Zhang Qiaoli, a physician in the Department of Human Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University

What do the urban white-collar women need to do preparing for pregnancy? Let’s look at a real-life story.

Song Jinyu is a foreign white-collar woman and a little fat. She seldom works out because of her hectic work schedule. With a lot of work pressure, she often stays up to midnight. Besides, food is also her favorite.

Zhang Qiaoli

She often goes out in search of delicacies. After six years of marriage, she planned to have a baby. Her husband and mother-in-law took very good care of her, and let her do no household chores after work.

Her weight increased by 10 kg in a short time. Nothing happened except her fat belly after preparing for pregnancy for nine months. The couple started feeling the pressure and began experiencing insomnia. She came to the hospital to seek medical help.

After physical and laboratory examinations, I found obesity and irregular menstruation was her major problems. Here is prescription I gave to her: lose weight through dieting and exercise, and maintain joyous mood. After four months, she lost 12 kg of weight. A few days ago, she told me that she was pregnant. I feel glad for her but still asked her to watch her weight for the entire pregnancy.

Overweight and obesity are important health issues, and the increasing prevalence of obesity is recognized worldwide. According to the World Health Organization, if the body mass index (BMI) ≥ 25 kg/m2, it is considered overweight, whereas if BMI ≥ 30 kg/m2, obesity. Overweight and obesity involve abnormal and excessive fat accumulation that negatively affects health.

Obesity is related to health risks such as hypertension, diabetes mellitus, coronary heart disease and is linked to various malignancies, particularly cancers of the endometrium, breast, and colon. Obesity might lead to reproductive disorders, particularly in women. It is associated with an ovulation, menstrual disorders, infertility, and difficulty in assisted reproduction, miscarriage, and adverse pregnancy outcomes, such as pregnancy-induced hypertension, preeclampsia, gestational diabetes, fetal macrosomia, preterm labor and delivery. The abdominal pattern of fat distribution may have a specific impact on ovulation and fertility.

These adverse effects of obesity are specifically evident in polycystic ovary syndrome. The Nurses’ Health Study reported that the risk of infertility increased in women with increasing BMI. A small weight loss in an ovulatory obese women resulted in improvements in menstrual cycles, ovulation, pregnancy rate, and pregnancy outcome.

Overweight and obesity may also affect fertility in males. The decline in male reproductive potential over the past half century may be a result of the increasing incidence of obesity. Obesity contributes to infertility by reducing semen quality, changing sperm proteomes, contributing to erectile dysfunction and increasing scrotal temperature. The lower sperm counts, motility and concentration were observed in obese and overweight males. Much more attention should be paid to the impact of overweight and obesity on fertility in both female and male. BMI had a significant and cumulative dose-dependent negative impact on fecundity. The overweight and obese female and male should be informed to lose weight for pregnancy. Weight loss might be an optimal treatment to improve obesity associated infertility, and be best achieved through a sensible eating plan that can cut down calories and be maintained over long periods of time.

A balanced diet with high fiber and low fat should be advised. The likelihood of maintaining weight loss is increased when the diet is combined with regular exercise in order to achieve a normal energy balance, cognitive behavior therapy and a connection with a supportive group environment. Lifestyle changes should also be made with reduction if not quitting of smoking, alcohol, fast food and coffee consumption. Losing weight is not a short-term task, and it entails perseverance. Not only for pregnancy, everyone should maintain a healthy weight for their whole life.