Before any treatment for infertility, some important factors affecting the outcome of this treatment must be taken into account and in particular, female age and body weight.
Advancing female age is probably the single most important factor influencing fertility potential. From the age of about 35 years onwards, there is a steady downward trend in fertility capacity and this is a reflection of the declining number of follicles remaining, biological aging and exposure to many deleterious influences on the eggs remaining in the ovaries.
After the age of 42, spontaneous pregnancy becomes quite a rare event and from the mid-thirties onwards, fertility potential decreases considerably. Public awareness of these facts is insufficient. In addition to the delaying of a wish for pregnancy until a later age, obesity is also an undesirable product of modern society and maternal weight seems to have a substantial effect on fertility potential. Obese women are less fertile and have higher rates of miscarriage than their counterparts of normal weight. The successful treatment of obesity is capable of reversing its deleterious effects on fertility potential. Weight loss is notoriously difficult to achieve and maintain, particularly it seems for women with PCOS. It is not enough merely to tell these patients to lose weight and come back in say three months time. Referral to a clinic dedicated to instruct in life style changes, diet and exercise is a necessity to achieve the goal.