
It’s often considered taboo to inquire about a woman’s age or weight, as these topics can evoke strong emotions for many. However, as a fertility professional, I must confront these questions head-on with my clients. Discussing age and weight can stir a whirlwind of feelings, particularly for those navigating the challenging path to motherhood, often leading to anxiety and emotional strain. Yet, age and weight are measurable factors, and numerous unbiased studies highlight their significant roles in fertility. Despite the impact these components may have, empowering clients with effective and practical strategies can notably enhance their chances of conception.
How Weight Affects Fertility
Our weight is an indicator of our overall health. Women who have a high body mass index (BMI), whether that is overweight (BMI of 25-29.9) or obese (BMI above 30), are more predisposed to specific health issues, including high blood pressure, high cholesterol, and high blood glucose levels. Having elevated glucose levels can negatively affect egg quality. Adipose tissue, also known as fat, holds estrogen. As a result, having excess fat can cause hormonal imbalances and may cause a woman not to ovulate. Measuring BMI is easily achievable by inputting your weight and height into a BMI calculator.
Health experts in the field of weight management sometimes place more emphasis on body fat percentage, as that is an accurate measure of fat. Individuals with a lot of muscle mass from being physically fit and having a high BMI may not have a lot of fat. Body fat percentage can be measured using several methods; the most common and easiest way is using skinfold calipers.

Tactics to Reduce Weight to Improve Fertility
Below are several tactics that can reduce your weight
1. Eat protein and fiber with every meal
2. Make fiber your entrée (the largest portion) in every meal
3. Have carbohydrates as your side dish (smallest portion)
4. Consume your carbohydrates last in every meal
5. Incorporate functional foods for weight loss including ginger, garlic, and coconut oil
6. Drink enough water: aim to drink half your body weight in ounces. For example, if you weigh 130 pounds, aim to drink 65 ounces of water.
7. Aim to get 30 minutes of cardio exercise 5 times a week
8. Strive to get 2-3 hours of strength training a week
9. Find exercises you enjoy doing, as you are more likely to stick with it
10. Stop eating by 7 pm
11. Target 8-9 hours of sleep a night
12. Talk to your physician about whether you are a candidate for GLP-1 agonist medication
The Impact of Low Weight on Fertility
While much of the focus tends to be on high BMI, being underweight (BMI less than 18.5) can also have detrimental effects on fertility. A low BMI can disrupt hormonal balance and lead to irregular or absent menstrual cycles, known as amenorrhea. Insufficient fat stores may interfere with estrogen production, a hormone critical for ovulation. Women who are underweight may also experience reduced implantation rates and an increased risk of miscarriage. Addressing a low BMI involves incorporating nutrient-dense foods, increasing caloric intake, and engaging in strength-building exercises to promote healthy weight gain.
How Age Affects Fertility
Age is an unmodifiable factor, since there is nothing we can do to prevent or stop aging. Women above the age of 35 have a decline in fertility, statistically speaking. This arises from decades of oxidative stress affecting the limited number of eggs women are born with. Unlike men, who produce fresh sperm every few months, women do not make fresh eggs every few months. Despite this being the case, many women can conceive well into their 40s, with or without fertility treatment.
Despite popular belief, women can enhance egg quality through strategic nutritional interventions. Having good egg quality and sperm quality enhances the chances of an egg being fertilized by sperm, and it will also reduce the chance of a miscarriage. Interventions implemented today and practiced daily will impact the egg you ovulate three months from now. As a result, it is important to prepare your body for conception in advance. Just like preparing for a wedding or a marathon, your body can be prepped and primed to accelerate the chances of pregnancy.
Women over the age of 35 who have been trying to conceive for a while might benefit from:
1. Supplements: along with a comprehensive PNV, women should consider the following: Coenzyme Q10, Vitamin D, Melatonin, DHEA
2. Holistic Medicine: consulting with a fertility herbalist, acupuncturist, or functional medicine practitioner regarding herbs for fertility
3. Fertility Consultation: seeing a fertility specialist to consider ovarian rejuvenation, IUI, or IVF

Relationship Between Age, BMI, and Fertility
Chronic stress is often overlooked as a factor influencing fertility. Yet, it has profound effects on both BMI and age-related fertility challenges. Stress can disrupt the hypothalamic-pituitary-ovarian (HPO) axis, leading to hormonal imbalances that affect ovulation. It may also contribute to unhealthy weight gain or loss, exacerbating fertility issues related to BMI. Incorporating stress-reducing practices such as yoga, meditation, and mindfulness can positively impact overall reproductive health.
Although we cannot control our age, there are many modifiable factors that can improve our ability to become pregnant and sustain a pregnancy. The intricate relationship between age, BMI, and fertility underscores the importance of understanding how these factors influence reproductive health. As you navigate your family planning journey, recognizing that both advanced age and extreme BMI can pose challenges to fertility is essential but should not be discouraging. This awareness empowers you to make informed decisions and seek appropriate medical advice when necessary. Promoting a healthy lifestyle and staying attuned to changes in body composition and age-related fertility trends can enhance your chance of conception and support overall reproductive well-being. Fostering a holistic approach to health can pave the way for a more positive fertility experience.
References
Dağ ZÖ, Dilbaz B. Impact of obesity on infertility in women. J Turk Ger Gynecol Assoc. 2015 Jun 1;16(2):111-7. doi: 10.5152/jtgga.2015.15232. PMID: 26097395; PMCID: PMC4456969.
Delbaere I, Verbiest S, Tydén T. Knowledge about the impact of age on fertility: a brief review. Ups J Med Sci. 2020 May;125(2):167-174. doi: 10.1080/03009734.2019.1707913. Epub 2020 Jan 22. PMID: 31964217; PMCID: PMC7721003.
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