Weight and fertility examined during Infertility Awareness Week

30th April 2012   ·   0 Comments

By Kelly Parker
Contributing Writer

Infertility: It’s a subject that often goes ignored, though some 7.3 million women in the country will experience the problem (one in eight couples). The topic was brought to light by the National Infertility Association as April 22-28 was observed as National Infertility Awareness Week.

NIAW began as a movement in 1989, led by RESOLVE, (The National Infertility Association) to raise awareness for infertility as a disease and the concerns of its patient community. In 2010, NIAW was recognized as a national health observance by the U.S. Department of Health and Human Services. The goal of the organization is to raise awareness about the disease of infertility and encourage the public to understand their reproductive health.

Infertility is a disease of the reproductive system. According to RESOLVE, One third (30 percent) of infertility can be attributed to male factors, and about one third (30 percent) can be attributed to female factors. In about 20 percent of cases infertility is unexplained, and the remaining 10 percent of infertility is caused by a combination of problems in both partners.

The American Society for Re­productive Medicine states you should seek the care of a specialist if you are unable to achieve pregnancy after 12 months of unprotected intercourse and the woman is under the age of 35, six months if the woman is more than 35 years of age. You should also seek the care of a specialist if you have had more than one miscarriage.

Though age is stated as a factor regarding challenges women face, obesity is also said to be linked to the problem of infertility.

While studies connecting obesity to anovulation (the absence of ovulation) are not news, an Academic Medical Center study shows that even women who regularly ovulate experience sub-fertility when their body mass index (BMI) is in the overweight or obese category. In layman’s terms, it was found that women with regular cycles, and otherwise no obvious fertility problems, still have a hard time getting pregnant if they are overweight. They also found that the more overweight the woman is, the lower her chances of pregnancy.

Clearly, all overweight women are not infertile. But overweight women do face increased risks for fertility problems compared to those women who maintain a healthy weight.

Polycystic Ovarian Syndrome, one of the more common causes of infertility, has been connected to trouble with gaining and subsequently losing weight. In other words, the very thing that is causing fertility problems may also be why you’re having trouble losing weight or maintaining a healthy BMI.

“PCOS is a condition where women of early child bearing age have abnormal menstrual cycles, multiple cysts on their ovaries, and suffer from abnormally high male hormones (androgens) with associated masculine changes,” Dr. Thomas Lavin, founder of The Surgical Specialists of Louisiana explains. “These are acne, in­creased body hair, deepening of the voice, and associated infertility. Their cells have increased resistance to insulin causing elevated insulin levels and eventually can lead to diabetes. These patients are overweight and most will have a BMI greater than 30. The weight gain, which is central (belly fat), causes a host of weight related problems in addition to diabetes such as hypertension, obstructive sleep apnea, high cholesterol, and heart disease.”

Dr. Lavin stated that child bearing women are at risk but there is no ethnic predisposition in regards to PCOS. Being heavier increases a woman’s risk and there seems to be a genetic predisposition. “If your mother had PCOS, you are at increased risk for it,” he adds.

Krystal Townsend, a resident of Sabine Parish, La., was diagnosed with PCOS back in 2003 and knew firsthand the role her weight played in her ability to conceive. She and her husband had been trying to get pregnant since 1999.

“When we got pregnant with our eight-year-old son, I had just lost about 30 lbs. and was able to finally ovulate, with the help of medication, and conceive,” she told The Louisiana Weekly. “Before losing weight, medication did not stimulate ovulation. When I reached my 30s I knew that I had to lose a considerable amount of weight if we were going to have our second child before I was 35. I was heavier than I had ever been at 229 pounds. Thanks to Dr. Lavin and POSE, I was able to have a very easy procedure and recovery, lose 61 lbs. and conceive within nine months with no medication to stimulate my ovaries.”

Dr. Lavin has been a pioneer in developing and promoting the field of laparoscopic surgery; he is the director of the Bariatric Surgery Program at Fairway Medical Center in Covington. Southeast Louisiana offices are located in Metairie, Slidell, and Lafayette.

POSE (Primary Obesity Surgery, Endolumenal) is a one-hour outpatient procedure that is performed through the mouth and does not require any incisions or cuts. It has a number of significant advantages over traditional bariatric surgery: POSE is an endoscopic incision less procedure designed to reduce the patient’s stomach size, and diminish the associated hunger cravings. This minimally invasive surgical treatment may be ideal for individuals who struggle to benefit from other weight loss options.

During the procedure, a tube is introduced into the patient’s mouth through the esophagus and is then situated in the spongy part of the stomach that stretches out to accommodate large meals. This portion of the stomach is also responsible for the secretion of powerful hunger hormones that can lead to overeating. After the tube is positioned it is turned and securely locked in a desirable position. The surgical instruments are threaded down small channels inside the tube into the stomach. These tiny instruments are used to clasp and maneuver small portions of stomach tissue, creating small folds. Using an anchor, the folds are then sutured to hold them in place. This process is repeated in strategic locations until the stomach volume is decreased sufficiently, and the desired effect is achieved.

“(Before the POSE procedure) I have tried most everything from prescription diet pills, over the counter diet pills, Weight Wat­chers, Atkins, South Beach, etc.,” Town­send says. “I was able to lose weight with the diets more so than the pills, but I never could get past about 20 to 40 lbs.”

She is also pleased with her lifestyle change since the procedure.

“Now, I have more stamina. I love exercising and I do boot camp style workouts three times a week and before becoming pregnant, I was also using a running program to increase my cardio activity.”

Townsend, now 10 weeks pregnant, weighs 170 pounds and has already set a goal to lose an additional 30-40 pounds after her baby is born.

According to RESOLVE, infertility affects approximately 10 percent of the population. Like PCOS; infertility in general strikes diverse groups; affecting people from all socioeconomic levels and cutting across all racial, ethnic and religious lines.

This article was originally published in the April 30, 2012 print edition of The Louisiana Weekly newspaper