Dr Ciara Wright was recently speaking at an international medical conference on safe and sensible weight loss for IVF.
When losing weight is the last thing you want to do
Hearing that you need to have IVF can be very difficult. It is an emotionally and often physically draining process, with the highs of your hopes and expectations and the lows of test results, bad news and failed cycles. When your dream of having a family is proving hard to realise, it can be just another blow to hear that you need to lose weight. We all know that losing weight is difficult at the best of times, but in the midst of the rollercoaster of IVF, it can be even more difficult.
Risks of being overweight in IVF and pregnancy
Many IVF clinics have an upper limit of BMI for women over which they will not proceed with an IVF cycle. Overweight or obese women are more likely to have a failed cycle and if it is possible to lose weight, then the chances of a successful cycle and a healthy baby are much higher. Carrying extra weight can alter hormone levels in the blood, including lowering levels of hormones that trigger ovulation. During an IVF cycle, if you are overweight you may need additional hormonal medication and it may be more difficult to manage the stimulation of egg production. It has also been shown that overweight and obese women produce less good quality embryos, have a higher rate of miscarriage and a lower chance of a healthy live birth.
Being overweight in pregnancy also carries increased risks to both mother and baby, including gestational diabetes and pre-eclampsia along with higher rates of caesarean section and pre-term delivery. There are lots of good reasons to lose weight before an IVF cycle, it’s just easier said than done.
It’s not all about the woman; being overweight as a man is linked to lower levels of testosterone and sperm quality issues. Working as a team to eat healthily and lose weight when necessary can make a significant difference to your chances of having a healthy baby.
Extreme dieting may upset your hormone levels
Weight loss is often synonymous with misery, deprivation and hunger. These are the kind of feelings you could do without on top of worrying for the future of your family and relationship. In addition, intense dieting can be physically stressful on the body. Research clearly shows that fasting or ‘starving’ oneself increases production of the stress hormone cortisol in the body. The main raw material needed to make this stress hormone just happens to be the same raw material you need to make sex hormones, oestrogen and progesterone. Simply put, making too much stress hormone means you may not have enough raw material left over to make your sex hormones.
Sensible weight loss is key to IVF success
The key to reaching and maintaining healthy weight loss is not to follow an extreme diet or go hungry. Eating smaller meals more often allows you to reduce your overall intake of calories without feeling hungry and therefore without stressing your body. We recommend eating three small meals per day and two healthy snacks. Each meal or snack should contain good quality protein or healthy for slow release energy. Focus on eating a wide range of healthy foods regularly throughout the day, helping to ensure you are getting the nutrients you need.
In addition, incorporating exercise is always going to be a key element of weight loss. We recommend gentle to moderate exercise at this time which may reduce cortisol levels. High intensity exercise can promote stress and is not advised before or during an IVF cycle.
Slow steady weight loss
Aim for a slow steady weight loss of approximately one pound or half a kilogram per week. Before IVF is not a time to starve yourself, it is time to nourish your body and take care of yourself.
Dr Ciara Wright PhD, Glenville Nutrition Ireland