Weight, fertility and pregnancy health

Please note: This page is about your weight before getting pregnant. If you’re already pregnant and want to lose weight it’s important to talk to your GP or a dietitian first.

Most people know that being overweight or obese increases the risk of health problems such as heart disease and diabetes. But many are unaware that this can also reduce fertility and the chance of having a healthy baby.

If you are trying to get pregnant, or plan to start trying, the closer you are to a healthy weight, the greater your chance of conceiving (getting pregnant) and having a healthy baby.

Ideal weight for conception varies

The ideal weight for conception depends on how tall you are. Your body mass index (BMI) is a number based on your height and weight. The healthy BMI range is between 18.5 and 24.9. Adults with a BMI between 25 and 29 are considered overweight and a BMI over 30 indicates obesity. You can find out what your BMI is using our BMI tool.

Overweight and fertility in women

Being an unhealthy weight can affect a woman’s fertility by causing:

• hormonal imbalances
• problems with ovulation (releasing an egg from the ovaries)
• menstrual disorders.

It can also lead to difficulties with assisted reproduction, such as in-vitro fertilisation (IVF), ovulation induction and intracytoplasmic sperm injection (ICSI).

Obesity is also associated with polycystic ovary syndrome (PCOS), a common cause of low fertility or infertility.

Overweight and fertility in men

Being very overweight or obese can also reduce a man’s fertility. This is likely due to a combination of factors including:

• hormone problems
• problems with erection
• other health conditions linked to obesity.

Weight loss in men who are overweight or obese can improve total sperm count and quality. Reaching a healthier weight at least 3 months before conception can improve the chance of conception. This is because sperm take about 3 months to develop and being in the healthy weight range during this time helps develop healthy sperm.

Overweight and pregnancy health

Getting closer to a healthy weight before conception increases the chance of the baby being healthy at birth and into adulthood.

Obesity and excess weight gain during pregnancy is also linked with a number of pregnancy complications. These include increased risk of:

• miscarriage
• high blood pressure
• pre-eclampsia
• gestational diabetes
• caesarean birth
• stillbirth.

Babies born to mothers who have obesity have an increased risk of childhood and adult obesity and other long-term health problems.

While the facts about obesity and reproductive outcomes can seem daunting, there is some good news. In women who live with obesity, even a small weight loss improves fertility and pregnancy health. Also, some diet and lifestyle changes that limit excessive weight gain during pregnancy can improve health outcomes for both mother and baby.

Getting ready for pregnancy

If you are planning to get pregnant, starting a healthy eating and exercise plan now improves your chances of getting pregnant and having a healthy baby. By making healthy changes to your diet and increasing your daily physical activity, you’ll be taking steps toward reaching a more healthy weight. This is also important when using IVF and other assisted reproductive technologies (ART).

Studies have found that obesity reduces the rate of pregnancy and live births in women using ART, and increases the risk of miscarriage. But weight loss through diet, lifestyle and other changes significantly improves these outcomes.

Ask your doctor about any dietary supplements you may need, such as folic acid and iodine.

Tips for a healthier weight before pregnancy

Try these steps to a healthier weight:

• Follow a healthy balanced diet drawn from the 5 food groups: vegetables and legumes; fruits; wholegrain bread and cereals; milk, yoghurt, cheese and alternatives; lean meat, poultry, fish, eggs, seeds and nuts.
• Cut back on discretionary foods (including chips, biscuits, fatty meats, pastries, cakes, fast foods and confectionary) and only eat them in small amounts.
• Eat regular meals and limit unhealthy snacking.
• Swap sugary drinks and alcohol for water.
• Make half your plate vegetables at lunch and dinner.
• Use a smaller plate to help reduce your portion sizes.
• Get moving every day. Fit in regular physical activity like walking to the shops, taking the stairs and walking with a friend.
• Spend less time sitting by getting up regularly while using a computer or mobile device, and swapping screen time for other activities.
• Set a realistic weight goal. It can help you feel motivated and active. Aiming for weight loss of half to one kilogram per week until you reach your target weight is a good goal.
• Start a healthy eating and exercise plan together with your partner to increase the chance of getting pregnant and having a healthy baby.

Making these changes will make a difference to your overall health, even if they don’t lead to weight loss. Begin making these changes before you start trying to conceive, and keep them up throughout your pregnancy and beyond.

Remember, if you’re already pregnant and want to lose weight it’s important to talk to your GP or a dietitian first, before you start making any lifestyle changes.

Underweight and fertility

Being underweight (BMI under 18.5) can reduce a woman’s fertility by causing hormone imbalances that affect ovulation and the chance of getting pregnant. Compared to women in the healthy weight range, women who are underweight are more likely to take more than a year to get pregnant.

If you are underweight and trying to conceive, a dietitian can work with you to change your diet and help you put on weight.

Where to get help

• Your GP (doctor)
• Obstetrician or Obstetrician-gynaecologist
• Fertility specialist
• Accredited practicing dietitian
• Victorian Assisted Reproductive Treatment Authority (VARTA)
• Your Fertility