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How High is Your BMI?

Posted Oct 21 2008 12:20am

    Did you ever hear about the Body Mass Index before you wanted to be a surrogate or have any type of IVF treatment? Perhaps you did if you were a body builder or really focused on your health. I have to admit that I never even heard of it until my first clinic visit. I went by the 5 pound rule: when I was 5 pounds over what I liked to be I cut back on my intake and that was that....(please don't hate me!) For a lot of people, however, BMI is an important issue and most clinics will not work with anyone with a BMI over a 30 or under a 18.

BMI Categories:

  • Underweight = <18.5
  • Normal weight = 18.5-24.9
  • Overweight = 25-29.9
  • Obesity = BMI of 30 or greater
The limits of this BMI calculation are:
  • It may overestimate body fat in athletes and others who have a muscular build.
  • It may underestimate body fat in older persons and others who have lost muscle mass.

    Why is BMI or body weight such an issue with IVF? Mainly it is a safety issue for the patient at the egg retrieval. (this means you, egg donors) When a woman is significantly overweight, the ovaries are usually pushed up "high" - away from the top of the vagina by the extra fatty tissue that is in the pelvis. At the time of IVF, the needle is pushed in vaginally to reach the eggs in the ovaries. If the ovaries are too high, the RE can not safely get the needle into the follicles to get the eggs out.

    Another problem is that the ultrasound images become very "fuzzy" from the extra tissue between the probe and the ovary. Therefore, it is often difficult to clearly visualize the ovaries and the egg-containing follicles. This makes it difficult to properly measure the follicles in the ovaries, and can also make it hard to be sure where the needle tip is located at all times during the egg retrieval procedure (a potential safety issue).

    In the case of a Gestational Surrogate and an ultrasound guided embryo transfer, the images can also become "fuzzy" and not allow for a clear picture that the RE needs to properly guide the catheter. Sometimes, even with a higher BMI, this isn't an issue because the weight is distributed in other areas other then the pelvic region. Each person is different and the RE needs to make the ultimate decision.

    Lastly, the over all health needs to be considered. A pregnant woman gains anywhere from 25-40 pounds during the pregnancy. Some of the aches and pains she'll feel during pregnancy are related to weight gain. Backache and feeling more awkward and clumsy (thanks to the changing center of gravity) are the most common problems. Many women complain of swollen legs and ankles (edema), but this is actually caused by the increased amount of blood and other fluid in your body, not by the extra pounds they are carrying.

    If she has struggled with controlling her weight in the past, or even if she's
never dieted in her life, she may have a hard time accepting that it's okay to gain weight now. It's normal to feel anxious and even depressed as the numbers on the scale edge up. Try to keep in mind, however, that the extra weight is important for a healthy pregnancy and that those extra pounds will eventually come off after the baby has arrived. And remember, it's important to pay more attention to how well you're eating than to how much you gain.


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