How does obesity affect fertility and pregnancy?

Obesity directly affects fertility, pregnancy and sexual relations.

Although the degrees of affectation are very variable, in general it can be affirmed that:

• It greatly decreases fertility, and therefore the possibility that a couple can have children.
• Significantly increases the risk of pregnancy, both for the mother and for the fetus or child.

However, it is always recommended to take contraceptive measures while suffering from morbid obesity (BMI > 40), and to avoid pregnancy.

Why does obesity affect fertility?

Fat acts like a sponge that captures all the hormones and markers that allow a normal hormonal cycle and therefore pregnancy. Many couples with infertility problems, associated with obesity in women, are cured spontaneously after an obesity operation. Even so, many women can become pregnant despite significant obesity, and it is therefore recommended to avoid it through contraceptive methods.

Can morbidly obese patients get pregnant?

In spite of what has been said in the previous paragraph, many women can become pregnant in spite of significant obesity, and it is therefore recommended that contraceptive methods be used to prevent it.

What problems can arise if a morbidly obese woman becomes pregnant?

The problems can be very numerous.

On the mother: The already precarious metabolic balance worsens. Many mothers who did not have it before, develop diabetes (gestational diabetes) and hypertension (Pre-eclampsia or eclampsia that forces to suspend pregnancy). In addition, there is always a sudden worsening of obesity. Childbirths are most often by caesarean section, causing frequent post-operative eventrations (failures in the definitive closure of the operation wound).

About the child: The most common is macrosomia (excessive size), as a result of metabolic alterations in the mother, and it is also known that it can influence a higher frequency of obesity of the child in adulthood. This also happens when they suffer from obesity during the first year of life.

Do patients operated for obesity need a special diet during pregnancy?

In principle, no, although in general vitamin supplements are reinforced more than if they take pregnant women and should be monitored in detail the variety and balance of the diet.

How long should you wait for your mother after the obesity operation?

In general, at least one year is recommended, and the ideal is for the patient to have stopped losing weight, and to have undergone a nutritional check-up, before seeking pregnancy.
However, as weight loss from the operation greatly improves fertility, “unplanned” pregnancies are very common among our patients.