American Society of Reproductive Medicine Scientific Congress & Expo

American Society of Reproductive Medicine Scientific Congress & Expo

Source:

O’Neill M, et al. Abstract O-124. Presented at: ASRM Scientific Congress & Expo; Oct. 17-20, 2021; Baltimore (hybrid meeting).

Disclosures: The authors report no relevant financial disclosures.
October 21, 2021
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OB/GYNs, infertility specialists need to educate women with obesity on weight loss

Source:

O’Neill M, et al. Abstract O-124. Presented at: ASRM Scientific Congress & Expo; Oct. 17-20, 2021; Baltimore (hybrid meeting).

Disclosures: The authors report no relevant financial disclosures.
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Women with obesity receive inconsistent counseling about the impact that their weight can have on fertility and about weight loss strategies before they begin infertility care, at ASRM Scientific Congress & Expo.

“The study was prompted by an increasing trend in overweight and obese patients presenting for infertility care at our center over the last several years,” author Margaret O’Neill, MD, an obstetrics and gynecology resident at the University of Massachusetts Medical School, told Healio.

O’Neill M, et al. Abstract O-124. Presented at: ASRM Scientific Congress & Expo; Oct. 17-20, 2021; Baltimore (hybrid meeting).
O’Neill M, et al. Abstract O-124. Presented at: ASRM Scientific Congress & Expo; Oct. 17-20, 2021; Baltimore (hybrid meeting).

The researchers noted that obesity is an increasingly important contributor to infertility among women of reproductive age. It also has been associated with increased maternal morbidity and reduced fecundity. Obesity reduces infertility treatment success as well, the researchers said, requiring complex workup before treatment begins.

Despite these obstacles and risks, few doctors regularly engage in weight counseling, the researchers said, even though it is associated with clinically significant weight loss. Women with obesity, then, often seek infertility treatment before being advised to lose weight or counseled on how best to do so.

The prospective survey study involved 48 women seeking infertility care at the Center for Advanced Reproductive Services in Farmington, Connecticut.

The participants were nonpregnant women of reproductive age (mean age, 36 years) who required an anesthesia consultation because they had an elevated BMI of 35 kg/m2 or greater before beginning in vitro fertilization. Also, 70.8% of the participants were white, 64.6% were college educated and 68.8% had an annual income greater than $75,000.

The mean BMI of the participants was 38.4 kg/m2, though a third of them did not know their BMI. About half of the participants said they knew their BMI, although the reported BMIs were on average 2 points lower than measured.

Margaret O’Neill

“We asked study participants to tell us about the counseling they have received from their primary OB/GYNs and infertility doctors about the relationship between excess weight and infertility. What we found is that most participants are able to identify being overweight as a factor that causes infertility and that all study participants reported attempting weight loss on their own in the past,” said O’Neill.

According to the study, 93.8% of the participants attempted to lose weight during the previous year. While 89.6% of them received weight loss counseling from a health care provider, although only 41.7% received specific weight loss counseling from their primary OB/GYN before referral for infertility treatment.

Also, 35.4% were referred to a weight loss specialist by their primary OB/GYN, and 45.8% were referred to a weight loss specialist by their infertility care provider. The women who were referred for weight loss counseling had an average BMI of 39 kg/m2, while those who referred had an average BMI of 37.9 kg/m2 (P = .2).

“Fewer than half of our participants reported that they received help in this effort from their primary OB/GYNs, and only 66% reported receiving help from their infertility specialist. Participants who had received help, in the form of referral to a dietician, weight loss specialist or bariatrics program, reported these efforts to be helpful,” said O’Neill.

The researchers concluded that primary OB/GYNs and infertility specialists have an opportunity to provide better patient education about obesity and infertility, including improved referral to weight loss specialists, to increase the success rates of treatment and decrease maternal morbidity.

Further, the researchers said future research should aim to identify the most effective methods for counseling patients about the relationship between obesity and infertility and to establish the most effective strategies for helping patients with obesity lose weight successfully.

“We think that this survey gives us insight into the fact that overweight and obese patients with infertility have awareness about their weight as a factor contributing to infertility,” said O’Neill. “However, their weight loss attempts could be better supported by primary OB/GYNs and infertility specialists. Providers of infertility care should become familiar with available resources in their community for patients trying to lose weight, and there is opportunity for improved referral to these programs.”