23% of women undergoing assisted reproduction techniques are overweight or obese, while in the case of men who are infertile, obesity could also be related. Six scientific and medical societies warn that obesity can double the risk of infertility.
In Spain, the estimated prevalence of overweight in adults is 39.3% and that of obesity 21.6%a factor that can double the risk of infertility.
Thus, the Spanish Society of Endocrinology and Nutrition (SEEN)the Spanish Society for the Study of Obesity (SEEDO)the Spanish Society of Gynecology and Obstetrics (SEGO)the Spanish Fertility Society (SEF)the Spanish Association of Urology (AEU) and the Spanish Society of Dietetics and Nutrition (SEDYN)have produced a document that addresses the impact of obesity on male and female fertility.
According to the doctor Inka Miñambres Donaire, first author of the positioning document and member of the SEEN Obesity Area“the increase in the prevalence of obesity among the population has the effect that the associated diseases also increase”.
17.5% of Spanish women are infertile
The endocrinologist explains that infertility associated with obesity is more easily detected in women, due to the direct consequences on the menstrual cycle which cause them to end up going to a specialist.
Although it “occurs in both sexes due to different mechanisms that include, among others, hormonal and physical factors”, he explains.
The SEEN points out that female infertility, between the ages of 30 and 49, is in Spain at 17.5%.
And besides, around the 23% of women who undergo in vitro fertilization techniques are overweight or obese.
As for the male factor, it answers the 20-50% of couple infertility cases and obesity could play a relevant role.
The role of specialists
The visit of women of reproductive age to the gynecologist is an opportunity for obesity diagnosis and subsequent treatment.
In this way, dieticians and nutritionists are key in the preparation and follow-up of women who want to become pregnant.
While urologists also play a prominent role when the appearance of obesity and male infertility are combined.
In this same line, the specialist explains the importance of establishing a joint and consensual management, with a view to assessing the most appropriate treatment to plan the pregnancy at the right time and to be able to achieve more pregnancy rates with the minimum possible complications.
Challenges and proposals of endocrinologists
The expert affirms that the main challenge from the endocrinologist “it remains the prevention of obesity”.
Point to the weight loss as one of the elements that improve the ovulation rate in women with polycystic ovary associated with obesity; however, the improvement in sperm parameters is less clear in men.
On the other hand, he emphasizes that the greatest advance that has occurred in the field of obesity is the appearance of new pharmacological treatmentswhich will vary in case of pregnancy.
Among the proposals created by the different societies, are:
- Prioritize on the waiting list of bariatric surgery in women with severe obesity and infertility and older than 35 years.
- Visualize the need for allocate resources from the National Health System for the creation of multidisciplinary units to tackle obesity.
- Cut down the waiting lists of obesity surgery.
- Assess the financing of anti-obesity drugs and the development of strategies with potential impact on fertility in obese patients.