Fertility & Pregnancy: A Guide for Overweight Women

Fertility and pregnancy are unique journeys for every woman, but for those who are overweight, they may come with unique and significant challenges.¹ Every pregnancy is a unique experience, and different couples have different prerequisites for becoming pregnant. Fertility rates are influenced by a range of factors in both women and men, such as gender, weight, and significantly across different ages, with statistical data showing a steady decline in reproductive success as both women and men get older (more about menopause and weight here). Research shows that female fertility varies with age, peaking between 20 and 24 years old and declining more sharply after that, while male fertility also changes but less dramatically.¹ For women, excess weight can further reduce fertility, making it even more challenging to become pregnant.¹ This is often due to the impact of excess weight on hormone balance, ovulation, and overall reproductive function.² Even though conceiving is successful, a high BMI during pregnancy and childbirth carries a risk for both the mother and the developing baby, due to conditions like gestational diabetes, high blood pressure, and pre-eclampsia.¹

Despite these obstacles, many overweight women conceive and deliver healthy babies. Knowledge and understanding of  how weight impacts fertility and pregnancy, along with adopting tailored strategies, can pave the way for a successful journey to motherhood. Together with a personally designed plan for eating habits and physical activity the chances can increase of getting pregnant and having a healthy pregnancy.¹

This guide explores the relationship between weight, fertility, and pregnancy, addressing common concerns, practical solutions, and the importance of personalised care from your healthcare provider. 

Understanding Your Body

Understanding your body is a vital first step when trying to get pregnant. The menstrual cycle, which is regulated by a complex interplay of hormones, is central to fertility.¹ Most women have a monthly cycle that lasts around 28 days, but it can be shorter or longer depending on the individual. During each cycle, the ovaries release an egg in a process called ovulation, and the uterus prepares to support a potential pregnancy. If the egg is not fertilised, the uterus sheds its lining, resulting in a period. Knowing how your menstrual cycle works can help you predict ovulation and identify the best time to conceive naturally. Tracking your cycle, paying attention to changes in cervical mucus, and noting when your period starts can all provide valuable insights into your fertility.  

Factors such as age, weight, and general health can affect fertility by influencing hormone levels, the regularity of your menstrual cycles, and the quality of your eggs. Being overweight can disrupt hormone balance and affect ovulation, while age naturally leads to a decline in fertility as the number and quality of eggs decrease.¹

By understanding how your body works and how factors like age and weight affect your fertility, you can make informed decisions and take proactive steps to support your reproductive health and increase your chances of getting pregnant.¹

How Weight Influences Fertility

Weight significantly impacts reproductive health, particularly through its effect on hormonal balance and ovulation¹. For women with overweight and obesity, it can be more difficult to conceive. Weight has a significant impact on our reproductive health by affecting our metabolic balance, through a range of mechanisms, including hormonal dysregulation, chronic inflammation, and altered energy metabolism. These disruptions can impair ovulation,  reduce oocyte quality, and compromise endometrial receptivity, thereby diminishing fertility.^1-2 

For overweight women, these challenges often include:

• Hormonal Imbalances: Excess weight disrupts hormones such as oestrogen and insulin, which can disrupt the menstrual cycle and lead to irregular or absent periods.¹ 
• Polycystic Ovary Syndrome (PCOS): PCOS mainly affects women with overweight and obesity, and causes too high levels of male sex hormones, cysts on the ovaries and irregular periods.¹ PCOS and other hormonal imbalances can lead to ovulation problems, which are a common cause of infertility. It affects fertility and reduces the chances of getting pregnant. Read more about weight and PCOS here
• Insulin Resistance: Insulin resistance negatively affects ovulation and fertility and is often associated with overweight and obesity.¹ 

It is essential to note that being overweight does not necessarily equate to infertility. Many overweight women conceive naturally or with minimal medical intervention, and healthcare provides support for those who need it.¹

Diagnosing Fertility Issues

If you’re experiencing difficulty conceiving, diagnosing fertility issues is an important step toward finding solutions. Fertility problems can affect both women and men, and there are several fertility tests available to help identify the underlying causes.³ For women, tests may include blood tests to check hormone levels, ultrasound scans to examine the ovaries and uterus, and ovulation tests to determine if and when you are ovulating. For men, a semen analysis can assess sperm count, motility, and overall semen quality.¹

Possible underlying causes:¹ 

• Pelvic inflammatory disease can cause scar tissue in the fallopian tubes and reduce the chances of getting pregnant.
• Sexually transmitted infections or endometriosis may impact fertility. In some cases, fertility drugs may be prescribed to stimulate ovulation or improve sperm production, and your healthcare provider may suggest treatments based on your specific needs.
• Environmental influences: Exposure to pesticides, heavy metals, or other harmful chemicals can lower fertility in both women and men.

