Some women seeking IVF are above what is considered a normal weight.
The body mass index or BMI takes height and weight into consideration by a rather complex formula, to help
determine the proportion of excess fat on the body’s structure. An online calculator can do a BMI assessment for you in 10 seconds, at www.nhlbisupport/bmi. The threshold for the definition of obesity applies if the BMI is over 30. In medical terms, a BMI over 40 is extreme obesity.The adverse effect that being overweight has on IVF outcomes was established in 2006 by a paper presented at the ASRM convention by Dr Mitwally of Wayne State University in Detroit, which conclusively showed there is a decrease in pregnancy rate associated with excess weight. On the other hand, all is not lost if one is overweight. It has been shown that overweight patients can already begin to benefit in infertility management from a loss of 15% of their weight. So it is not necessary to become slim to increase your odds of becoming pregnant, just somewhat slimmer.
Of course, weight loss has other benefits. Recent bad news on that front not only relates to infertility, but to long term health being affected by obesity. The long term impact of a 5 point increase in BMI has been measured by recent studies. The cumulative results of conditions associated with obesity: there is a strong association with endometrial cancer, gall bladder cancer, esophagus and kidney cancers. Weaker associations were noted with postmenopausal breast cancer, pancreatic and thyroid cancers. Some of these risks extend to men, as well (Renhan 2008).
For the extremes of obesity, bariatric surgery may be the only solution for achieving more permanent weight loss. The good news is that now, more and more women are taking this step, once limited to the most desperate. That is because in the past, the procedure required major surgery, with weeks of recovery. Now, conventional open bariatric surgery is being replaced by the much simpler laparoscopic banding technique, in which recovery is much shorter and the surgical risks fewer. In addition, it has been shown to be nearly as good as the open surgery in achieving resolution of diabetes (Parikh, 2007). Though certainly not without risk, this surgery can now be considered by some women who may have found that IVF centers will not accept them, due to the anesthesia-related risks involved, if they remain over a set BMI limit.If your infertility is being complicated by excess weight, you should consider measures to reduce that weight by at least 15%. Of course the best goal would be to achieve a BMI that falls within the normal range, in terms of fertility, cancer risk, diabetes risk, heart disease risk, the longevity required to raise a child, flexibility, and a general state of increased well-being. Weight control through portion control, reasonable dieting or perhaps even laparoscopic banding should therefore be considered. It may just be time for a change.
Parikh M. Title. J Am Coll Surg 2007; 205:631-5.
Renhan AG. Title. Lancet 2008; 371:569-78.This update is provided by New York Fertility Services of New York, NY, which besides treatment for infertility, can provide nutritional counseling. At times, changes in diet and weight may be almost all that is required for treating an infertility problem. New York Fertility Services also offers low-cost IVF services.