INFERTILITY AND OBESITY
Infertility and obesity? That's right! 30 percent of infertility is associated with obesity or diet.17 infertile patients became pregnant while on the weight loss program at the Center for Health Management (CHM), some infertile for many years, having endured multiple infertility treatments.
Obesity and diet independently influence the hormonal mechanisms of ovulation, sperm formation and fetus implantation.
Ovulation
Ovulation is caused by a complex interaction between hormones originating in the brain that stimulate the ovary, the response by the ovary forming a mature egg, the release of the egg, and the production of hormones from the egg sac (corpus luteum). If there is minor instability anywhere:
- in the hormone circle between the brain, the ovary, the egg sac
- the traverse of the egg from the ovary through the fallopian tube into the uterus
- implantation of the egg onto the uterine wall after joining with the sperm
infertility occurs.
Excessive sugar and fat in the diet and obesity cause the following hormonal abnormalities:
- Increased cortisone production
- Increased testosterone production in women (decreased in men)
- Conversion of Estradiol to estrone which is a more "male-like" estrogen.
- Altered sensitivity of the hormone receptors on target cells. Loss of receptors of the hormone impair cell function
- Abnormal circulating levels of adrenal hormones and progesterone.
- Increased Leptin (fat hormone) levels. Leptin directly suppresses ovulation hormones manufactured in the brain.
Low calorie diets and exercise:
- decrease insulin levels
- decrease cortisone levels
- increase growth hormone levels
- decreases testosterone levels in females (increase testosterone levels in males)
- decrease excessive adrenal hormone production
- decrease Leptin levels
Correction of the abnormalities in this circle of hormones, by dieting and exercise, improves fertility.
The more rigid the diet, the better the chance of correcting these abnormalities. It may not be necessary to lose all excess weight, requiring as little as ten percent weight loss to improve fertility. Most of the pregnancies in previously infertile obese patients occurred in the first 8-12 weeks of diet intervention at CHM.
Obese men are also more likely to be infertile due to decreased testosterone and growth hormone production. These hormone levels quickly normalize on low calorie diets
High insulin levels, high leptin levels, and high cortisone levels seen in obesity have a direct effect on sperm motility, impacting male fertility. Infertility is frequently seen in both partners due to shared food and exercise environments, hence both partners should strive for improved diet and vigorous exercise.
Mechanical
Once the egg is fertilized, it must mechanically land and implant onto the uterus. The uterus must be in a "primed" condition to receive and implant the egg. Obesity causes excessive production estrogen by fat cells through conversion of circulating adrenal hormones, into estrone . The excessive estrone stimulates thickening of the uterine lining, not conducive to implantation of the egg. Increased risk of uterine endometrial cancer in obese women is due to these excessive estrogens made by fat cells.
