Plus-Size Fertility

by Brette Sember for Elegant Plus Magazine

The decision to become a parent is an exciting one. You and your wonderful man are going to create new life together through the power of your love. It’s a heady feeling and one that definitely can bring you closer together. But if you’re a plus-size woman, you may worry about what kind of impact your weight will have on getting pregnant.

Schedule a Pre-Conception Physical

Make an appointment to see your gynecologist before you toss that birth control out the window. It is now recommended that all women have a pre-conception check up to discuss medications, lifestyle changes, and any possible stumbling blocks to conception that they might face. As a plus-sized woman, one of things your physician will likely discuss with you is weight. Being overweight can cause irregularities with your cycle and suppress ovulation. It’s likely that you’ll be encouraged to get close to your ideal weight by your doctor (according to body mass index charts), but losing even 10 pounds can have a significant positive impact on fertility for many women. Diet drugs are an absolute no-no though when trying to conceive.

Losing weight is a personal choice (and for many women, a difficult path), so be sure to weigh your own feelings into the decision. It’s also important to note that too much weight loss too quickly can make it difficult to conceive.

Discuss Major Causes of Fertility Problems

When you see your physician, it is a good idea to ask about two common medical issues that impact the ability to conceive for many plus-size women. If you have never had your thyroid tested, ask for a complete thyroid profile (the traditional TSH test is NOT enough because an underactive thyroid sometimes is only detected with thyroid antibody levels). An underactive or overactive thyroid can impair fertility and also cause problems during pregnancy. Overweight women are most likely to experience an underactive thyroid since the failure of thyroid to function properly can lead to weight gain. Hashimoto’s thyroiditis, the most common form of underactive thyroid, is five times more prevalent in women than in men. 

You should also discuss Polycystic Ovarian Syndrome (PCOS) with your physician. Between five and ten percent of all women of childbearing age have PCOS, which is a complicated metabolism and hormone imbalance. Symptoms include infrequent or irregular cycles, acne, facial hair, high cholesterol, thinning hair, skin tags, and sleep apnea. PCOS is a leading cause of infertility in overweight women (and there is a higher incidence of it in overweight women), because the imbalance of male and female hormones makes it difficult to get pregnant.

Some women find they have both of these problems, creating a double whammy. These disorders are things that many physicians are not as aware of as they should be, so asking to be tested for both will offer you peace of mind about your own fertility.

Make a Trip to the Drugstore

Your physician will prescribe prenatal vitamins for you, an important way to make sure you will have a healthy pregnancy. While prenatal vitamins are important, there is some research to suggest that the typical prenatal vitamin does not contain enough folic acid to provide protection in overweight women against neural tube defects in the baby. Some physicians believe plus-size women should take additional folic acid supplements (since it is a harmless vitamin) along with their prenatal vitamins in order to obtain full protection. Ask your physician about a higher dose of folic acid.

Track Your Cycle

While trying to get pregnant can be a romantic and exciting proposition, there is a science to it. Learning how to maximize your cycles can mean getting pregnant more quickly. Start tracking your basal body temperature each morning before you get up. Talk to your physician about how to read this chart (essentially you’re looking for a temperature drop, then an increase of at least .4 degrees, which indicates ovulation). Over the counter ovulation predictor kits are also a valuable tool. The key is to try to have sex at least every other day during the five days before you ovulate and the two days after. For more information, see www.FertilityPlus.org.

Stay Positive

Feeling good about your body and keeping a positive outlook will not only ease stress (which has been shown to have a negative effect on fertility), but will help you stay happy as you begin trying to get pregnant. Many women hope they will get pregnant right away, but in actuality there is only a 25% chance of getting pregnant each month, so you may have a long road ahead of you. Make time for your relationship and for yourself and try not to let all your hopes and happiness ride on that monthly pregnancy test.

Staying positive about your body is key, because many full-figured women often have low self-esteem. This is the time in your life when you should appreciate the amazing things your body can do, and learn to love it for what it is.

When to Seek Help

According to the CDC, 55% of couples get pregnant within three months, 72% within six months and 85% within one year. The standard advice is to try for a year before seeking assistance, but overweight women should seek assistance sooner, since weight can impair ovulation. If you do not ovulate (based on your basal body temperature chart or ovulation predictor kits), you should call your physician immediately. If you are over age 35 you also should not wait a year, since your window of opportunity is getting smaller.

Recommended Books

About the Author

Brette Sember is a plus-size mom of two and co-author of Your Plus-Size Pregnancy: The Ultimate Guide for the Full-Figured Expectant Mom (Barricade Books, 2005). Her web site, www.YourPlusSizePregnancy.com, contains a section on plus-size fertility.

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