Obesity, Fertility and IVF

It is important to consider your weight when thinking about pregnancy, as well as if you are having issues with falling pregnant.

With rising BMI, time to pregnancy increases, and nulliparity (never having given birth to a child) rates increase. There are also increased risks to the mother of the pregnancy, as well as potential anaesthetic complications. It is important to note that a higher BMI is also problematic when considering IVF treatment. Medications used for IVF are less effective, and the results of IVF with a higher BMI are poorer.

There has always been some controversy when discussing obesity and IVF, as there are challenging ethical and medical issues. The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) has a ‘Pre-Pregnancy Counselling’ statement, which recommends ‘active steps to correct obesity’ prior to a pregnancy are worthwhile. It also confirms the known increased risks of a higher BMI, including increased risks of miscarriage, stillbirth, and fetal abnormalities. This document is currently under review. In New Zealand, there is currently a cut-off of BMI 32 for public IVF, which is a challenging ethical and medical issue to balance, and I am not sure this is the most appropriate way forward.

The following table comes from the RANZCOG ‘Management of Obesity in Pregnancy’ statement. It is from a retrospective cohort of over 72 000 Australian women delivered in a tertiary centre and allows some quantification of the obstetric risks by BMI. This statement is also currently under review.

There are many safe options for obesity or weight loss currently available in Adelaide with Dr Balalis. There are medications available, including Saxenda and Contrave, which are safe and can assist in decreasing hunger. There is also a gastric balloon, the Elipse by Allurion program, which Dr Balalis performs to assist patients in creating new routines. It provides a feeling of fullness sooner and for longer periods. Dr Balalis performs all types of weight loss surgery, including sleeve gastrectomy, gastric bypass, and revision surgery, which are all very safe and recommended for patients with a BMI from 35.

It is always important to consult with a Bariatric specialist prior to consideration of the options available – a tailored approach. This would consider all individual patient factors, including the health of the mother, IVF success rates, as well as the health of the fetus during pregnancy.

For further information, please contact Dr Balalis.