Maintaining a healthy lifestyle and addressing any underlying health conditions can all help improve your chances of conceiving.¹ If you have concerns about your fertility, seeking advice from a healthcare professional is the best way to get a clear diagnosis and explore your options for treatment.

Fertility Treatment Options

For couples experiencing difficulty conceiving, there are a variety of fertility treatment options available to help overcome fertility problems. These may include fertility drugs to stimulate ovulation, fertility tests to identify underlying issues, and assisted reproductive technologies such as in vitro fertilization (IVF).³ A healthcare provider can suggest treatments based on the specific causes of infertility, which may be related to age, weight, or other health factors.¹

The availability of fertility treatment options may vary depending on your local area, and accessibility can influence your choice of treatment.

The success of fertility treatment can be affected by several factors, including age, weight,  and overall health of both partners. Adopting a healthy lifestyle — such as maintaining a balanced diet, managing weight, and addressing any medical conditions — can improve the chances of getting pregnant with fertility treatment. Consulting with a fertility specialist or reproductive medicine expert can help couples understand their options and develop a plan tailored to their needs.¹

Getting Pregnant with Fertility Treatment

Getting pregnant with fertility treatment involves more than just medical procedures — it requires a holistic approach that includes lifestyle changes and ongoing support. Couples trying to conceive with the help of fertility treatment should focus on maintaining a healthy weight, eating a balanced diet rich in whole grains and folic acid, and avoiding alcohol to support a healthy pregnancy. A commitment to overall health can further improve the chances of getting pregnant.¹

It’s important to work closely with a healthcare provider to create a personalised treatment plan that addresses the factors affecting fertility. By understanding how lifestyle choices, such as diet and alcohol consumption, can affect fertility, couples can take proactive steps to increase their chances of conceiving and having a healthy pregnancy. Staying informed, making healthy choices, and seeking professional guidance are key to a successful fertility journey.¹

Tips for Enhancing Fertility

Research shows that certain lifestyle changes and habits can significantly improve fertility and increase the chance of getting pregnant¹:

• Adopting Healthy Eating Habits: Choose nutrient-dense food, i.e. food that is rich in vitamins, minerals, antioxidants, whole grains, healthy fats and healthy protein sources.¹ 
• Physical Activity: Exercise with moderate intensity, such as walking, swimming or yoga, improves hormone balance and insulin sensitivity.¹ 
• Regular Sex: Engaging in regular sex without contraception is one of the most effective ways to increase the chance of getting pregnant.¹ 
• Medical Guidance: Talk to your healthcare professional about fertility treatments; such as ovulation induction, these are often more effective after modest weight loss.^4-5 Seeking medical advice can also help improve your chance of getting pregnant.¹
• Stress Management: Chronic stress affects hormone levels. Stress management techniques like mindfulness, meditation and counselling reduce stress and promote well-being. Reducing stress can further increase your chance of getting pregnant.¹
• Weight Loss Increases Fertility: For individuals with a high BMI, addressing weight management can be a proactive step to optimise chances of successful conceiving. Studies suggest that even a modest weight loss (around 5-10% of body weight) can improve fertility outcomes significantly.^4-5 If you are overweight or obese, modern weight loss medication in combination with a structured lifestyle treatment  is an alternative to help you lose weight to enhance fertility and have  a healthy pregnancy. If you are considering this, it is important to remember, that these  medications are not recommended just before and during pregnancy, why weight loss with medications needs to be done before trying to conceive. 
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If you are planning to become pregnant or are seeking support with weight management, please contact your healthcare provider for personalised guidance and to discuss the most suitable options. Yazen offers expert support and personalised plans for healthy conception and pregnancy outcomes — offering tailored care, knowledge, and weight management guidance for better outcomes.

