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Weight Fertility

Kate’s Chances of Success with IVF

We’ve all become fans of the hit TV show This Is Us and follow them religiously each week. On last week’s episode Kate started IVF treatments after suffering a miscarriage and struggling to get pregnant again. As we saw the doctor was extremely concerned about her weight to the point that she had denied Kate’s request for IVF. Later in the show she had a change of heart and let her proceed with fertility treatment with the understanding that there was a 90% failure rate because of her weight. The doctor cautioned “the chances of a successful pregnancy are risky…egg retrieval is invasive at your BMI.” So how does obesity affect pregnancy rates and why is it riskier to undergo fertility treatments at a higher BMI?

“Most clinics, including Piedmont Reproductive Endocrinology Group (PREG), provide sedation during the retrieval.” Dr. John Payne, the third-party reproduction director at PREG states that, “Our BMI limit for anesthesia is 45 because of safety concerns for our patients. There are more risks associated with breathing problems with someone who is overweight and even sedation can pose a potential life-threatening condition if the patient stops breathing on their own and the anesthesia provider has difficulty managing the patient’s airway.” He continues “Obesity can make visualization of the ovaries more difficult and can create a situation where the eggs cannot be safely retrieved under transvaginal ultrasound guidance. We do address each patient on an individual basis based on their past medical history and current medical conditions before making a decision on treatment.”

Excess weight affects fertility

In a 2015 article published by the American Society of Reproductive Medicine, (insert link) the prevalence of obesity is a worldwide epidemic. In the US alone, two thirds of women and three fourths of men in reproductive years are overweight or obese. Obesity increases the risks of high blood pressure, diabetes, and breathing problems just to name a few. Women with excess weight and abdominal fat have increased menstrual abnormalities and ovulatory disorders which requires the use of more fertility medications to be given with fewer mature follicles (eggs) and many times poor egg quality. There is a higher risk of miscarriage and complications during the pregnancy as well.

Dr. Payne recommends that all patients considering fertility treatments meet with a board-certified reproductive endocrinologist to review the risks and benefits of treatments. Our goal is a healthy mother, healthy pregnancy and one healthy baby.