Weigh-In On Our Poll: Should Doctors Do More Than Suggest Weight Loss for Infertility in Overweight Women?
Wednesday May 14, 2008
However, just because weight has been linked to infertility, I don’t think that means that every overweight woman who has trouble getting pregnant is having trouble *just* because of her weight.
While I do believe that losing weight is a great first step in regaining health, and perhaps a key towards improving fertility, I do not think it’s right for doctors to ignore women who are having trouble getting pregnant and happen to be overweight. I’ve been seeing this, unfortunately, more and more.
Take for example dibs_6901’s story, from our forums. She’s been trying to get pregnant for years, but her doctors keep telling her that she needs to lose weight. She lost 20 pounds and still can’t get pregnant. It’s as if until she loses all the weight, they won’t look further into her infertility. This doesn’t seem fair to me at all.
Years ago, my former gynecologist told me that my weight may be the cause of my infertility. I was a mere five pounds overweight. Four years later, and ten pounds lighter, my infertility isn’t any better, and a reproductive endocrinologist told me the five pounds had nothing to do with my infertility.
What do you think? Should a woman have to lose weight before receiving fertility treatments? Or should doctors provide the same care and help that they provide any other woman dealing with infertility? Take the poll, and share your thoughts in the comments.
Comments
Discrimination against people due to weight — whether over- or under-weight — is foul. It is even more foul when practiced by the medical professions.
At the risk of sounding offensive … yes, women with weight issues should have to loose weight prior to undergoing infertility treatment.
I have polycystic ovarian syndrome (PCOS), type 2 diabetes, and Hashimoto’s Thyroiditis – all medical problems that lead to weight gain and infertility. I once weighed nearly 300 lbs. I tried infertility treatments for years but it did not work because I was obese. (I went on to adopt three children.)
Overweight women’s bodies need higher doses of dangerous drugs. It is not only harder to become pregnant, but harder to maintain the pregnancy. This creates a nightmare for doctors, insurance companies, and even women because there are just too many high-risk factors in drug-induced pregnancies even when a woman has a normal body weight.
Higher does of drugs like clomid, can lead to permanent vision problems and hyperstimulation of the ovaries that can be serious enough to even cause death.
Women with BOTH infertility and weight problems often have underlying medical problems that will affect the pregnancy and her baby.
Even if the woman does not have to loose weight, underlying medical problems that lead to, or were created by weight gain still need to be addressed.
After 15 years of infertility (and multiple failed attempts) I finally lost 150 lbs. Quite by surprise, at age 39 I became pregnant and now have a miracle 4th child. Losing the weight caused me to ovulate on my own, for the first time in my life.
The irony is, I was actually on birth control pills at the time I got pregnant to treat my PCOS and prevent pregnancy because my doctor would not put me on Rezulin (a new diabetes drug at the time known to cause birth defects) unless I was on the pill!
Thank you for the comments Beth and Lahle.
Your story, Lahle, is truly amazing, and inspiring, if I say so myself. You have many good points, and I think readers will take away some good insights from your experiences.
I still hold by my opinion that all women (and men), irregardless of weight, should get a full work-up if infertility is a factor. I’d hate for a doctor to keep saying it’s the weight, and then it turn out to be something structural, or something like endometriosis, which is best to be treated earlier than later.
Doctors resort to these instructions to lose weight because they have little else to go on. My doctors used to tell me over and over again how I needed to “relax” and “not think about it”, even though the problem was male infertility due to medicine taken. You can relax all you want, without sperm, it’s never going to happen, doc.
Infertility is complex, doctors tend to look at the easy stuff (oh, you are overweight, that must be it) and not the whole person (as for most diseases). Treatment is percentage based (10% respond to this treatment, so 100% get this treatment) because it’s easy and defend-able.
That being said, a healthy diet can’t hurt, but it should be just part of the treatment, unless the weight is definitely messing up the hormones.
An “overweight” woman is a woman first and overweight second. And “overweight” is in the eye of the beholder. Standards for what constitutes “overweight” shifted radically in the twentieth century… much of it due to the influence of Barbie in the latter half. Life is an individual experience. Every woman who wants to have a child needs to address it in their own way. I personally think it would be great to see women relying on spiritual means to overcome both obesity and infertility.
Absurd that any woman should be denied treatment because of her weight.
There are so many factors to infertility. For instance PCOS can cause infertility, but blood sugar levels and insulin resistance causes PCOS and weight problems with thyroid etc. Until those issues are addresses it can be impossible for a woman to lose weight. Herbal treatments can help with insulin resistance as can a raw food diet. If weight were the only factor a woman could easily lose weight rapidly on a raw food diet supposing she is sufficiently motivated to stick with it long enough to conceive, then she could return to introducing cooked foods into her diet at any time or even after delivery. It can be difficult at first but after a few weeks on a raw diet cooked food loses its appeal when actually eaten as it seems very dry and lifeless. The energy to be had from raw food is motivating in itself. And that’s just one example of many variables to be considered.
