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Why won’t my doctor let me go through infertility treatment until I lose weight?

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Updated January 06, 2012

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Question: Why won’t my doctor let me go through infertility treatment until I lose weight?
Answer:

More and more clinics are reporting policies where patients must be under a certain body mass index (BMI) in order to be treated. This may sound mean and discriminatory, and can definitely hurt when the doctor tells you that you’ll need to lose weight first, but I promise that there’s a good reason.

While, yes, women of all shapes and sizes have been getting pregnant throughout time, getting pregnant while very overweight can put you and the baby at risk for severe complications. In addition to being at higher risk for infertility and miscarriage, an obese woman who gets pregnant is at higher risk for developing gestational diabetes, pre-eclampsia (high blood pressure in pregnancy that can lead to seizures), and even stillbirth. Labor and delivery can be significantly more difficult, as can your recovery.

Another thing to keep in mind is that if you are undergoing IVF, a surgical procedure under general anesthesia is required at the end of the cycle. Since many of these procedures take place in small office procedure rooms (as opposed to the hospital), the facility may not be equipped or able to deal with potential surgical complications associated with obesity. Obese patients are much more likely to develop adverse reactions to the anesthesia, including issues with breathing and your airway, that can be dangerous if not managed immediately with advanced equipment. If such an emergency were to occur, your life would be at risk and no responsible physician would knowingly take that chance.

If you find yourself in this position, there are a few things you can do. First -- and this might be hard to do -- try to resist the urge to get angry. I understand that it may be painful to hear, but the doctor is genuinely trying to protect your health and that of your baby. Second, ask your doctor specific questions -– what his particular concerns are, and if there’s a way to still proceed with treatment (for example, trying insemination instead of IVF) while you are losing weight. What weight do you need to get to? Can he recommend a weight loss plan or method? He should be able to point you in the direction of a support group or specialist that can assist you further.

If your doctor isn’t particularly helpful, some specific suggestions might include:

  • Join Weight Watchers
  • Find an Overeaters Anonymous support group
  • Weight loss surgery may be appropriate in some situations
  • Check in with a nutritionist
  • Build in extra activity during the day; for example, try parking in the farthest spot in the lot instead of right next to the door
  • Reduce intake of sugary and fatty foods
  • Focus on eating fresh fruits and vegetables
  • Try making one change at a time; for example, switch out your daily soda for a flavored seltzer
  • Find a local cooking class that focuses on healthy eating
  • Drink more water during the day
  • Instead of watching TV in the evening, try taking a walk with your partner
  • Join an adult sports league
  • Check out a local farmers market for fresh produce
  • Enlist some help from family, friends or your partner -– it’s much easier to do this with someone else

You can, of course, get a second opinion. The policy of one clinic won’t necessarily reflect that of other centers nearby. But before you get angry and storm out, or make an appointment with another center, try and remember what the point of losing weight is: a healthy pregnancy.

Weight loss isn’t easy, but isn’t having a happy and healthy pregnancy, birth experience, and baby worth an attempt?

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