Wednesday, October 14, 2009

Obesity, Infertility and IVF

I saw a patient today who was in tears. She wanted a baby, but because she was obese, her doctor refused to treat her infertility until she lost weight. She already had low self-esteem because of her infertility - and this just made a bad situation even worse.

She said - Doctor, I have tried so hard to lose weight. I have joined a gym and spent a fortune on diet books, but nothing seems to help. I don't like being fat, but no one is able to help me lose weight. Should I be punished for something I cannot control ? My biological clock is ticking away - and I feel it's very unfair to refuse to treat me just because I am obese. It's not that I am lacking will-power - it's just that I cannot lose weight, no matter what I do. How does blaming me for my obesity help ? If I was diabetic, would you refuse to treat me ? Isn't obesity a medical problem too ? Life is so unfair ! My sister is even fatter than I am - and she has 2 kids . I am sure I can get pregnant with the right treatment - and I will make a good mom, so can you please help me doctor ?

It is true that being overweight reduces fertility and that reducing weight helps to improve fertility. However, blaming the victim does not help. Doctors need to take a constructive approach and try to help them, rather than refuse to treat them point-blank. It's a good idea to refer them to a dietitian for help - but we all know that the weight-loss industry has a terrible track record and that we really are not very good at helping our obese patients to lose weight.

This is actually our failing rather than the patients, and I don't think it's fair to reject them.

In any case, making a baby just needs 4 things - eggs, sperm , uterus and tubes. Where do calories come into the picture ?

I agreed to do her infertility workup , so that we could find out what medical problems were reducing her fertility and try to fix them. She was extremely grateful because she could finally see light at the end of the tunnel !

1 comment:

  1. Anonymous7:31 AM

    Good for you! I've been turned away from one of the top US clinic -- told to lose weight and come back after I have kept it off 6 months. As a 41 year old woman and mother of a 3 year old conceived naturally and carried to term without a single medical problem, I was upset and offended. Even more so because I had asked up front if I could be excluded based on BMI and was told they needed to do testing first. After 2 months of xrays, ultrasounds, and clomid challenge tests they found I was functioning 100 percent, but declined to treat me because of the reading on the scale which they knew the first day. Clearly this was about protecting their success rates, not about treating me as an individual! Luckily I have found another local physician in private practice with a more open mind and am moving forward to give it a try to have a second baby.

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