The desire for children often remains unfullfilled for morbidly adipose women

Egg maturation and ovulation are defective in morbidly adipose women. But the fertility will increase again once the woman manages to loose weight.

For many couples a child seems to be the true fullfillment of their partnership. The desire for children, however, often remains unfullfilled for morbidly adipose women. Just like for 30-year-old Peggy K. who was treated at the Integrated Research and Treatment Center (IFB) AdiposityDiseases. She used to weight 145 kg and wear size 58. The desire for children used to be just a wish for her and her husband for many years. Even several therapies in reproductive medicine couldn't help the couple.

“Whenever a friend told me she was pregnant I would become depressive. We were pretty desperate. Neither losing weight nor getting pregnant was working," says Peggy K. about her situation back then.  Her doctors had told her that extreme overweight might decrease the fertilitiy of women. The chance for pregnancy decreases significantly starting at a BMI of 40 kg/m2. Responsible for that are the disturbance of egg maturation and ovulation. The disturbance is caused by an increase of the insulin and blood sugar and lipids levels as well as fat tissue hormones. The balance of the hormones of the pituitary gland that are important for the egg maturation are also affected. An increase of male hormones can frequently be monitored, too. Mathias Faßhauer, Professor for endocrinology of adiposity at the IFB explains the connection like that: "With morbidly overweight patients different messengers circulating in the blood are significantly changed in their concentration, leading to a decreased fertility." Insulin is playing a central role in this: Even though the insulin levels in adipose patients are increased, the effect of the hormone in the body cells is reduced (insulin resistency). "This will lead to the disturbance of other hormone systems, e.g. of the male hormones and the fat tissue homones," says the adiposity specialist.

Obesity in young women also increases the risk for the so-called polycystic ovary syndrome (PCOS) which is disturbing the function of the ovaries by an excess of male hormones. Ovulation only occurs very seldom or never, the period becomes irregular or stops all together. These symptoms will make the women seek out a gynocologist; most of the time these are the first signs of the PCO syndrome. This was the case with Peggy K. "I only had my period three times a year approximately. Often I hoped I finally got pregnant and made a test - but always without success." A polycystic ovary syndrome is present in five percent of the pubescent women - this high incidence makes the PCOS the main reason for infertility nowadays. The disease occurs more often in families and is often accompanied by the metabolic syndrome. People suffering from this syndrome are suffering from adiposity, high blood pressure, sugar and fat metabolism defects as well as arteriosclerosis as a consequuence. The more often an adiposity with metabolic syndrome occurs among the female population, the more women will also suffer from PCOS and therefore from decreased fertility.

Thus, the treatment of adiposity not only reduces the overweight and the metabolic syndrome but will also increase fertility. With the lost pounds the chance for a pregnancy increases. That was also the case with Peggy K. Thanks to a gastric bypass surgery and a special diet program she has lost 35 kilos. And also the long existing wish for a child will now be fullfilled: she surprisingly became pregnant and the pregnancy is progressing without problems so far. "Of course I have to pay special attention to the ingestion of enough nutrients and vitamins because of the surgery. But I am very happy! Also the other troubles such as angina pectoris, high blood pressure or diabetes have improved significantly."

By the way, also men with severe overweight can be suffering from decreased fertility or even infertility. That is due to a low testosteron level, a disturbed   sperm production and a reduced sperm mobility.
(In further articles you will find out more about the riscs and dangers for mother and child when the pregnant woman is obese.)

Doris Gabel

Keywords: kids & family, associated diseases