23% of women who undergo assisted reproductive techniques are overweight or obese, while in the case of men who are infertile, obesity could also be related. Six scientific-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.
So, 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 position document and member of the Obesity Area of the SEEN“the increase in the prevalence of obesity among the population means that its associated diseases also increase”.
17.5% of Spanish women are infertile
The endocrinologist clarifies that infertility associated with obesity is more easily detected in women, due to the direct consequences on the menstrual cycle that cause them to end up going to a specialist.
Although “it occurs in both sexes by different mechanisms that include, among others, hormonal and physical factors,” he explains.
The SEEN points out that female infertility, between 30 and 49 years of age, is situated in Spain in the 17,5%.
And also, around 23% of women who undergo in vitro fertilization techniques are overweight or obese.
As for the masculine factor, it responds to 20-50% of couple infertility cases and obesity could play a relevant role.
EFE/ Sáshenka GutiérrezThe role of specialists
The visit of women to the gynecologist of reproductive age is an opportunity for the diagnosis of obesity and its subsequent treatment.
In this way, dieticians and nutritionists are key in the preparation and follow-up of women who wish to become pregnant.
While urologists also play a prominent role when the onset of obesity and male infertility are combined.
Along the same lines, the specialist explains the importance of establishing joint and consensual management, in order to assess the most appropriate treatment to plan pregnancy at the ideal time and to be able to achieve higher pregnancy rates with the fewest possible complications.
Challenges and proposals of endocrinologists
The expert affirms that the main challenge of the endocrinologist “remains the prevention of obesity.”
Point out the weightloss as one of the elements that improve the ovulation rate in women with polycystic ovaries associated with obesity; however, the improvement in sperm parameters is less clear in the male.
On the other hand, he stresses that the greatest advance that has occurred in the field of obesity is the appearance of new drug treatmentswhich will vary in case of pregnancy.
Between the proposals created by the different companies, are:
- Prioritize on the waiting list bariatric surgery to women with severe obesity and infertility and older than 35 years.
- Make visible the need for allocate resources from the National Health System for the creation of multidisciplinary units to address obesity.
- Reduce las waiting lists obesity surgery.
- Evaluate the financing of the anti obesity drugs and the development of strategies with potential impact on fertility in patients with obesity.