holistic living farm

1. OBESITY AS ONE OF THE LEADING
CAUSES OF INFERTILITY,
PREGNANCY COMPLICATIONS, AND
POLYCYSTIC OVARIAN DISEASE.
EFFECTIVE WEIGHT LOSS IS ESSENTIAL
FOR WOMEN'S HEALTH.
Dr. David Thuo
Obstetrician and Gynaecologist
Velvet Healthcare

2. DEFINITION OF TERMS
 INFERTILITY - refers to an inability to conceive after
having regular unprotected sex. Infertility can also refer
to the biological inability of an individual to contribute to
conception, or to a female who cannot carry a pregnancy
to full term
 PREGNANCY COMPLICATIONS - are health problems that
occur during pregnancy. They can involve the mother's
health, the baby's health, or both.
 POLYCYSTIC OVARIAN SYNDROME - is a set of symptoms
due to a hormone imbalance in women.

3. STATISTICS
 Kenya Fertility rate – 4.38 number of children that would
be born to a woman if she were to live to the end of her
childbearing years and bear children in accordance with
current age-specific fertility rates.
 > 1 billion people in the world are overweight (WHO)
 > 300 million obese (WHO)
 26% of non pregnant women ages 20-39 are overweight
/obese (WHO)
 And the prevalence of obesity is on the increase

4. BMI

5. MECHANISM OF ENDOCRINOLOGIC
CHANGES IN OBESITY
 Obesity represents a state of hormone imbalance as levels
of SHBG (sex hormone binding globulin) decrease linearly
with percentage of body fat, leading to increased free
androgen (masculine hormone) levels.
 Abdominal obesity is associated with both insulin
resistance and elevated circulating androgens.
 Hyperinsulinemia, insulin resistance and elevated free
circulating androgens cause ovulatory and menstrual
disturbances
 Hyperinsulinemia, insulin resistance and
elevated free circulating androgens cause
ovulatory and menstrual disturbances

6. EFFECT OBESITY AND REPRODUCTIVE
HEALTH
1. Absence of menstruation (amenorrhea)
2. Failure of ovulation (anovulation)
3. Being less than normally fertile though still capable of
effecting fertilization.(Sub fertility)
4. Inability of a sexually active, non-contracepting couple
to achieve pregnancy in one year. (infertility)
5. Irregular menses
6. Masculine hormone (Androgen) excess

7. 7. PCOS (polycystic ovarian syndrome)
FEATURES:
a) Central obesity
b) hyperandrogenism (male hormone excess)
c) Insulin resistance (inability of a sexually active, non-
contracepting couple to achieve pregnancy in one year)
 All the above features contribute to female infertility

8. CONTD
 8. obesity leads to poorer prognosis with Assisted
reproduction (e.g IVF). By half in women with
BMI>35KG/M2
 9. Obese women also suffer lower pregnancy rates due to
altered receptivity of the endometrium (inner lining of
the uterus)
10. There are higher rates of miscarriages.
11. There are increased rates of medical complications in
obese women (pregnancy induced hypertension, gestational
diabetes and thromboembolism(blood clots).

9. Contd.
 12. In labor obese women experience more – preterm
birth, fetal deaths, still births (baby born dead) and
congenital anomalies.
 13. post partum (after delivery) complications are more in
obese women.

10. 14. Male infertility

13. TAKE HOME
 THINK HEALTHY,
 TALK HEALTHY,
 EAT HEALTHY,
 EXERCISE HEALTHILY
 REGULAR HEALTH CHECKUPS
 STAY HEALTHY

14. THANKYOU