A couple trying to become pregnant for six months without success sought medical care. The husband had a body mass index of 28 and the woman had irregular menses. During their medical visit, the woman mentioned that she had lost 10 pounds one month ago because she was worried about gaining too much weight in pregnancy. What types of dietary or lifestyle behaviors would be important to discuss?
The husband's body mass index indicates that he is overweight. His excess body fat may be affecting his fertility. Thus, he may be advised to eat a healthier diet, following nutritional guidelines, and exercise because loss of body fat is related to improvements in hormone levels, oxidative stress and chronic inflammation, and conception rates. The woman's irregular menses after losing 10 pounds suggests that her weight loss negatively affected her fertility. Particularly, if she was originally of normal weight and lost 10 to 15% of her body weight through her diet, such weight loss has been linked to decreased estrogen, LH, and FSH concentrations. Her irregular menses, termed amenorrhea, may return to normal if her weight is restored to within 95% of her previous weight. Through regaining weight, her hormone levels may be returned to normal and her fertility improved.
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