This is certainly a very emotional and controversial subject. To read the coverage on this, you would think doctors are refusing care to patients because they don’t like people who are overweight. This is far from the truth. A host of studies that look at IVF outcome based on BMI (body mass index or height to weight ratio) have clearly demonstrated that success rates are dramatically lower in individuals with BMI greater than 35, 38, etc based on the particular studies. Results are not just lower or less, they are dramatically lower as reported in one study where the <38 BMI had PR’s per cycle of roughly 40% and those over had rates of 6%. So beyond the surface, it is unethical for doctors to take patient’s money to undergo expensive treatments with such a poor outcome potential. In addition, the pregnancy associated risks for the mother and fetus are also dramatically increased for fetal demise, premature birth, pregnancy associated hypertension, seizures and diabetes etc. As a reproductive specialist, we have an unborn patient that we have a duty to protect as well as the mother. The last concern is the anesthesia for the egg retrieval associated with the IVF procedure. These procedures are done in office for the majority of the practices in the US and most centers would have a safety cut off for BMI at 40 or just above. As reproductive specialists, we hope this clarifies the decisions that might be perceived otherwise as a discriminatory practice.
Obesity is a disease with very significant health concerns that requires treatment as any other disease. Treatment does exist that can reverse the health risks both chronic and pregnancy associated. The unfortunate situation we find ourselves in today includes a medical system and our government that has turned its back on the primary treatment (that works) and prevention associated with low carbohydrate and high fat foods. The food and drug industry has completely brainwashed the entire system to ensure high profit. Until we fix the deficiencies in our food supply, we are going to continue to be forced to deal with this ever increasing problem that not only limits fertility treatments but many other medical treatments for other diseases as well. A short course of the keto diet can dramatically improve health and fertility, making fertility treatment much more successful. We has been committed to nutritional treatment now for over 15 years.
Michael D. Fox, MD
Advanced Reproductive Specialists