# Denying fertility treatment to obese women?



## Tad (Sep 21, 2011)

Article here: http://www.theglobeandmail.com/life...ity-treatments-to-obese-women/article2173941/

In essence, the odds of health issue associated with in-vitro treatment goes up for BMI above ~35, apparently, so some fertility doctors and support groups think that it should not be provided to women larger than that. (for reference, a 5'5" woman would have a BMI of 35 around 210 pounds).

The counter argument is that this is a paternalistic protection of adults who can weigh the risks and benefits themselves, and make up their own mind about pursuing it.


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## CastingPearls (Sep 21, 2011)

This is for Canada, yet I have a 300 lb. friend who went through 8 in vitro treatments in Ottowa. And here in the states I have friends who are the same weight and are given fertility treatment as well so I don't know what the US policies are or if it's just recommendation and up to the individual doctor and patient.

Also the article states ONE of the leading infertility patient support groups agree, which to me means others don't support it.


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## Tad (Sep 21, 2011)

It is only people and groups expressing opinions at this point, not policy in place. I just thought it is a discussion that people might want to be aware of.


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## Miss Vickie (Sep 21, 2011)

It's definitely a complex issue, and I can see it from both sides. On the one hand, certain fertility issues can be resolved with weight loss and definitely, fertility treatments aren't harmless; *if* can lose weight to regain fertility, that seems much safer. However, fat women shouldn't be denied a safe treatment that would otherwise be given to a thin woman. It's tough. I remember wanting to donate eggs for a friend and being refused because I was over the weight limit for clomid, the medication that stimulates the ovaries to create more mature eggs. Many of those medications are given per kg of body weight and they worry about our body's ability to manage high doses. It's just not safe. Is it worth getting ovarian cancer? And is the doctor then responsible for dispensing a drug that increases your risk of a life threatening illness and shortens your life?

But still... ow. To be told that would be heartbreaking.


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## ZainTheInsane (Sep 24, 2011)

Miss Vickie said:


> It's definitely a complex issue, and I can see it from both sides. On the one hand, certain fertility issues can be resolved with weight loss and definitely, fertility treatments aren't harmless; *if* can lose weight to regain fertility, that seems much safer. However, fat women shouldn't be denied a safe treatment that would otherwise be given to a thin woman. It's tough. I remember wanting to donate eggs for a friend and being refused because I was over the weight limit for clomid, the medication that stimulates the ovaries to create more mature eggs. Many of those medications are given per kg of body weight and they worry about our body's ability to manage high doses. It's just not safe. Is it worth getting ovarian cancer? And is the doctor then responsible for dispensing a drug that increases your risk of a life threatening illness and shortens your life?
> 
> But still... ow. To be told that would be heartbreaking.



Heartbreaking yes, but I think your point of per kilo medication dosage, combined with Doctors being risk adverse to begin with, weighs heavily in most decisions.

If I were a doctor, and I saw the risk as unacceptably high for a patient, but they still wanted it anyway, I might recommend some other place to go. I'd rather not lose a patient, but on the other hand, I also would rather not (directly or indirectly) be responsible for killing someone, or causing them serious health issues in the long term. 

It is likely it is all about the woman being obese, but not necessarily for the reasons you'd think.


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## Sweet Tooth (Sep 25, 2011)

I think I've mentioned it elsewhere, but I had an infertility doc who provided fertility services when I was married. I'm not going to go into details about what the issues were except to say that there was no weight-related issue compromising our fertility.

However, every visit - and I had to have regular visits with the doc, not just with a nurse practitioner - included the lectures on weight including the "Do it for your baby." comment. Even though I had been involved in SA for 15 years at that point and was reasonably self-confident, I remember coming home from my first visit sobbing. I'm not surprised docs do this. I'm sure mine would've if she felt it wouldn't have resulted in some penalty, legal or otherwise, for her. I know of others who are facing this very thing, although their story is not mine to tell.

It's hell. Every month of a woman's adult life, her fertility is slipping further and further away, which doesn't feel like a big deal in your 20s. But when you're in your 30s, and you know you have to balance the risk to the baby of having a pregnancy as an older mother versus any risk involved in pregnancy as a fat woman, it can feel like you're being judged and not supported instead of receiving sound, compassionate medical advice that's unique to your situation.


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## Fat Brian (Sep 26, 2011)

A few years ago when Crystal and I were looking into her getting pregnant two different docs refused to help with her PCOS other than prescribing birth control until she lost weight. It was pretty crushing for her at the time.


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## Tad (Sep 27, 2011)

Fat Brian said:


> A few years ago when Crystal and I were looking into her getting pregnant two different docs refused to help with her PCOS other than prescribing birth control until she lost weight. It was pretty crushing for her at the time.



That puzzles (and angers!) me--into PCOS known to cause a tendency to put on weight? You'd think if they really wanted her to lose weight, they'd want to help deal with the PCOS? (I don't know any of the medical details, so there could well be reasons).

Also, really sorry for you and your wife that you were treated that way. After deciding that you want to do something like that and going to ask for help....then getting that response. Ouch to about the 100th power 

And even if the woman does get pregnant, many on here can attest that many health care professionals are not really supportive of obese moms to be (my wife's ob-gyn saw that her BMI was around 34-35, and immediately told her "I don't want you to gain any weight while pregnant, you are already too fat." Then didn't understand why the only place my wife's blood pressure ever measured as high was in her office......)


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## Jes (Sep 27, 2011)

For the laymen among us: what would the weight cut off be for IV fertility treatments, in your opinion? Would it be 1000 lbs if the patient seemed healthy and tested well? Would it be 180 if the patient were ill and tested poorly? Mind you, pregnancy puts strains on a body, healthy or otherwise, and can certainly be a tipping point for some. Is providing IV treatments for a 1000 lbs woman along the same lines as the treatment given to the Octomom, or, say a 65-year old woman? Why or why not?


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## supersonicsuper (Sep 29, 2011)

Hi,
We went through five rounds of fertility and finally have a beautiful baby girl! We live in Canada and some doctors will not treat larger patients. We were lucky to find a doctor who cared enough about patient care to provide us with the treatment I needed to get pregnant. I did lose quite a bit of weight before I conceived, but I was about 299 when I got pregnant. I think it is important to find the right doctor and be a good advocate for yourself. The other doctor in town who does fertility treatments has a reputation for not wanting to work with overweight women. We are very thankful for our beautiful daughter! I think everyone should deserve the chance to become parents!


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