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Weighing In on Fertility
If you're hoping to get pregnant, there are several reasons to think about your weight. Women with a healthy weight have an easier time becoming pregnant, are more likely to have a healthy pregnancy once they conceive, and have higher odds of delivering without complications.

Conception
It may take longer for overweight women to conceive than their normal weight peers. One study showed that obese women on average took 11 months to become pregnant, compared to an average of seven to eight months in average sized women. Another study found that the length of time to conceive increased as body mass index (BMI) increased. This means that on average, the more a woman weighed, the longer it took her to get pregnant. One reason for the delay is that overweight women may ovulate (release an egg for conception) less frequently than women of normal weight. While most obese women eventually conceive, many require the assistance of fertility specialists. However, obesity may impair the effectiveness of fertility treatments. Obese women may need higher doses of fertility drugs and may require more IVF (in vitro fertilization) cycles to achieve success.

Miscarriage and Birth Defects
Obesity increases the risk of miscarriage, both in spontaneous conceptions and those achieved through in vitro fertilization. Studies have also found a link between obesity and the risk of birth defects. The risk of neural tube defects, for example, is higher in the infants of obese women. Because of this elevated risk, women with moderate obesity are advised to take higher levels of folic acid before conception than women of normal weight.

Long-term Outcomes
Children of obese mothers are more likely to be heavy at birth, putting moms at risk for Caesarean sections, and babies at risk for future obesity in childhood, adolescence and adulthood.

Improving your Health—Exercise, Healthy Foods and Vitamins
If you're overweight and wanting to improve your chances for an easy conception and healthy pregnancy, now's the best time for healthy eating and exercise. Adhering to a healthy diet and exercise program can be challenging, especially when surrounded by advertisements and food vendors tempting us with sweets and junk food. Choose a weight-loss program that appeals to you, and cultivate a good support system. Staying active is also important for a healthy pregnancy, and regular exercise should be part of your routine. Excellent forms of exercise include walking, swimming, and low-impact aerobics.

Meet with your own doctor to get specific advice on the safest ways to reach a healthy weight. In addition to standard prenatal vitamins, obese women with a BMI over 35 are advised to take 5 milligrams of folic acid a day for three months before pregnancy to lower the risk of neural tube defects. If conventional weight loss programs are unsuccessful, your doctor may recommend medications to aid with weight loss. Consider joining a support group to help you meet your new goals. And don't forget about your partner. You will have an easier time sticking to a healthy lifestyle if your partner adheres to your new diet. Studies have indicated that male obesity is linked to fertility difficulties as well, so you and your partner can boost your chances of success if you both aim for a healthier weight.

Losing weight is hard work, but don't despair. Even moderate amounts of weight loss have been linked to improved fertility.

Laura E. Stachel M.D. Obstetrician & Gynecologist