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2A - Women with a BMI over 40 Should Be Refused Fertility Treatment

For

from Section I - Limits for IVF

Published online by Cambridge University Press:  25 November 2021

Roy Homburg
Affiliation:
Homerton University Hospital, London
Adam H. Balen
Affiliation:
Leeds Centre for Reproductive Medicine
Robert F. Casper
Affiliation:
Mount Sinai Hospital, Toronto
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Summary

Class III female obesity impairs both natural and assisted conception and increases obstetric complications and postnatal chronic diseases in the offspring, leading to higher economic costs. Weight reduction before conception may improve these undesirable outcomes. To date, no well-designed randomised trials of intervention programs for weight reduction with adequate follow-up and monitoring by a multidisciplinary team and a significant number of patients have been published in the field of assisted reproduction. Considering the demonstrated economic and health consequences, morbidly obese women should be refused fertility treatment. However, weight loss options, associated infertility factors and ethical considerations should also be taken into account in the decision-making process.

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Chapter
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Publisher: Cambridge University Press
Print publication year: 2021

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References

Sermondade, N, Huberlant, S, Bourhis-Lefebvre, V, et al. Female obesity is negatively associated with live birth rate following IVF: a systemic review and meta-analysis. Hum Reprod Update. 2019;25:439–51.CrossRefGoogle Scholar
Sim, KA, Dezarnaulds, GM, Denyer, GS, Skilton, MR, Caterson, D. Weight loss improves reproductive outcomes in obese women undergoing fertility treatment: a randomized controlled trial. Clin Obes. 2014;4:61–8.CrossRefGoogle ScholarPubMed
Espinós, JJ, Polo, A, Sánchez-Hernández, J, et al. Weight decrease improves live birth rates in obese women undergoing IVF: a pilot study. Reprod Biomed Online. 2017;35:417–24.CrossRefGoogle ScholarPubMed
Mutsaerts, MAQ, van Oers, AM, Groen, H, et al. Randomized trial of a lifestyle program in obese infertile women. NEJM. 2016;374:1942–53.CrossRefGoogle ScholarPubMed
Einarsson, S, Bergh, C, Friberg, B, et al. Weight reduction intervention for obese infertile women prior to IVF: a randomized controlled trial. Hum Reprod. 2017;32:1621–30.CrossRefGoogle ScholarPubMed

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