Obesity is rising across the country, mainly among women in their reproductive years. Busy schedules, lack of physical activity, high stress levels, and unhealthy eating habits are the causes behind obesity. Experts emphasise that weight control and healthy lifestyle practices must become central to fertility care.
Couples affected by obesity can still become parents through lifestyle modifications, if that doesn’t work, then Intrauterine Insemination (IUI). And if that doesn’t work then advanced fertility treatments such as In Vitro Fertilization (IVF) can be taken up.
Obesity has become one of the most common health challenges, and it often shows up when women come for fertility or reproductive health issues. Dr. Kaishreen Khan, consultant- Obstetrician and Gynaecologist, Motherhood Hospitals, Kharadi, Pune, explains, “Around 60–70 per cent of the women who visit me have obesity-related concerns. So, it is 6-7 women in the 10 aged 25 to 35 years. When it comes to couples, around 10–12 couples every day come with obesity-related issues, and this number is steadily rising. In women, excess fat leads to hormonal imbalance with higher insulin and estrogen levels, which disrupts ovulation and menstrual cycles. Obesity in women is strongly linked to infertility, with conditions like PCOS (polycystic ovarian syndrome) causing irregular periods and difficulty in egg release. It also worsens complications such as diabetes (DM), hypothyroidism, and hypertension (HTN), risk of miscarriages, and preeclampsia, all of which directly affect fertility and pregnancy outcomes. Even assisted reproduction outcomes are affected, as obese women tend to have lower egg retrieval rates, poorer embryo quality, and reduced IVF success. Additionally, excess weight gain can worsen varicoceles- swollen testicular veins, further reducing fertility potential.
In men, obesity is linked to poor sperm health, reduced testosterone levels, erectile dysfunction, and poor sperm quality, including conditions such as asthenoteratozoospermia (reduced sperm movement and abnormal shape). This can lower fertility potential and delay conception for couples,” adds Dr Kaishreen.
The Pune-based health expert further explains, “Couples should ensure to adhere to lifestyle modifications such as eating a nutritious diet, exercising five times a week for 45 minutes, sleeping well, reducing stress by relaxation techniques like yoga and meditation, and seeking timely intervention for PCOS management. They should also focus on mindful eating and avoid emotional eating, control the proteins, cut back on hidden sugars, and processed foods. An increase in daily movement is very important; a few simple ways are taking stairs, using standing desks, walking after meals, and making sure to track the process. Also, seek professional help in terms of weight management and nutrition intake. Maintaining a healthy waist-to-hip ratio rather than only focusing on body weight can give better metabolic health. Ensure you get enough vitamin D, stay hydrated, and avoid smoking and alcohol, as they can directly affect weight and fertility outcome.”
“A Body Mass Index (BMI) range according to the World Health Organization (WHO), which is normal, is considered between 18-25. Above 25, it is called overweight, and over 30, the patient can be termed as obese. The effects of obesity on fertility can be many. In women, obesity is linked with hormonal imbalances, PCOS. Age plays an important role and especially when it is associated with obesity, fertility can decline after the age of 35. So, obesity even accelerates this, worsening the quality of eggs and implantation rates. In men, if the age is above 40, it reduces sperm quality and increases the risk of genetic abnormalities. Younger obese patients may still conceive with lifestyle changes, but older obese patients may face double the risk from both age and obesity,” said Dr Bushra Khan, Fertility Specialist, Nova IVF Fertility, Kharadi, Pune.
Dr Bushra Khan further added, “The percentage of couples that face infertility-related issues and obesity is very high globally, nearly 15 to 20 percent in fertility clinics. We observe around 40 percent of women who are seeking infertility treatments who are obese. We have a higher number of obese patients in urban populations as compared to rural populations. Nearly one out of every three couples who are obese presents with infertility. It is hard to say if obesity and infertility are more prevalent in females or males. A lot of PCOS patients can turn out to be obese, especially if they have insulin resistance, ovulatory dysfunction, and they have excess adipose tissue, which has an environment that is testosterone-dominant, whereas men also they are also not spared. Male infertility and DNA damage in the sperm are seen in men when they have general abdominal obesity, but overall, women show a higher infertility risk from obesity as compared to both partners.”
Obesity contributes to other health concerns beyond fertility. “An obese patient can be more prone to diabetes, insulin resistance, complicated metabolism, cardiovascular problems, hypertension, heart attacks, strokes, hormonal imbalance, PCOS, and thyroid abnormalities as well,” concluded Dr Khan.
