Many of the patients who visit our center are surprised to find out how much their weight can impact their ability to conceive. In fact an estimated 12 percent of all infertility issues are weight related and maintaining a healthy body mass index (BMI) is one of the most helpful things you can do to enhance your fertility.
I was reminded of this by a recent patient who came to me having experienced the disappointment of a failed IVF cycle. She was about 35 pounds over weight and so, before she scheduled her next IVF, I suggested she diet a little. I showed her the clinical research that proves that overweight women have lower success rates when it comes to IVF and pointed out that she would not need to lose much weight to dramatically increase her chances of success. She was relieved that I wasn’t asking her to be skinny and together we came up with a plan for her to lose about 10 pounds. Motivated by the thought that she would increase her chance of having a baby she stuck to her diet and within five weeks she had lost the weight we’d agreed upon. This time IVF was successful and she’s currently about five months pregnant and expecting a little girl.
In overweight women infertility is usually related to erratic ovulation. Fat cells release estrogen which inhibits FSH (follicle stimulating hormone) production which can prevent ovulation. In Chinese medicine these women are classified as yang deficient with yang referring to all the aspects of your body’s function that relate to movement, activity and transformation. Women who are yang deficient have slower metabolisms than other women. At our center we give our overweight patients Chinese herbs that tonify yang and help them to plan a sensible weight loss regimen. We will also ask them to limit their intake of plant estrogens found in tofu and soy milk. The good news is that you don’t need to slim down to a size 2. Clinical research has shown that 60 percent women who lose just 5 to 10 percent of their overall bodyweight resume regular ovulation.
However, it’s not just women who are overweight who should keep an eye on their BMI. At the other end of the spectrum I see patients who are just a little too thin. If you are chronically malnourished or underweight your body may go into survival mode and you may produce less estrogen. This means that you are not able to build a follicle and may ovulate erratically or not at all. Low estrogen levels also lead to reduced fertile cervical mucus which can also be a problem for women trying to conceive. We all know that women who are suffering from anorexia nervosa often don’t have periods but did you know that you only need to be 10 percent underweight to adversely affect your hormones? The good news for most women is that they don’t need to put on lots of weight in order to get pregnant. For many of my patients gaining as little as 2 or 3 pounds can make all the difference.
I am reminded of a patient of mine who was an actress. The screen really does add 10 pounds so many actresses are very disciplined about keeping their weight down. My patient had a long history of missing periods and had been encouraged by her doctor to take fertility drugs. I felt that her body was telling her that she wasn’t strong enough to sustain a pregnancy and my fear was that the fertility drugs would make her ovulate and that she would conceive only to miscarry due to the lack of nourishment. The solution, I felt, was to help her to resource her body so that she could sustain a healthy pregnancy. I encouraged her to increase her consumption of healthy fats and whole grains and within three months she resumed a regular cycle. After a further 6 months she conceived naturally and just before Christmas gave birth to a healthy baby girl. I was thrilled.
In Chinese medicine underweight women fall into a category we refer to as yin deficiency. Yin is the Chinese term for those aspects of your body that are about substance and nourishment. Women who are yin deficient exhibit signs of estrogen depletion such as hot flashes, insomnia, light periods, and reduced cervical fluid. At our clinic we give women Chinese herbs that supplement yin as well as helping them to change their diet. Specifically we ask our underweight patients to increase their consumption of healthy fats such as those found in olive oil, avocados, nuts, seeds, and oily fish. We also suggest that they increase their consumption of plant estrogens by eating some soy products and flax seeds.
Obviously if you are trying to get pregnant and having no luck you should get all the medical advice you can, but don’t neglect this very simple way of helping yourself. Have a look at your weight and try to get it in a healthy range. For 12 percent of women suffering from unexplained infertility this will be the only change necessary and they’ll go on to conceive. Its a solution that’s simple, effective and within your control.