What the Scale Isn't Telling You About Your Fertility

Someone recently asked about the correlation between weight and infertility. I thought that was a really good question and one that is not discussed nearly enough. When going through infertility (IF) we are so focused on what's going on in that mysterious region south of our belly button that we neglect to see what's going on right before our eyes. In thinking about my friend's question, I saw two possible ways to tackle this topic: on the one hand, the effect of weight on one's fertility; on the other is how infertility affects our weight. Today I'm going to focus on the former and provide you with some topline information for your to discuss with your doctor.

Being too thin or too fat can affect your fertility. In fact, an estimated 1 in 5 is coping with IF has an underlying issue with an eating disorder. You do not have to be dealing with a clinical eating disorder to be struggling with weight and IF. People with an eating disorder just happen to be at each extreme of the spectrum, but there are many gray areas before you can achieve a healthy middle.

In a culture where you can't bee too thin, it's very difficult to feel sorry for women who are barely filling a size 0. But in truth, an unhealthy thinness can have a huge effect on your fertility. When you are just 10-15% below your healthy weight (for your height), that corresponds to a third of body fat loss, which consequently leads of menstrual dysfunction (this is called the "Critical Weight Hypothesis"), a common cause of IF. So imagine what someone dealing with anorexia is doing to her body. Living with a very distorted sense of body imagine, people with this eating disorder starve themselves to a point where their organs and reproductive systems are affected. Sadly, in some cases, even after recovery, women who have dealt with anorexia for years may have caused permanent damage to their body. Another group that I would include under "too thin to ovulate" are over exercisers -- those women who spend hours at the gym, running miles and miles on the treadmill and then jumping into a aerobics class, to eventually treat themselves to a mini-smoothie. While the scale might indicate a "healthy weight," the lack of body fat affects them in similar ways as a someone who is overly thin. Behind those perfectly defined abs are women who have very little body fat and therefore have trouble ovulating and hence, conceiving. Whether you are dealing with anorexia, over exercising or are simply too thin, you are very likely to suffer from amenorrhea (no ovulation or menstrual cycles), irregular menstrual cycles, PCOS and reduced egg quality. While it is important to feel good about yourself, especially during a time when everything has come into question as a result of your IF, I urge you to focus on increasing your food intake. Include more good fats (avocados, nuts), lots of protein (chicken, milk) and Omega-3 rich foods (wild salmon). Avoid artificial sugars, especially if you're struggling with PCOS. And don't over exercise. Trust me, your baby isn't going to care if you have a six-pack.

On the other end of the spectrum are women who are overweight. Some women are genetically predisposed to being overweight, others have grown from being an overweight child to an overweight or obese woman, and lastly you have your compulsive eaters -- this overlooked eating disorder involves bingeing on food without purging. To be considered overweight you need to be in the 25-30 BMI, and anything over 30 is considered obese. Above I talked about the importance of some body fat, excessive body fat can have similar effects to your reproductive system as someone who is too thin. Some overweight and obese women suffer from amenorrhea, PCOS with insulin resistance (an inability to process sugars), which ironically can be both the cause for the extra pounds and the result of them. Studies have shown that overweight women aren't as much affected by IF as overly thin women, but the pregnancy risks associated with the excessive weight increases your chances of gestational diabetes and pre-eclampsia. Following a lean diet high in protein, whole grains, fruits and veggies, combined with regular exercise still remains the best way to manage your weight. Recently, women who are overweight and PCOS have found some success when taking Metformin, which has helped with more regular and higher quality ovulation, and yes, weight loss.

If you have been experiencing unexplained weight gain or weight loss, your first step should be to check your thyroid function. Hyper and hypothyroidism can affect your weight and as a result your reproductive system.

Discuss any concerns you have about your weight with your doctor and don't be afraid to meet with a nutritionist who can guide you in the right direction.

Stay tuned for my next entry where I will discuss how IF affects your relationship with food, your body and your mind.