Fertility At Every Size: A Discussion of BMI Bias in Fertility

Fertility at Every Size

Fertility At Every Size

Chances are, if you have a higher BMI than what is considered “normal” by the American medical establishment, you will have heard from doctors, friends, and family that you need to lose weight if you want to have a baby. These beliefs are often based more on cultural biases than fact, and simply may not be true. There are many options for growing your family, let’s explore fertility at every size. 

BMI Bias

BMI’s use in healthcare is being largely questioned and is no longer considered to be the determinant of health as it once was. As is so often the case, much of the data used to create the BMI scale was based on white European males.

In addition, the BMI scale was never intended to be used in the medical field – it was developed for the insurance industry to determine if someone qualified for life insurance. It has never been an accurate assessment of health. Do keep this in mind before you take BMI too seriously in any context. 

In addition, the relationship between fertility, health, and weight is complicated. Some people with a high BMI will have hormonal issues that lead to issues with ovulation and sperm production, but others may not have any of these issues.

People with a low BMI may have these hormonal issues too. So, BMI, by itself, doesn’t tell us much at all about a person’s metabolic, hormonal, physical, or mental health. In fact, while the chances of infertility may be greater in people with a high BMI, most are, in fact, fertile. 

Dietary and Exercise Changes

Losing weight is not necessarily the answer. Sure, improving your dietary choices and exercise habits while reducing stress may result in some weight loss, but more importantly, these changes will likely result in better insulin and blood sugar regulation which leads to better hormonal balance.

That would be the case for anyone in any weight bracket who wanted to have a child. We at Portland Acupuncture Studio recommend lifestyle changes for every person based on people’s individual needs, not based on weight or BMI.

What the Studies Show

Recent research shows that people with a high BMI who have no issues with ovulation have the same chance of having a baby whether or not they lose weight first. And there’s a good indication that people going through IVF with higher weight produce genetically normal embryos at the same rate as people with a BMI of 18.5-24.5.

The American Society for Reproductive Medicine recently published a document on “Obesity and Reproduction.” In this document, they review current practices, research, and recommendations. One of the most interesting charts in the document is Figure 1, which shows the percentage of live births resulting from IVF based on age and BMI.

It is notable that in most cases, people with a BMI of 18.5-24.5 are only marginally more likely to have a baby than people with a BMI of 30-35, and in some cases in the higher age range, the ones with the lower BMI are less likely to conceive. 

We know that there are barriers to fertility for people in larger bodies, like provider biases, difficulties with ultrasound techs, or the possibility of being automatically considered at higher risk for health complications during pregnancy. We don’t want to minimize those challenges in our current culture.

At Portland Acupuncture Studio, we believe that every person deserves to have the family they long for. We provide kind, compassionate care to every patient equally. We hope the info above gives you some confidence to move forward with your plan to grow your family and to find providers that support you.

We strongly support health, and fertility at every size, and would be delighted to help you on this journey. Contact us to learn more. Lastly – For an even more powerful resource on self-love and body acceptance, check out The Body is Not an Apology by Sonia Renee Taylor.

Established patients can schedule online, patients who haven’t seen us at Kwan Yin Healing Center call (503) 701-8766, or email us to schedule your appointment.

About Lisa Tongel

We are practitioners of Acupuncture and Chinese Medicine specializing in fertility, IVF support, pregnancy care, reproductive health, and pelvic pain.