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Overweight Women and Fertility Treatment

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by Rachel Gurevich, June 29, 2010

A few weeks ago, yet another study came out showing that being overweight can lead to fertility woes. In this study, women who had a BMI over 25 had a higher risk of miscarriage than women with a BMI under 25. Also, there are many previous studies that have shown high BMI to raise the risk of infertility.

(Quick note, for those who don’t know: BMI, or body mass index, considers your height and weight togetherto help you gauge whether you are at a normal weight. A BMI over 25 is considered to be overweight.)

Advice to Lose Weight

Every time one of these studies on weight comes out, there’s talk about strongly advising overweight women to lose the weight before they receive fertility treatment. In the harsher opinion pieces, it’s been said that women should be refused treatment if they are overweight.
Also, it’s no secret in the fertility community that women who have higher BMIs are often told by doctors to go lose weight, and then come back if they still can't get pregnant. Or, when treatments fail, women are told the reason is their weight, and that they should lose it to solve the problems.

Sometimes, weight is brought up when it’s not even that high. I had my gynecologist tell me the reason I stopped ovulating and was miscarrying was related to my weight. Except in my case, I was only five pounds overweight — weight I gained from all the miscarriages! (A reproductive endocrinologist, later told me that my weight had nothing to do with my infertility. Plus, I later lost that weight. It didn't help.)

I understand why doctors would want to encourage a couple to drop some pounds. (They should advise men AND women to lose weight, in my opinion). Not just because of the increased fertility risks, but also the increased risks of pregnancy complications and general health concerns.

But refusing treatment doesn’t seem right to me. In fact, simply telling a woman or man that they should go home and come back when they are thinner is downright stupid.

Why Fertility Treatment Shouldn’t Be Refused

Losing weight is not easy. Because losing weight requires support, information and sometimes medical help if the weight is connected to an untreated health issue. (Thyroid problems, for example.)

Instead of just telling a woman she should drop a few pounds, what if clinics offered weight loss as a treatment? Maybe they would have a dietitian on staff who would speak to couples, help them look into what they can change to improve their health, and support them along the way.

There would be screening for undiagnosed medical problems that may lead to weight problems. They would also screen for age-related infertility, so they can advise a couple whether or not they have time to try weight loss first.

What if clinics offered weight loss support groups? They could be led by a psychologist or social worker who is versed in infertility, but also in eating disorders, including emotional eating (something many women coping with infertility deal with.)

I still think that if the woman so chooses, she should get standard fertility treatment as she wishes, even before she loses the weight.

But for those who do want to give weight loss a try, it’s cruel to just tell them to go lose the weight without any support or help.

These are my thoughts. What are yours? Do you think women should have to lose weight before receiving fertility treatments? Do you think clinics offering weight loss support are a good or bad idea? Share your thoughts and experiences in the comments, I’d love to hear from you!

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Comments (5)

Being told to lose weight in order to get fertility treatment or proper fertility treatment is discrimination. Pregnancy is risky for any woman thin or not. Miscarriages happen to women of all sizes. Women still die during childbirth in every country. So what makes my risk any more riskier than any other woman's because I am fat? And who has the right to take my choice away of getting pregnant because I'm fat? Why don't they think I am worthy to be a mom because I'm fat? And that BMI is B.S. that doesn't apply to everyone. Its just another way to help discriminate.

I've been grappling with this issue for the three years that my husband and I have been dealing with infertility. At the time we started, my BMI was around 29, not great, but not obese. 6 failed IUI's and 6 failed IVF's later, I am 60 pounds heavier then when I started. Every treatment seems to lead to more weight gain and the breaks in between treatments seem to be too short to allow for greiving and losing the weight put on during each cycle. I agree 100% that weight loss treatment should be included as an avenue of infertility care. I see a psychologist, have a nutritionist and go to a commercial weight loss program. But, the weight loss seems separate from the infertility care. My first RE was on my case about my wieght so often that I left and went to a more laid back RE (the best choice I ever made). There are too many "what if's" in this process to be making women feel guilty about their weight as well. I intend to deal with this topic on my blog - - at some point in the future because it is certainly a hot button topic for most of the fertility friends that I have right now. Thank you for starting the discussion and for your own insights.

Even skinny women can't get pregnant so what good is it to lose weight if the issue is beyond it. I agree that being overweight during a pregnancy can be dangerous but I see women that are way above what I weight conceiving without any issues. I am a heavier woman 212 pounds and 5'8" and I have been trying to conceive for over two years. I lost 30 pounds prior to doing my treatments because I wanted to, not because I was told to. After three failed Clomid treatments I gained back 10 pounds and got very depressed. They still don't know what exactly is causing my infertility. I have never been properly diagnosed and if it is PCOS they are not treating it at all. I have never been offered Metformin as a solution.

I am 31 years old and I am worried that I may never have a child if I have to get down to my suggested BMI. I would have to be within the weight range of 135-164. I am seriously considering a lap band or gastric bypass but the issue is that at my weight I am not HEAVY enough to get one of those but yet I am not SKINNY enough to get fertility treatments. RIDICULOUS!! As you can tell I am fuming about this and just want help and answers!

I do understand that weight can play a role in infertility and other issues. However it's obviously not the end all. I am overweight and have been trying to conceive for almost 10 years now. One of the most frustrating thing to me is seeing a woman who is my size or larger pregnant or with babies. I think refusing treatment for women who are overweight is extremely unfair. Why should an overweight woman who just happens to be able to get pregnant naturally have more of a right to be a mother than ones that need help. Refusing treatment to an overweight woman, is like a Plastic Surgeon refusing to help an ugly person. Both just want some hope on improving their life.

I live in the UK and was told to lose some weight. I started trying to do that but only managed a couple of pounds. I agree to a point that women should lose weight to reduce miscarriage or high blood pressure but ultimately it should be about being pregnant first as we all have a ticking clock. I was on clomid to help with fertility. However it came to a point when they said I would need IVF as that was my only option left to conceive, but the hospital refused treatment until I had dropped a couple of stone. Now as well as endometreosis I also have PCOS, BOTH are known for making you gain weight and I had never had any treatment for any of my conditions or to help weight loss. I did my own research and found a diet that might help (GI Diet) and tried that. I also went on weight loss tablets. I think it would be a good idea to have a weight loss advisor in fertility clinics and also ones that can prescribe weight loss medication too. Now my weight is no longer an issue but that myself and my husband are 'incompatable' meaning his sperm and my eggs wont go together!? well thats that now after years of trying I have to live with not being a Mum too. Therefore I dont think my weight was ever the real issue and had they concentrated on other causes it could have saved me years of heartbreak and failure.

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