Survey assessing obesity policies for assisted reproductive technology in the United States

Kaye, Leah; Sueldo, C.; Engmann, Lawrence; Nulsen, John; Benadiva, Claudio

doi:10.1016/j.fertnstert.2015.11.035

Cited by 32 publications

(19 citation statements)

References 13 publications

(12 reference statements)

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“…Moreover, Koning et al (2010) suggested that overweight and obesity in ovulatory infertile women leads to a 44% and 70% increase in costs due to pregnancy complications, respectively. A recently published study by Kaye et al (2016) suggested how relevant it is to develop reasonable standards of care for obese patients, to encourage them to lose weight before undergoing fertility treatment, giving priority to safety and overall health status, although patient's autonomy must be balanced with non-maleficence and the avoidance of interventions that may be unsafe both immediately and in the long run.…”

Section: Discussionmentioning

confidence: 99%

Outcome of assisted reproductive technology in overweight and obese women

Mackenna¹,

Schwarze²,

Crosby³

et al. 2017

JBRA Assisted Reproduction

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ObjectiveThe main objective of this study was to assess the prevalence of overweight and obesity among patients undergoing assisted reproductive technology (ART) in Latin America and its consequences on treatment outcomes.MethodsWe used the Latin American Registry of ART to obtain women's age and body mass index (BMI), cancellation rate, number of oocytes retrieved and embryos transferred, clinical pregnancy, live birth and miscarriage rates from 107.313 patients undergoing autologous IVF and ICSI during four years; a multivariable analysis was performed to determine the effect of BMI on cancellation, oocytes retrieved, pregnancy, live birth and miscarriage, adjusting for age, number of embryos transferred and embryo developmental stage upon embryo transfer, when appropriate.ResultsThe prevalence of overweight and obesity was 16.1% and 42.4%, respectively; correcting for age of female partner, overweight and obesity were associated to an increase in the odds of cancellation and to a lower mean number of oocytes retrieved; after adjusting for age, number of embryos transferred and stage of embryo development at transfer, we found that the BMI category was not associated to a change in the likelihoods of pregnancy, live birth and miscarriage.ConclusionsThe prevalence of obesity among women seeking ART in Latin America is surprisingly high; however, BMI does not influence the outcome of ART performed in these women.

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Section: Discussionmentioning

confidence: 99%

Outcome of assisted reproductive technology in overweight and obese women

Mackenna¹,

Schwarze²,

Crosby³

et al. 2017

JBRA Assisted Reproduction

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“…The Royal Australian and New Zealand College of Obstetricians and Gynaecologists have published guidance that a BMI over 35 should be regarded as an absolute contraindication for IVF [ 56 , 57 ]. In the absence of professional body guidelines, a 2016 survey of providers of fertility services in the United States found that the majority of responding centres have a formal policy of setting a maximum BMI threshold for IVF [ 18 ]. A draft report from the Canadian Fertility and Andrology Society does not recommend imposing a BMI cutoff, though notes that there is significant appetite for this, and that a 2014 survey of Canadian medical directors found that 50% of respondents imposed a cut-off [ 7 , 24 ].…”

Section: Policy Guidance and Exclusion Of People With Obesitymentioning

confidence: 99%

Irresponsibly Infertile? Obesity, Efficiency, and Exclusion from Treatment

Brown

2019

Health Care Anal

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Many countries tightly ration access to publicly funded fertility treatments such as in vitro fertilisation (IVF). One basis for excluding people from access to IVF is their body mass index. In this paper, I consider a number of potential justifications for such a policy, based on claims about effectiveness and cost-efficiency, and reject these as unsupported by available evidence. I consider an alternative justification: that those whose subfertility results from avoidable behaviours for which they are responsible are less deserving of treatment. I ultimately stop short of endorsing or rejecting such a justification, though highlight some reasons for thinking it is unlikely to be practicable.

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“…In both women who conceive spontaneously and those who conceive using reproductive technology, the rate of conception is lower in women with obesity than normal weight counterparts . While most obstetric care providers have policies around the care of women with obesity during pregnancy, there is significant variation in how fertility clinics manage obesity . A study of fertility centres in the United States reported that 16% had no policy regarding obesity, while 21.4% did not offer in vitro fertilization to women with BMI >35‐40 kg/m 2 …”

Section: Rationale For the Management Of Obesity Prior To Conceptionmentioning

confidence: 99%

“…While most obstetric care providers have policies around the care of women with obesity during pregnancy, there is significant variation in how fertility clinics manage obesity . A study of fertility centres in the United States reported that 16% had no policy regarding obesity, while 21.4% did not offer in vitro fertilization to women with BMI >35‐40 kg/m 2 …”

Section: Rationale For the Management Of Obesity Prior To Conceptionmentioning

confidence: 99%

Preconception management of women with obesity: A systematic review

et al. 2018

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The prevalence of women of child-bearing age with obesity continues to rise at an alarming rate. This has significant implications for both the short-term and longterm health of mother and offspring. Given the paucity of evidence-based literature in this field, the preconception management of women with obesity is highly variable both between institutions and around the world. This systematic review aims to evaluate studies that inform us about the role of preconception weight loss in the fertility and pregnancy outcomes of women with obesity. Current therapeutic interventions are discussed, with a specific focus on the suitability of weight loss interventions for women with obesity planning pregnancy. There are significant knowledge gaps in the current literature; these are discussed and areas for future research are explored.

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Survey assessing obesity policies for assisted reproductive technology in the United States

Cited by 32 publications

References 13 publications

Outcome of assisted reproductive technology in overweight and obese women

Outcome of assisted reproductive technology in overweight and obese women

Irresponsibly Infertile? Obesity, Efficiency, and Exclusion from Treatment

Preconception management of women with obesity: A systematic review

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