GLP-1 medicines, contraception and pregnancy

All individuals of childbearing potential (who are able to become pregnant) using GLP-1 medicines should take steps to ensure they do not become pregnant.⁶

GLP-1 medicines should not be taken during pregnancy or immediately before attempting to conceive. This is because there is insufficient safety data to determine whether taking a GLP-1 medicine could potentially harm the baby. In some animal studies, GLP-1 medicines were found to be harmful to the developing foetus; however, further information is needed to establish whether the same effects might occur in humans. If you are using a GLP-1 medicine and suspect you might be pregnant, you should consult a healthcare professional immediately.⁶

As a precaution, you should use effective contraception while taking GLP-1 medicines and continue to do so for a specified 'wash-out' period after stopping treatment — this is the length of time the medicine should be discontinued before trying to conceive. Different GLP-1 medications have different recommendations regarding when to stop treatment prior to pregnancy:⁶  

Semaglutide (Wegovy®, Ozempic® and Rybelsus®) — At least 2 months
Tirzepatide (Mounjaro®) — At least 1 month
Liraglutide (all brands) — 0 months*

If you are using Mounjaro® (tirzepatide) and taking an oral contraceptive (a pill), it is advisable to use a non-oral, barrier method of contraception — such as a condom — for four weeks after starting GLP-1 treatment, and also for four weeks following any dose increase, whilst continuing your pill, or switching to a non-oral contraceptive method such as a coil or implant. This precaution is advised because the medication may reduce the effectiveness of oral contraceptives, particularly in individuals who are overweight or obese.

*These medicines are cleared from the body more quickly than other GLP-1 medicines, which is why they should be stopped just before trying to conceive.

Preconception Planning

Planning ahead before trying to conceive can make a significant difference in achieving a healthy pregnancy.¹  Preconception planning involves making positive lifestyle changes that support both fertility and overall health:

• Adopt a healthy diet: A balanced diet rich in whole grains, fruits, vegetables, and lean protein helps regulate hormone levels and prepares  your body for pregnancy.¹
• Engage in regular physical activity: Exercise consistently to improve fertility and overall well-being.¹
• Take recommended supplements: Women trying to conceive should take daily folic acid supplement to reduce the risk of neural tube defects in the baby.³
• Avoid harmful substances: Refrain from alcohol and tobacco, as they can negatively impact fertility and increase pregnancy risks. Men should limit or stop drinking alcohol, since excessive alcohol consumption can lower sperm count and semen quality.^1,3
• Be mindful of environmental exposures: Limit exposure to pesticides and harmful chemicals, which can affect fertility in both partners.¹
• Make informed lifestyle choices: By avoiding excessive alcohol, eating nutritious foods, and steering clear of harmful substances, you can increase your chances of conceiving naturally.¹

Working together as a couple, taking these steps jointly creates the best environment for conception and supports a healthy pregnancy.¹

Pregnancy and Overweight Women: What to Expect

Many women with overweight and obesity have uncomplicated pregnancies, but linked to weight there is an increased risk of certain complications.While many overweight women have healthy pregnancies, there is a higher risk of complications, including¹ :

• Gestational Diabetes: Obesity during pregnancy increases the risk of gestational diabetes, partly caused by insulin resistance.
• High Blood Pressure: Overweight and obesity leads to an increased risk of high blood pressure and complications during pregnancy.
• Delivery Challenges: Increased BMI is linked to risks in connection with childbirth and a higher proportion of caesarean section.

With proper care from your healthcare providers and a proactive approach, these risks can often be managed effectively, supporting a healthy pregnancy and delivery.¹

Tips for a Healthy Pregnancy

• Personally Adapted Follow-up and Care: Specialist maternity care – or other healthcare providers with experience of pregnancy in people with obesity – can provide personally adapted care to manage e.g. gestational diabetes.¹ 
• Healthy Eating Habits: Nutritious food (including knowing what foods to avoid in pregnancy) and moderately sized portions⁷ can reduce the risk of complications and limit weight gain during pregnancy.¹ Mealsizer^® meal measure in size medium, is an easy alternative to portion lunch and dinner with, when you are pregnant, to make sure you eat moderate portions but still get the right nutrition for your growing baby. 
• Stay Active Safely: Exercise at a moderately strenuous level, such as yoga, swimming and walking, improves health and reduces the risks associated with pregnancy.^1,3 If you were not active before pregnancy, it's a good idea to consult your midwife or doctor before starting a new exercise plan⁷.
• Prioritise Antenatal Care: Regular and frequent check-ups, for example for gestational diabetes and pre-eclampsia, are of great importance to follow both the mother’s and the foetus’s health.⁷
• Seek Emotional Support: For those who need psychosocial and emotional support during pregnancy, counselling and a supportive network can be helpful.⁸

Debunking Common Myths

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Myth: Women with overweight or obesity have difficulty becoming pregnant — Fact: Many overweight women become pregnant naturally or with minimal medical efforts.¹ ‍‍
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Myth: Pregnancy risks can hinder motherhood for overweight women — Fact: With appropriate medical care, most overweight women have successful pregnancies, delivering healthy babies.⁴

Addressing Societal Stigma

The stigmatisation associated with weight adds stress and pressure in the fight against involuntary childlessness – a situation that is complex in itself. Instead, the focus needs to be on respectful treatment, evidence-based care and the best possible health – for both mother and child.¹  Weight-related stigma adds stress to an already complex journey. At Yazen we advocate for respectful, evidence-based care and focusing on health overall. Every woman’s journey is unique, and each experience is valid.

