ABU DHABI 15 August 2017: Trying to start families later in life, many couples in the Gulf find it difficult to conceive – why?
With changing lifestyles and increasing stress levels, obesity – caused by poor diet and a sedentary lifestyle has emerged as one of the major cause for higher infertility rates in the region than the west.
Trying to start families later in life, Vitamin D deficiency, consanguinity, diabetes and smoking are also other important causes that affect a couple’s child bearing capacity.
“It is estimated that infertility affects 15 per cent of the global population of reproductive age, but this percentage is even higher in the GCC,” said Dr Laura Vidales, IVF Specialist at IVI Middle East Fertility Clinic.
It is, therefore, no surprise that there is an high prevalence of obesity particularly in the GCC including Bahrain, Kuwait, UAE, Oman and Saudi Arabia, which has witnessed rapid regional economic advancement resulting in increased food access, consumption, and lifestyle changes, family history, urbanisation and high-calorie diets.
Staring at a computer screen while drinking countless cups of coffee and eating junk food has become the way of life for most of us. The result is weight gain – which eventually leads to obesity.
What Does Obesity Do?
Obesity directly affects your fertility. It causes hormonal imbalances and problems with ovulation in women, thus affecting their ability to conceive. In addition, obesity is associated with infertility in men as well, resulting in decreased libido, erectile dysfunction and poor semen quality,” said Prof. Dr. Human Fatemi, Subspecialist Reproductive Medicine and Reproductive Surgery, Medical Director, IVI Middle East Fertility Clinic.
“In today’s fast-paced world, infertility is globally acknowledged to be a major health problem, but its causes are specific. I believe that if you address the root cause, your chances of treating the problem successfully are much higher,” added Prof. Dr. Fatemi.
IVI Middle East Fertility Clinic recently collaborated with Aristotle University of Thessaloniki, Greece on a study of fertility in the Gulf, which was published in the
international journal titled Fertility and Sterility.
Gulf Research
The study not only brought to light the region specific causes of infertility, but also highlighted how obesity, vitamin D and marriage within the family, affects fertility rates.
To add to it, the study also highlighted that hormonal abnormalities and ovulation dysfunction were associated with obesity.
“Our lifestyle has changed completely in this part of the world in the past 30 to 40 years. Fifty years ago, there was no air conditioning and now people are inside all the time,” said Dr Laura on why obesity is increasing at such an alarming rate in the Middle East.
She also informed how body mass index (BMI) impacts an individual’s fertility rate. “Obesity is determined by the BMI (Body Mass Index) level of a person,
which is calculated as an average ratio of one’s height and weight. If one’s body mass index (BMI) is higher than 29, the receptivity of the uterus declines, as well as the chromosomal formation of the eggs decline too,” added Dr Laura.
High BMI
An elevated BMI can cause hormonal abnormalities, ovulation dysfunction, menstrual irregularities, anovulation and low conception rates.
Also, overweight women have an increased chance of a cesarean section for delivery.
In men, obesity is associated with low testosterone levels. In severely obese man, reduced sperm production (spermatogenesis) related with severe hypotestosteronemia (Low abnormal concentration of testosterone) may favor infertility.
Moreover, the occurrence of erectile dysfunction increases with increasing BMI.
It has been noted that overweight women undergoing IVF treatment are significantly more likely to respond inadequately to controlled ovarian hyper
stimulation (COH) and fail in achieving pregnancy compared with non-obese women.
Increased BMI is also associated with a greater need for fertility hormones such as gonadotropins, lower pregnancy rates (PRs), fewer eggs, and higher miscarriage rates amongst women undergoing assisted reproductive technique (ART). A reduction in endometrial (uterine lining) quality represents a further outcome which can compound the effect of obesity on fertility.
How to Control Obesity
“It is important to control obesity at the right time. The foremost treatments for obesity and weight-loss are regular exercise and a balanced-diet. These help restore ovulatory function and reduce the rate of miscarriage in obese women who face infertility problems.
A multidisciplinary approach to weight management is important. This includes the initial assessment of infertility and BMI, emphasis on the importance of lifestyle change, education about proper diet, exercise and behaviour modification.
A more holistic approach to obesity and reproductive health may help,” concluded Dr Laura.
It is noted that if a person can attain a decent BMI level within six months of following a healthy lifestyle with a balanced diet and regular exercise, the chances to bear a child increases. While preventing obesity, especially among those with a family history, is not easy, it is certainly important to make health a priority.
By Sheena Amos