Women who are overweight should get the same work up as everyone else, and the added support of a compassionate nutritionist who can be a practical, empathetic cheerleader. I don’t know any overweight woman who doesn’t want to get to a healthy weight. A little support and proper guidance goes a long way.
Seems to me that “overweight” is a very tricky term. are we talking about a woman who is morbidly obese, or a woman who is ten pounds over ideal?
If the former, then there are obviously many other issues to consider when thinking about pregnancy – starting with diabetes, blood pressure, and other health concerns. There’s a reasonable chance that a morbidly obese mom-to-be could be placing her own and her child’s health at risk.
Not sure I feel a doc should just ignore those concerns and move forward with fertility treatment. In fact, I’d be worried about a doctor who encouraged someone with potentially life threatening overweight issues to go ahead and get pregnant.
Lisa
I don’t believe a woman should be denied help just because they are overweight. I am overweight because of PCOS. I went off of birth control and within 3 months, gained 30 pounds (putting me at 199). It is so hard to lose weight while dealing with the stress of wanting a baby and not being able to have one and trying to follow a strict diet aimed at the PCOS. My doctors have been wonderful and I have successfully given birth to two beautiful daughters (now 3 and 1) with the help of clomid. For those of you who are struggling with getting pregnant, be strong!
some people have weight and infertility problems
because of other reasons. like pcos!!!! i have gained 70 pounds in the past two years because of this. i have tried so hard to loose the weight but it is not as easy as it sounds. just because your fat dosent mean you you just sit and eat bon bons all day.!!! i have tried so hard to have a baby and loose the weight and to have someone say its your fault your fat and cant and cant have a baby is just sick.some people need to grow up ans quit being so shallow!!!!!!!!!!!!!!!!!!
I do think that the doctors should strongly stress/counsel an obese patient wanting to become pregnant. My stepdaughter is pregnant , weighs about 400 lbs and is 29 wks ready to deliver at any moment. Why she was ever given meds to make her ovulate, in my view is wreckless and irresponsible on the doctor’s part. She has been on bed rest for the last 4 weeks!
What happens when the weight is a symptom? These are just bad doctors. I have PCOS and it was a nightmare trying to get help. I had a gyno who told me to lose weight (I was 20, 120 lbs at 5′6 medium frame, size 6 clothing) as I had a very slightly rounded belly which she found offensive somehow. I was in excellent shape at the time might I note. My non-cycles were seen as due to my exercisng. Then when due to the underlying condition I gained 60 lbs in one year for no reason – my problems were suddenly due to the weight. My cycle was messed up regardless of weight. But that didn’t matter to them. All other symptoms were brushed off. The beard, the skin tags, the listlessness, etc…
So, I became depressed and gave up on my health for a number of years. Great doctoring – almost killed the patient there. What is that whole thing about “first do no harm” in your oath again? When people seek help – they NEED to be helped. If I was a man coming in with chest pains, regardless of weight – tests would be done. This is malpractice.
As i do believe it can be! I still think its not in all cases.
I lost 2 stone and got pregnant im now over weight and im on Clomid and its not even working.
I know what i have o do to get pregnant again.
So yes it can in some cases but not all cases.
Doctors are to lazy to do anything about it so just make that as an excuse!
It has no offense of the woman that is overweight. I have lost 70lbs this past year on my own, and I KNOW ITS HARD. I was recently just an egg donor. BUT
I think weight should be discussed and in extreme cases yes lose weight before thinking of becoming pregnant. In my case however, i am frustrated. I have Turner’s syndrome and i am over my ideal weight. My weight does not have a thing to do with my infertility, this medical condition is. No matter how much weight i lose, unless i use a infertility treatment, I will not be pregnant. My current employer added infertility benefits this year, which made myself and my husband very excited. We made the appointment, went to the doctor and was told unless I lose 60lbs they will not do the procedure. I do not know if these benefits will continue next year, and i am very stressed out that this opportunity will not happen. We are hopiong and praying we can get my weight down and the benefits will continue next year. We plan on adopting our second child, but this opportunity to use the infertility treatment is amazing.
I find this completely rediculous! I am condsidered obese. I understand that before trying IVF i should lose some weight. I also have PCOS like many of these women though and when we say its hard to lose weight, it is harder than you can even imagine! People with PCOS will lose weight at a rate almost half than that of a person who is healthy. I was told to get IVF they normally want you around 30 bmi. For me at my height though that means being around 160 lbs. I have weighed this before but it really is my plateu. I have tried for years to get under that and I was heardly eating at 160 lbs. I may be obese but my blood pressure, heart, and cholesterol are all 100% normal. I think women woh are overweight should be considered for IVF individually, not statistically.