Weight loss improves reproductive outcomes in obese women undergoing fertility treatment: a randomized controlled trial

Abstract

For women attempting pregnancy, obesity reduces fertility and is an independent risk factor for obstetric and neonatal complications. The aim of this evaluator-blinded, randomized controlled trial was to evaluate a weight loss intervention on pregnancy rates in obese women undertaking fertility treatment. Forty-nine obese women, aged ≤ 37 years, presenting for fertility treatment were randomized to either a 12-week intervention (n = 27) consisting of a very-low-energy diet for the initial 6 weeks followed by a hypocaloric diet, combined with a weekly group multidisciplinary programme; or a control group (n = 22) who received recommendations for weight loss and the same printed material as the intervention. Anthropometric and reproductive parameters were measured at baseline and at 12 weeks. The 22 women who completed the intervention had greater anthropometric changes (-6.6 ± 4.6 kg and -8.7 ± 5.6 cm vs. -1.6 ± 3.6 kg and -0.6 ± 6.3 cm) compared with the control group (n = 17; P < 0.001). The intervention group achieved a pregnancy rate of 48% compared with 14% (P = 0.007), took a mean two fertility treatment cycles to achieve each pregnancy compared with four in the control group (P = 0.002), and had a marked increase in the number of live births (44% vs. 14%; P = 0.02). A group weight loss programme, incorporating dietary, exercise and behavioural components, is associated with a significant improvement in pregnancy rates and live births in a group of obese women undergoing fertility treatment.

Position of the Academy of Nutrition and Dietetics: Obesity, Reproduction, and Pregnancy Outcomes

“…The intervention group lost 5 kg more weight on average (mean loss of 6.6 kg among intervention subjects) and reduced their BMI by 1.8 units more (total of 2.4 BMI unit reduction) when compared to control subjects. 69 Waist circumference dropped by 8.7 cm (8 cm more than among control subjects) indicated loss of abdominal body fat. Pregnancy rates were 14% among control subjects and 48% among intervention subjects; three women in the intervention group conceived naturally and none of the control subjects conceived without assistance.…”

“…69 The intervention included 6 weeks of a very-low-calorie preformulated dietary supplement (providing 2,550 KJ, 65 g protein, 12 g fat, 54 g carbohydrate), followed by 6 weeks of an individualized diet plan (formulated by a registered dietitian nutritionist [RDN]) combined with a weekly group education program that included dietary monitoring and 10,000 steps of daily walking that was monitored through pedometer use. Eighty percent of participants completed the intervention component.…”

Is There a Dose‐Response Relationship Between Weight Loss and Symptom Improvement in Persons With Knee Osteoarthritis?

“…The dietary program used in these patients with KOA was modeled on a similar dietary program that included KicStart for rapid weight loss in other conditions. This program was proven to be effective in obese or overweight persons with type 2 diabetes mellitus, obese women undergoing fertility treatment, and in weight reduction in atrial fibrillation management (16)(17)(18).…”

Female Obesity and its Consequences: A Review

“…Weight reduction leads to high spontaneous conception rates, better response to ovulation induction therapy and improves pregnancy outcomes. [16][17][18][19][20] Folic acid supplementation with 4mg once daily for 12weeks before conception and 13weeks post conception reduces the incidence of neural tube defects which occur at higher rates in obese patients. Obese patients must lose weight before attempting ovulation induction or in vitro fertilisation techniques.…”