Saturday, October 20, 2012

Infertile & fat, but not infertile because of the fat!

Fat people are perhaps the last "minority" group people can discriminate against & not suffer the consequences of the law.  Deny a gay person, a black person or a person in a wheel chair medical treatment & you'll get sued.  Deny an obese person medical treatment while dealing with infertility & you have medical science to back you up, right?  

Apparently not.

A recent study from Penn State found that women who underwent gastric bypass surgery did not become any more "fertile" after losing weight.  While the women reported an increase in libido, rates of ovulation remained the same.  I' m guessing these women were probably more in the mood because they thought they might finally get pregnant with the excess weight gone so they reported "gettin' it on" more.  And if the researchers followed them more long term, the level of sexual desire probably decreased with each cycle they didn't get pregnant.

But here's the finding I am most interested in: "The quality of the ovulation also remained unaltered. The only change seen was a shortening of the first half of the menstrual cycle, from the end of the previous menstrual flow until the release of the egg."  So my egg quality may still suck.  And given my body is pretty much a Swiss watch when it comes to my menstrual cycle, I'm guessing losing weight would not shorten my 28 day cycle or lengthen my 14 day luteal phase.

I've struggled with my weight all my life.  So have my mom & sister, both of whom got pregnant with no issue.  Granted I'm bigger than they are, but they are both classified as obese too.  And so what?  Are they or the millions of other obese women not allowed to have kids?  

Unfortunately, many infertility practices practice such discrimination.  For IVF #1 I was needlessly given an epidural because of my weight.  My current RE had to battle for them to not give me an epidural & just do the routine "knock out" for IVF #2 because of my BMI. I'm not diabetic.  I don't have GERD or apnea.  I was knocked out for oral surgery & for an exploratory lap to look for endo before with no issues.  Hell, before I got married I was actually denied the very same weight loss surgery this study looked into because besides being obese, I have no other medical issues (besides a wonky thyroid & beta thalassemia which have nothing to do with my weight) that would "warrant it" according to the surgeon.

I guess I should just be glad I don't live in the UK where women my size are outright denied IVF.  Hopefully more studies like this will change that policy. 


ADSchill said...

Ugh. I hear you. I am in a similar boat with weight. Overweight with no medical problems besides PCOS and even with that I have relatively normal cycles with ovulation. I am always told about BMI like it's how we should all measure ourselves. I've talked about this before, but if I went by BMI I should be about 130lbs. I have been this weight in highschool and I looked sickly. Not what I want to look like.

I do believe in being a reasonable weight and being healthy, but I don't think we should all be measured by the same scale or denied medical procedures based on weight alone.

Rebecca said...

I'm obese too but ovulate on my own with crappy eggs. My PCM actually told me I needed a gastric bypass done. I'm 32 for BMI, while it isn't morbidly obese I don't think I need to do a surgical procedure to fix things with me either.

satto said...

eI am morbidly obese.
Thank God my RE was smart enough to not discriminate based on my weight or my THREE IVF BABIES would not exist.

jak said...

great post and insightful analysis. i'm small, bmi about 20. i get my period like clockwork, just like you. i have weak response to stims just like you, needed ISCI just like you, and had jack squat to freeze after several ivf cycles (you had a totsicle though, so really, you were MORE successful than me!!). only 1 single egg out of all 21 total eggs from all cycles ever made it to a healthy blast for me.

it is unfair, discriminatory, and just plain bad medicine to assume that everyone's individual problems with ivf success can be boiled down to weight. while i do believe that it is the case for some people that weight has an effect (there def are stories of people starting to ovulate after weight loss) that can't be the case for everyone. especially if their cycles are completely normal and everything else appears fine.

i thought the following was a VERY good point, and was/is definitely true in my journey through IF:

"And if the researchers followed them more long term, the level of sexual desire probably decreased with each cycle they didn't get pregnant."

true dat. again, awesome post.