Is there a BMI limit for fertility treatment?
In the NHS, the BMI limit for treatment is 30. Most private clinics have a BMI limit of 35. The reason why there is a limit is because pregnancy with high BMI is associated with increased risk, like babies born with high weight, increased likelihood of Caesarian section, thrombosis and also a higher risk to babies born to mothers with high BMI.
Another reason for the BMI limit is related to the fact that success rates of fertility treatment reduce as BMI increases. And finally, most clinics also need to consider if treatment at the clinic is safe for women with high BMI as these won't have the same facilities as in large hospitals.
Dr Khaled Abaoub explained, clinics need to calculate the risk and not expose patients to increased risk.
However,
Dr Khaled Abaoub highlighted that this BMI limit for treatment poses an ethical dilema, and explained
""women with high BMI with spontaneous pregnancy, healthcare professionals take care of them and help them deliver healthy babies as far as possible, even though there is increased risk. So why should those who are struggling, not be able to have some help? In my view they have the same right as any other woman to start a family, it's a basic human right."
Dr Khaled Abaoub
Is weight loss always necessary and/or possible?
We know it can be challenging for women to lose weight for fertility treatment.
Dr Khaled Abaoub explained that if women are able to lose weight, the pregnancy risks associated with high BMI also reduce. However, each situation is unique, and delaying treatment to lose weight, may not be ideal for women in their late 30s or with reduced ovarian reserve.
How can women with high BMI be supported to achieve pregnancy?
Support can come in many ways, like nutritionists, mental health specialists, nursing support, acupuncture, reflexology. Having a holistic approach can be useful, as it helps patients feel more relaxed, feel supported and they may be able to lose weight and improve their chances of healthy pregnancy.