The Truth About Overweight Women & IVF

In-vitro fertilization helps those who are struggling to conceive to experience a healthy pregnancy. This assisted reproductive technology method works by using surgical and medical procedures to help sperm fertilize an egg, and allows the fertilized egg to implant in the uterus. During this procedure, the doctor will remove eggs from the woman’s body and mix it with sperm in a lab setting. “While most people are familiar with the basics of IVF, they may have preconceived notions about what’s really happening with the procedure and how it affects people who are considered overweight,” says Conceive Health, a fertility clinic.

For starters, there’s a common misconception that overweight people with a higher BMI than “average” will be unable to have a successful IVF procedure. There’s a reason why this myth continues to be perpetuated.

Even in modern times, some doctors refuse treatment because the patient is deemed overweight. One New York Times article profiled the story of Gina Balzano, who was essentially told she was too fat to have a baby in 2013 when she weighed 317 pounds. Many clinics consider a BMI of over 50 (around 300 pounds for a 5’5 woman) the cutoff point for treatment. At other clinics, it’s even lower.

Balzano was told that her doctor would not see patients for IVF with a BMI of under 30. To put this into perspective, a 5’5 woman who weighs 180 pounds has a BMI of nearly 30. Unfortunately, this isn’t too far off from what overweight women have to deal with in the reproductive health care industry. One study analyzed recordings of 117 doctor visits among a pregnant group, and found that doctors were less likely to ask overweight women about their lifestyle habits and provided less information about responsible care.

But to fully understand both sides of the coin, it’s important to consider why so many clinics prefer not to give IVF procedures to women with higher BMIs. The rate of prenatal conditions, such as stillbirths, miscarriages, and pre-eclampsia, increases with higher BMI. On the other hand, although the chance of complication does increase with weight, the chances of those complications are low. Furthermore, another Scandinavian study found that losing weight prior to pregnancy doesn’t help—and could actually have a negative impact on pregnancy.

This isn’t just an issue happening in the United States. There are cultural biases surrounding larger people all around the world. One study conducted in Australia found that doctors in prenatal care expressed less approval and sympathy for patients that were above average weight, compared to those that fell within standard weight guidelines. While these experiences and details seem grim, changes are underway. Doctors in Australia are currently fighting against current IVF guidelines that recommend clinics to turn obese patients away.

Still, many doctors take a more progressive approach to IVF with overweight women, and prefer to address each patient that’s in front of them. “Obesity can require special care, but a majority of women with BMI over 30 don’t have a complicated pregnancy and do have healthy babies,” said Dr. Chloe Zera, a maternal fetal medicine specialist at Beth Israel Deaconess Medical Center in Boston.

For these forward-thinking doctors, a woman is not a number, and is certainly not her BMI. A great clinic will always address a woman’s health from a holistic perspective, talking to her about her dietary and lifestyle habits. Many women—even vegans with careful diets—have struggled with their weight their entire lives.

In fact, one study analyzed nearly 300 IVF lifecycles and found that body mass index had no effect on IVF. A larger study conducted in 2018 analyzed the IVF success of just over 50,000 American women found that while obesity is linked to lower egg levels, it doesn’t necessarily mean an IVF procedure will be less successful.

For women who struggle to conceive, statistically speaking, that struggle would continue if they had a lower BMI. Even with surgical weight loss, there remains a high chance that those same struggles would continue. The problem is expounded when doctors assume the issue with conceiving revolves around weight. Instead, more doctors are choosing to understand the patient and analyze all aspects of treatment and possibilities.
 
This is a guest blog entry.