OBESITY AS ONE OF THE LEADING CAUSES OF INFERTILITY, PREGNANCY COMPLICATIONS, AND

POLYCYSTIC OVARIAN DISEASE. EFFECTIVE WEIGHT LOSS IS ESSENTIAL FOR WOMEN'S

HEALTH.Dr. David Thuo

Obstetrician and GynaecologistVelvet Healthcare

DEFINITION OF TERMS

INFERTILITY - refers to an inability to conceive after having regular unprotected sex. Infertility can also refer to the biological inability of an individual to contribute to conception, or to a female who cannot carry a pregnancy to full term

PREGNANCY COMPLICATIONS - are health problems that occur during pregnancy. They can involve the mother's health, the baby's health, or both.

POLYCYSTIC OVARIAN SYNDROME - is a set of symptoms due to a hormone imbalance in women.

STATISTICS

Kenya Fertility rate – 4.38 number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children in accordance with current age-specific fertility rates.

> 1 billion people in the world are overweight (WHO)

> 300 million obese (WHO) 26% of non pregnant women ages 20-39 are

overweight /obese (WHO) And the prevalence of obesity is on the increase

BMI

MECHANISM OF ENDOCRINOLOGIC CHANGES IN OBESITY Obesity represents a state of hormone imbalance as levels of

SHBG (sex hormone binding globulin) decrease linearly with percentage of body fat, leading to increased free androgen (masculine hormone) levels.

Abdominal obesity is associated with both insulin resistance and elevated circulating androgens.

Hyperinsulinemia, insulin resistance and elevated free circulating androgens cause ovulatory and menstrual disturbances

Hyperinsulinemia, insulin resistance and elevated free circulating androgens cause ovulatory and menstrual disturbances

EFFECT OBESITY AND REPRODUCTIVE HEALTH1. Absence of menstruation (amenorrhea)2. Failure of ovulation (anovulation)3. Being less than normally fertile though still capable

of effecting fertilization.(Sub fertility)4. Inability of a sexually active, non-contracepting

couple to achieve pregnancy in one year. (infertility)5. Irregular menses6. Masculine hormone (Androgen) excess

7. PCOS (polycystic ovarian syndrome)

FEATURES:a) Central obesity b) hyperandrogenism (male hormone excess)c) Insulin resistance (inability of a sexually active, non-

contracepting couple to achieve pregnancy in one year)

All the above features contribute to female infertility

CONTD

8. obesity leads to poorer prognosis with Assisted reproduction (e.g IVF). By half in women with BMI>35KG/M2

9. Obese women also suffer lower pregnancy rates due to altered receptivity of the endometrium (inner lining of the uterus)

10. There are higher rates of miscarriages.11. There are increased rates of medical complications in obese women (pregnancy induced hypertension, gestational diabetes and thromboembolism(blood clots).

Contd.

12. In labor obese women experience more – preterm birth, fetal deaths, still births (baby born dead) and congenital anomalies.

13. post partum (after delivery) complications are more in obese women.

14. Male infertility

TAKE HOME

THINK HEALTHY, TALK HEALTHY, EAT HEALTHY, EXERCISE HEALTHILY REGULAR HEALTH CHECKUPS STAY HEALTHY

THANKYOU