr. Jason Bromer, who specializes in reproductive endocrinology and infertility at Shady Grove Fertility’s Frederick location, estimated that one-third of the patients he sees are having trouble getting pregnant because of obesity or being overweight. He also sees some underweight patients, although he says that’s not as common. Not weighing enough can be just as serious when it comes to getting pregnant, however.

The most common explanation for difficulty getting pregnant, Bromer said, is that being overweight can lead to hormonal problems. That, in turn, makes ovulation irregular.

A particular case he sees often with overweight patients is polycystic ovarian syndrome. This as a hormonal imbalance that interferes with the signal between a woman’s brain and her ovaries, Bromer said. The condition can often involve small ovarian cysts, and can later lead to diabetes and heart disease if untreated.

The exact relationship between the ovary and brain signal is still somewhat unknown, but Bromer said being overweight can cause elevated insulin and androgen in the blood. This can cause an over-production of estrogen and, as a result, an irregular menstrual cycle and ovulation.

The definition of being overweight or obese enough to experience fertility problems can vary from person to person. Often, Bromer said, it is correlated with a person’s body mass index, or BMI, which is based on size, height and weight.

Women with a BMI above 35 tend to have a higher risk of infertility and miscarriage, according to Bromer. Overweight women generally are more likely to lose a pregnancy, because their uterus can be a less hospitable environment for an embryo to implant and grow well, he said.

Overweight women also have a higher risk for gestational diabetes, high blood pressure and needing a cesarean section, he said.

On the other end of the spectrum, Bromer said underweight women or women who have suffered from an eating disorder may also have difficulty conceiving. Their challenges are related to the stress a woman’s body can experience from excessive weight-loss or over-the-top exercise, he said.

“When your body’s under a lot of stress, it can stop your body’s ability to ovulate,” Bromer said. “A lot of women with eating disorders will stop getting periods.”

In the cases of being both over and underweight, Bromer said infertility issues can be overcome once women get to a healthy weight. But it is the process of getting women to that point where the doctor said he runs into problems and resistance.

Bromer avoids putting women on fertility medications until he feels their weight can lead to a healthy pregnancy, so a host of lifestyle changes are in order to get them to that point. After initially ensuring that no underlying medical issues, such as a thyroid problem, exist, Bromer will set up his patients with a counselor and a nutritionist.

He has seen the weight-loss process take anywhere from a fast-paced couple of months to a slow-but-steady year.

“Once pointed in the right direction, the problem is almost always fixable,” Bromer said.

from myhealtyze http://www.myhealtyze.tk/obesity-and-pregnancy-excess-weight-can-make-it-difficult-to-conceive-frederick-news-post-subscription/