Do You Really Need To Lose Weight For IVF?

What you need to know about in-vitro fertilization if you are overweight

Updated 08/28/17

Megan Madden / Refinery29 for Getty Images

For those who are considering in-vitro fertilization (IVF), it can be a difficult field to navigate if you’re over a certain weight. And let’s be honest, IVF is confusing enough—between the testing, the treatments, and the total lack of a guarantee, it can be an overwhelming and scary time for a couple or a woman trying for a baby. But if you’re obese or even just overweight, there are added pressures and complications. Unfortunately, when it comes to advice, there’s a lot out there—and it doesn’t always add up. One article will tell you that time is of the essence and that you don’t need to lose weight; another will tell you that it’s totally imperative that you slim down asap. So, here are the basics of what you need to know, while keeping in mind that everyone is different—always consult your doctor to confirm what’s best for your individual situation.

There Are A Variety Of Ways Your Weight Affects IVF

"Obesity is definitely a factor that leads to decreased success with IVF," Mindy Christianson, MD, assistant professor of obstetrics and gynecology specializing in fertility at Johns Hopkins University of Medicine tells Refinery29. But there are many different ways it can affect the treatment, which is where some of the confusion arises. Obese patients have issues with egg quality and are more likely to miscarry, which is why Christianson says that "a BMI [body mass index] less than 30 is preferred, but the pregnancy and live birth rates drop off most with a BMI greater than 35 to 40.” But there are also problems with administering anesthesia and the retrieval process with obese patients, as well as all the normal pregnancy risks like pre-eclampsia and gestational diabetes, which are more likely in obese patients.

It’s a lot to take in, but much of it can be taken step-by-step. So, if you’re worried about your weight and have a BMI that is higher than 30, it’s worth talking to your doctor about the specific ways you might be affected.

But Losing Weight Is Tricky

OK, here’s the really complicated part. There is a good chance that you will want to try and lose some weight for IVF if you are obese—and that’s totally cool if that’s your choice—but you should be careful how you do it. As much as being overweight may have an impact on IVF, losing weight isn’t a guaranteed solution. For example, a 2006 study in Fertility and Sterility found that very-low-calorie diets had a negative effect on IVF—so crash dieting could be a bad idea.

That being said, as fertility decreases with age, it may not make sense to embark on a five-year weight loss journey if your fertility rates are already low. It’s incredibly frustrating, because the truth is, there’s just not a clear “right” answer. That’s why it’s so important that you find a doctor who will work with you to find the best choice for you. There’s a balance between weight, diet, and time—and it’s not going to be the same for everyone.

Find The Right Doctor

Chances are, if you’re embarking on IVF you’re probably feeling vulnerable. Make sure that you find the right doctor: that could mean someone with the most prestigious medical qualifications; maybe it means someone with stellar qualifications who is also a fat-friendly doctor. The choice is yours. Don’t be afraid to ask advice from friends or even from Internet forums. Anyone who is overweight and/or has been through IVF themselves will understand how you’re feeling. Even better if they’re both. Get a recommendation for a doctor who will make you feel the most comfortable is going to make the entire process a lot easier.

There still needs to be more consensus among doctors when it comes to IVF and weight loss. Not the relationship—the evidence is strong that being obese leads to less IVF success—but in terms of what you should be doing about it. Because really, practical advice is what you need. So instead of drowning in Internet information and WebMD, try to find a doctor who can discuss your unique situation. Know the potential risks, go in armed with questions, and keep an open mind. You just need to find the right balance for you.

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