ON RACE, BMI THRESHOLDS, AND INFERTILITY TREATMENT - EXAMINING THE OUTCOMES OF PATIENTS WHO EXCEED BMI THRESHOLDS AT FIRST VISIT

Abstract

In the United States, pre-pregnancy obesity impacts about 1/3 of reproductive aged women, with the highest rates of elevated BMI among underrepresented minorities. As a single parameter, BMI is a relatively poor predictor of health, and tends to estimate health risks of Black patients less accurately. While there is no universal BMI cutoff above which all SART-fertility clinics deny IVF treatment, ∼65% of programs have a self-imposed cut-off that typically ranges from 35-45 kg/m2. As rates of obesity are higher in Hispanics and non-Hispanic Blacks compared with non-Hispanic White patients, BMI thresholds for fertility care may inadvertently discriminate against populations of patients who already face barriers to access to care. The objective of this study was therefore to evaluate the characteristics of patients who exceeded the BMI threshold for IVF treatment at their initial visit, to examine likelihood of treatment initiation, and to elucidate associated demographic factors.