The landscape of IVF treatment is evolving, yet certain barriers remain formidable for many. In 2021, the U.S. witnessed nearly 100,000 babies born through assisted reproductive technology, such as IVF, underscoring the growing reliance on these medical interventions. However, the journey to parenthood via IVF is fraught with challenges, especially for women classified as overweight or obese. A comprehensive analysis of a quarter million IVF cycles in North America revealed a stark disparity: live birth rates stood at 31.4% for women of normal weight, but only 26.3% for those with class 2 obesity. This data not only highlights the impact of BMI on IVF outcomes but also raises questions about the accessibility and effectiveness of fertility treatments across different weight categories.

Overweight and obesity are known to influence the outcomes of IVF treatment in several ways. Women with higher BMI face worse IVF outcomes compared to those with a normal BMI, including higher cycle cancellation rates, fewer harvested oocytes, and lower live birth rates. The quality and quantity of embryos are also adversely affected, reducing the chances of a successful pregnancy. These findings underscore the complex relationship between body weight and reproductive health, challenging both patients and healthcare providers to navigate these hurdles carefully. Moreover, the role of male BMI in IVF success has recently come under scrutiny, suggesting that fertility is a shared responsibility, and outcomes are influenced by the health of both partners.

The exclusion of women with high BMI from IVF treatment raises profound ethical and discriminatory concerns. Critics argue that BMI restrictions systematically remove reproductive choices for an entire group of people, unfairly penalizing those who may already face social and medical marginalization. This practice not only reflects a narrow understanding of health and fertility but also overlooks the potential of IVF to offer hope to a diverse range of families. As the debate continues, it’s clear that a more inclusive approach, guided by shared decision-making and a comprehensive evaluation of individual health profiles, is essential for advancing fertility care.

Here’s why.

BMI and IVF: Recent studies have shown that while BMI and IVF success rates are correlated, a nuanced approach is necessary to understand the full picture.

Your reproductive system is one of the least important to keep you alive. Your body understands this and so if the stress load you put on your ordinary functioning is too high, your body will draw extra resource from where it can. Invariably the outcomes of this mean that it’ll draw from your reproductive organs.

Think about it. How grumpy are you when you starve yourself? This is because your hormones are out of whack — there’s nothing left to keep you balanced and happy as you would normally be. And we’ve all seen women who suffer from eating disorders such as anorexia who don’t have periods. Incidentally, this is why the NHS has a base level BMI of 19.

Obviously this is a vast oversimplification, but you get what we’re saying.

Essentially, when you limit your food and calorie intake, you’re putting less energy into your body so you have less left to help you get pregnant.

When the focus of a doctor is entirely on your BMI, it can force women into starvation which can affect their infertility in the short term.

You have two options.

1.There are some private clinics that will take a patient with a BMI up to around 35ish. They exist. For sure you have to pay to go private, but they exist. However, there are some issues with this in terms of evidence of a healthy pregnancy which we describe fully in this article. But, in a nutshell, studies show evidence in their analysis that your loss rates are either higher, so your chances of carrying a live baby to full term are reduced, or clinical insemination or the in vitro embryo just doesn’t take as well when you’re carrying the extra pounds.

2.Lose the weight. But we’ve already discussed how a crash diet and severely limiting your calorie intake can not give the body the care it needs for your reproduction cycle and overall health. By the way it’s important for us to note at this point that we understand why doctors use this data so strictly, there has to be a cut off, but this black and white comparison seems unfair for many ladies, particularly if a woman is at the older age on the spectrum. Their rules almost seem to force a reprod quick win otherwise the situation is you are overweight so pay for IVF or IUI treatment and pump your body full of drugs, with a lower chance of success.

However, NOTE: Embryo quality: Overweight and obesity have been linked to a decrease in both the number and quality of available embryos during IVF treatment.