The answer is, of course it does. In the present time, a lot of research has been done on the impact of diet and weight on just about every health issue that exist and the findings for the most part have been that higher weight and poorer diet are associated with a number of health problems. Why should fertility be any different? After all, the fertility status of an individual is a reflection of that individual’s overall health.
I tell all my patients to think of your body as a fruit tree. If that tree is unable to produce fruit or if the fruit that it produces is not good quality, then this is a reflection of the amount of water, nutrients, and the environment that the tree is trying to thrive in. Humans are really no different. We depend on vitamins, minerals, proteins, and a certain environment in order to keep our bodies in a healthy reproducing state. Therefore, we have to be very careful about what we put in and on our bodies and also how much weight we subject our bodies to carrying.
How can fat affect menstrual periods?
Especially in women, body fat can have a definite impact on menstrual regularity and fertility. Even though the accumulation of body fat was initially meant as a survival mechanism for periods of starvation, in the present time where food is quite plentiful, this excess tissue can cause problems with metabolism, hormone secretion mechanisms, and subsequently with fertility. It turns out that estrogen is held in adipocytes, or the fat cells of the body. These cells randomly release estrogen, especially when it is in excess.
Estrogen is a hormone that can suppress the secretion of hormones from the brain that are responsible for generating monthly egg development. Local release of estrogen from the fat cells causes the ovaries and uterus to become confused as to which signals to follow. Therefore, ovulation does not occur and subsequently progesterone does not get secreted. This is a big problem because it is the secretion and withdrawal of progesterone that causes menses to occur. Also, unopposed estrogen exposure can lead to diseases such as endometrial cancer.
So how can this condition be treated?
The best way of course is with diet and exercise. Consuming a diet high in protein and low in carbohydrates and performing aerobic exercise three to four times a week for at least an hour may result in about 10 percent of total body weight loss, which for some women is enough to return them to regular menstrual cycles, allowing ovulation to occur and possibly pregnancy. On the other hand, some women are unable to lose the weight due to having a slow metabolism. For these women, they may need to take a tablet called clomiphene citrate in order to induce ovulation. Sometimes, these women also need to be on insulin regulating drugs such as metformin or rosiglitazone.
In a small number of cases, women who are not getting pregnant or who don’t respond to clomiphene citrate may need more aggressive therapy such as injectable gonadotropins or in vitro fertilization. When a woman with polycystic ovarian syndrome is not trying to conceive, the best therapy is for her to take oral contraceptive tablets or birth control pills. These tablets release a steady amount of estrogen and progesterone, which helps to regulate menstrual cycles and increase sex hormone binding globulin, which will bind excess androgens.
What about having a low body weight—can this affect fertility?
The answer again is yes, of course ... if your body feels that it is in a state of starvation, then it will secrete a hormone called corticotropin releasing hormone, which is a stress hormone. This hormone can block crucial reproductive hormone receptors in the body and cause anovulation, which is the absence of ovulation and subsequent amenorrhea or the absence of menstrual periods. Without development of a dominant egg and ovulation, natural reproduction cannot occur. So the pendulum swings both ways when it comes to weight and fertility.
How about obesity in men and how this relates to fertility?
It turns out that there is a direct correlation between male obesity and decreased fertility as well. As mentioned above, estrogen is stored in adipocytes, or fat cells. This means that obese men have elevated estrogen levels. Obese men also have reduced male hormone levels and reduced sex hormone binding globulin levels. Therefore, men who suffer from obesity also have an altered reproductive hormonal profile, which has been associated with abnormal semen parameters and subsequent infertility.
Other factors that may contribute to increased fertility issues in obese men are mainly due to having a larger size. Men with increased body mass index have altered retention and metabolism of environmental toxins and the excess tissue surrounding the testicles can increase the basal temperature in which the testicles are surrounded causing modifications in sperm morphology or shape. Unfortunately, there have not been many studies done to date on the reversibility of obesity–associated male infertility with weight loss. The recommended treatment for men with male fertility issues depends on the degree of abnormality in the semen parameters and can range from intrauterine insemination to intracytoplasmic sperm injection, which requires retrieval of the female partner’s eggs and manually injecting an individual sperm into the egg to promote fertilization.
So to summarize, a person’s weight whether too high or too low can directly impact their fertility. The optimal body mass index for a female of reproductive age is between 19–24 and for men is between 20–26.