Pro-fertility medical treatment for obesity

Women who wish to get pregnant and have a body mass index in excess of 30 kg/m2 can help to improve both the quality of their ova and uterus receptivity through weight loss (*1)

Pro-fertility medical treatment for obesity
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Excess weight negatively affects a woman’s reproduction prognosis. With this in mind, our Endocrinology and Nutrition Department, which specialises in fertility and is managed by Dr Pino Navarro, has designed an intensive weight loss programme that aims to improve women’s chances of getting pregnant. It can be followed by both women who need to have assisted reproduction treatment and those who are able to conceive naturally.

The benefits of weight loss include improved health for the mother and foetus and it helps to ensure that the pregnancy concludes in the best possible manner. (*2)

Who can benefit from this programme?

Women with a body mass index over 30 kg/m2 (BMI between 27-30 if comorbidities are associated) seeking pregnancy naturally or through assisted reproduction techniques (both with their own oocyte and with a donated oocyte).

What does the pro-fertility medical treatment of obesity programme entail?

The aim of the treatment is to achieve an estimated weight loss of between 5 and 10%. This improves the patient’s fertility prognosis by improving and/or recuperating the reproductive system’s biological functions.

The treatment does not aim to ‘cure’ obesity but it does seek to play a role in achieving the birth of a healthy child. It can:

  • Improve oocyte quality and avoid malformations in the foetus through an antioxidant diet and appropriate vitamin supplements (3*)
  • Increase endometrial receptivity and, in turn, the chances of embryo implantation by reducing the risk of spontaneous pregnancy loss
  • Improve the prognosis for the mother and the foetus during pregnancy by decreasing complications such as gestational diabetes, pre-eclampsia and macrosomia

Phases of the programme

The whole process is designed and followed by our specialist in endocrinology and nutrition, an expert in fertility and pregnancy.

The programme is estimated to last about 10 weeks, but can be extended at the patient’s request if she wishes to lose more weight prior to pregnancy.

It is divided into three phases:

PHASE 1. Diagnostic orientation and Treatment Planning

 

1st visit: consists of the study of each individual case to evaluate the magnitude of the problem, comorbidities such as arterial hypertension, alteration of glucose metabolism/diabetes, hypercholesterolemia and other associated complications such as thyroid disease or others.

    In most cases, complementary analyses will be required to evaluate the nutritional status prior to treatment and the situation of possible comorbidities for a global adjustment of all of them.

    2nd visit: assessment of the analytical results. Design of the treatment plan based on personalised diet, physical activity and pharmacological treatment using the latest drugs available for obesity (4*). Adjustment of treatments for associated comorbidities.

 

PHASE 2. Follow-up

 

Initial follow-up 4 weeks after the start of treatment with assessment of the initial response, which will determine the treatment adjustments and allow a realistic estimate to be made of the final treatment objective and the time to achieve it.

    During this follow-up phase, the patient and the doctor will decide together when treatment will be suspended and the active search for pregnancy will begin.

 

PHASE 3. Clinical report. Pregnancy Licence

 
  • Final assessment is made with a clinical report
  • Treatments are adjusted and adapted for the time of gestation
  • Complementary analytical tests will be requested if necessary (when weight loss is of such magnitude that it is of interest to re-evaluate the nutritional status or adjust any comorbidity (thyroid…)

(1*) Improving reproductive performance in overweight/obese women with effective weight management

HUMAN REPRODUCTION UPDATE. Robert J.Norman , Manny Noakes , Ruijin Wu , Michael J.Davies , Lisa Moran and Jim X.Wang

(2*) Female obesity is negatively associated with live birth rate following IVF: a systematic review and meta-analysis

HUMAN REPRODUCTION UPDATE. Nathalie Sermondade, Stéphanie Huberlant, Vanessa Bourhis-Lefebvre, Elisangela Arbo, Vanessa Gallot, Marina Colombani, Thomas Fréour

(3*) Adherence to the Mediterranean diet and IVF success rate among non-obese women attempting fertility

HUMAN REPRODUCTION. Dimitrios Karayiannis, Meropi D. Kontogianni, Christina Mendorou, Minas Mastrominas, and Nikos Yiannakouris

(4*) The effect of semaglutide 2.4 mg once weekly on energy intake, apetite, control of eating, and gastric emptying in adults whith obesity

DIABETES OBES METAB. Martín Friedrichsen, Astrid Breitschaft, Sayed Tadayon, Alicja Wizert and Dorthe Skovgaard

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