Lifestyle Changes for Long-Term Health

Beyond medical care, sustainable lifestyle changes can support fertility and pregnancy:

• Nutrition: Healthy eating habits can give a better hormone balance.¹  Whole, unprocessed foods and avoiding crash diets promote hormonal balance.⁸ Before and during pregnancy, you need to ensure that the diet provides enough of e.g. folate (folic acid), iron and calcium. For individuals with obesity (BMI of 25 or higher) who are planning or are pregnant, a higher dose of 5 mg  folic acid daily  is recommended to reduce the risk of neural tube defects in the baby⁹ . 
• Physical Activity: Regular physical activity with moderate intensity, preferably 150 minutes per week, is healthy, among other things for weight and for hormonal health.^1,3 
• Stress, Sleep and Recovery: Poor sleep, especially shorter or longer durations than the recommended range (7-9 hours of sleep) for healthy adults, can impact weight loss efforts and contribute to obesity.¹⁰ Quality sleep and reduced stress improve overall health and reproductive outcomes.¹ 

Knowledge-Based Treatment and Care in a Vulnerable Period in Life

Fertility and pregnancy are deeply personal journeys, and while being overweight can involve challenges, many women go on to have healthy pregnancies with the right support and care. Understanding the factors that affect fertility — such as age, health, lifestyle, and environmental influences — can empower you to make choices that improve your chances of getting pregnant.

Every woman’s path to-, and pregnancy, is unique. With knowledge, support, and evidence-based care, you can increase your chances of conceiving and enjoy a healthy pregnancy. Healthy habits, individualised evidence-based care, personalised treatment and seeking medical advice when needed are also important to reduce the risks during pregnancy and in connection with childbirth, for both mother and child.

Whether you are just starting to try or have been on this journey for a while, taking proactive steps and reaching out for help when needed can make all the difference. 

— And remember to plan and get help in time, to maximise your chances of successful conception and a healthier pregnancy, especially if you are considering modern weight loss medications that are currently not approved for treatment during pregnancy. While there are never any guarantees, studies suggest that even modest weight loss can improve fertility outcomes significantly.^4-5

At Yazen, we have helped many achieve increased fertility and a healthy pregnancy with the help of modern obesity medications in combination with a structured lifestyle treatment. We know and understand what it means to finally be able to get that plus sign on the stick, and we know how to help you!

References

1. Barbouni et al 2025. When Weight Matters: How Obesity Impacts Reproductive Health and Pregnancy‑A Systematic ReviewCurrent Obesity Reports. 14:37. https://doi.org/10.1007/s13679-025-00629-9
2. Athar et al. 2024. Metabolic hormones are integral regulators of female reproductive health and function. Bioscience Reports. 44 BSR20231916. https://doi.org/10.1042/BSR20231916
3. NICE - Endometriosis guideline: https://www.nice.org.uk/guidance/ng73
4. Norman et al. 2004. Improving reproductive performance in overweight/obese women with effective weight management. Human Reproduction Update, 10(3), 267-280. https://doi.org/10.1093/humupd/dmh018
5. Vitek et al. 2022. Worth the wait? Preconception weight reduction in women and men with obesity and infertility: a narrative review. Fertility and Sterility, 118:3, 447-455. https://doi.org/10.1016/j.fertnstert.2022.07.001
6. UK Government (2025)  GLP-1 medicines for weight loss and diabetes: https://www.gov.uk/government/publications/glp-1-medicines-for-weight-loss-and-diabetes-what-you-need-to-know/glp-1-medicines-for-weight-loss-and-diabetes-what-you-need-to-know
7. NHS - Obesity and Pregnancy: https://www.nhs.uk/pregnancy/related-conditions/existing-health-conditions/overweight/
8. WHO recommendations: https://www.who.int/publications/i/item/9789241549912
9. NICE - Maternal and child nutrition: https://www.ncbi.nlm.nih.gov/books/NBK612342/pdf/Bookshelf_NBK612342.pdf
10. NICE - Overweight & Obesity: https://www.nice.org.uk/guidance/ng246/resources/overweight-and-obesity-management-pdf-66143959958725