The following is the long version of the BS that the RE and I went through:
So my RE called and left me a message 3 minutes before the office closed last night. I had the phone in my hand when I got the voicemail notification... but I don't remember the phone ever ringing. I may just be paranoid, but I'm starting to think he used a 3rd party service to bypass my phone ringing and go straight to voicemail so he could avoid talking to me last night. But I digress.
The voicemail was about a "new study" with donor oocytes showing there's a significant decrease in the success of IVF rates in patients with BMI >40. The message rambled for several minutes but the gist was "your BMI is 42-44, and puts you in a group that 's significantly less likely to achieve a live birth regarding this new study". He ended with "I'm sure you've got lots of questions, I'll be in the office all day tomorrow, give me a call."
So of course at 4:29 I call the office back and the phone is already off. FUCKERS. You know he was making those calls at the end of the day to hopefully avoid talking to me. What he forgot was several months ago he called me from his personal cell phone with a blocked number to leave a message for me on his day off. I have software on my phone that automatically forces a redial for blocked numbers and unmasks the block... so I knew I had his personal cell number. I figured it would come in handy one of these days. Yesterday was that day.
So I called him back... probably around 4:35 or so. Not obnoxiously late. He was BEEEEEEEEYOOOOOOOOOND pissed that I was calling for a non-emergency. But frankly if he wants to play dirty pool, so will I.
The conversation lasted about 10 minutes. It was a lot of "this new study just came out, it was with donor oocytes from "average weight" individuals so we know the egg quality wasn't compromised by a high BMI" and talks about how women with a BMI >40 had "something like a 60% lower chance of having a take-home baby at the end". And then he mentioned that he knew I had had "problems" with my weight, and highly encouraged me to think about cancelling my cycle until I lose some weight. He went into the details (that he remembered) of the study and went on and on about how women with a BMI >30 really aren't good candidates for IVF, and moving forward he will be refusing them as clients.
I told him we're not cancelling our cycle and that I'd see him next week.
So I got home, panicked, cried for about an hour straight, took my meds, and then sat down to research. Turns out the ASRM annual meeting was this week (Monday) and this "study" was presented by its authors. It's not been peer-reviewed, and it hasn't been published or replicated. And yet he decided it would be a good idea to call a bunch of patients and fat shame them over preliminary data.
I don't have the links to the full studies with me right now ( you can pull them from the ASRM website) but here is an excerpt from the press release from the conference:
"Often eggs from one donor are provided to different patients. Using records of fresh, shared donor cycles performed between 2004 and 2012 investigators from the National Institutes of Health (NIH) were able to examine cases where one donor’s eggs went to different patients and those women had different BMIs. Of the nearly 4,000 cycles examined, 63% of the recipient patients had a BMI of less than 25, 24% had a BMI of between 25-30, 8% were between 30-35 and 5% reported a BMI of greater than 35. A higher BMI was associated with a lower live birth rate. This difference persisted even when controlling for other factors such as age and number of embryos transferred. The impact was strongest in recipient patients with a BMI greater than 35, who showed a 21% lower live birth rate."
SOURCE
The part that really bothers me about the above is the bolded. The VAST MAJORITY of the sample was skewed toward an average/normal/healthy BMI, and only 5% of the sample (so roughly 200 women) had BMI's "greater than 35". So if we're talking a 5'6 woman, that minuscule part of the data subset could have ranged anywhere from 217lbs-300+lbs.
So of course, I've spent a bit of time researching studies that have actually been PUBLISHED regarding obesity and IVF in the year 2014 alone. Here are some of the highlights:
The Impact of Maternal Body mass Index on In Vitro Fertilization Outcomes
Alexandra Legge, Renda Bouzayen, Linda Hamilton, David Young
Objective: To examine the effect of body mass index on gonadotropin dose requirements for ovarian stimulation, as well as other clinical outcomes in women undergoing in vitro fertilization.
Results: There were no significant differences between the three BMI groups for any of the IVF cycle outcomes measured, including the total FSH dose required for ovarian stimulation. The likelihood of cycle cancellation, clinical pregnancy, and live birth were not significantly different between normal weight, overweight, and obese women.
SOURCE
Obesity is not associated with the poor pregnancy outcome following intracytoplasmic sperm injection in women with polycystic ovary syndrome
Funda Akpinar, et al
Objective
To determine if body mass index has an effect on the outcome of in vitro fertilization in patients with polycystic ovary syndrome undergoing controlled ovarian hyperstimulation.
Results
Total gonadotropin consumption increased, and the number of retrieved oocytes decreased as the body mass index increased. The implantation rate and clinical pregnancy rate were similar in all 3 groups. In response to the mid-luteal long protocol, the cycle cancellation rate was lower and the number of retrieved oocytes was higher in the overweight and obese groups, as compared to the antagonist protocol.
So honestly, I'm not that concerned. I'm more concerned that my doctor is apparently an idiot for basing this rash decision on an unpublished study.
Renda Bouzayen, Linda Hamilton and David Young are the doctors in my clinic. They are fantastic. I trust them,.
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