New Debate: Is It Time for Infertility Weight-loss Programmes to be Couple-based?

Damian Best; Alison Avenell; Siladitya Bhattacharya; Gertraud Stadler

Disclosures

Hum Reprod. 2017;32(12):2359-2365. 

In This Article

Potential Benefits of Weight Loss

Weight loss has shown benefits in overweight women and men experiencing fertility problems (Best et al., 2017). In overweight women, a weight loss of 10% or more has been shown to improve insulin resistance (Zain and Norman, 2008), spontaneous pregnancy (Duval et al., 2015; Mutsaerts et al., 2016; Lan et al., 2017) and live birth rates (Kort et al., 2014). A reduction of body weight by 2–5% has been associated with restoration of ovulation and a 71% increase in insulin sensitivity (Huber-Buchholz et al., 1999). Weight loss exceeding 3 kg has been associated with an improvement in the numbers of mature oocytes retrieved in IVF cycles (Chavarro et al., 2012). However, it is uncertain whether this translates into improved pregnancy or live birth rates in these cycles, as some studies suggest no added benefit (Moran et al., 2011; Chavarro et al., 2012; Einarsson et al., 2017), while others do (Clark et al., 1998; Sim et al., 2014a). In obese men, a weight-loss programme was associated with improvement in semen quality (Hakonsen et al., 2011), while a dietary programme resulted in reduced abdominal fat, decreased sperm DNA fragmentation, and improvement in metabolic and hormone profiles, with all spouses in the latter case series becoming pregnant (Faure et al., 2014). In a prospective uncontrolled pilot study (Homan et al., 2012), 23 infertile couples received motivational face-to-face interviews on an on-going basis with one to two weekly phone calls over 4 months. The weight loss achieved was not precisely described, but 47% were reported to having 'a modest loss of between 1 and 5 kg'. Eight of the twenty-three couples conceived by the end of the follow-up period (Homan et al., 2012).

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