Infertility is defined as the inability to conceive after one year of unprotected intercourse. Various studies show that being obese not only affect one’s sexual life but also causes infertility (male/ female).
Obesity and female infertility:
W H O tells us that nearly 50-80 million women world-over have infertility. The risk of infertility is three times more in obese women than non-obese women. Obesity increases the risk of PCOD which is a major risk factor for infertility.
Infertility in women is primarily driven by two mechanisms- hyperinsulinemia and hyperandrogenemia. Increased adipokines (chemicals released by the fatty tissue) levels lead to hyperinsulinemia. Derangement of hypothalamic- pituitary pathway leads to hyperandrogenemia. Obesity can eventually lead to impaired development of the ovarian follicles (which contain the egg), impaired qualitative and quantitative development of the female eggs, decreased chances of fertilization, embryo development, and implantation.
Obese women also find it difficult to conceive by assisted reproductive technologies. Advanced treatments, such as in vitro fertilization (IVF), also does not show good success rates in obese women. IVF procedures makes the egg retrieval and embryo transfer more difficult in obese women.
Obesity and male infertility:
Studies show an association between high body mass index and low testicular volume, and impaired sperm production. Increased weight is also associated with low testosterone levels. Obesity in males may cause alterations in the sperm parameters like sperm count, total motile sperm count, sperm structure and sperm DNA changes.
Studies tells us this:
- High BMI is associated with reduced levels of sex hormone binding globulin (SHBG) and testosterone and high levels of plasma concentration of estrogen. This affects sperm quality and quantity.
- Hyper-insulinemia contribute to low testosterone levels
- Sleep apnea which is common in obese people is associated with decreased pituitary gonadal function and decreased morning testosterone concentrations.
- High temperatures in the scrotum due to excess fats could damage sperms.
- Metabolic syndrome is associated with hypogonadism and erectile dysfunction.
- Obesity increases the risk of oxidative stress induced damage of sperm DNA