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Obese women also tend to respond more poorly to fertility drugs. “You have to use a lot more drug to get a reasonable response,” Dr. Laskin said.

“When I do see women with BMIs that are high, I work with them,” he said. “I don’t think it’s right to say, ‘You’re too heavy, go away and lose X amount of pounds and then call me.’

“I work out a plan for them. I say, ‘This is who you want to see, these are the options you can look at to lose weight, yes, you may have been there before but now you have a bigger reason for it.

“I give them all the risk factors and then I bring them back every three months until they are in a range that I believe is safe.”

In B.C., private IVF clinics outside hospitals are not permitted to perform egg retrievals in women with a BMI over 38.

Alberta has no restrictions, said Dr. Min, of Calgary’s Regional Fertility Program.

We’re not at a point where we think it’s fair or ethical to limit access to treatment based on a person’s weight

“In Calgary, at our clinic, we don’t have a BMI cutoff above which we won’t treat a patient with IVF,” said Dr. Min. “We’re not at a point where we think it’s fair or ethical to limit access to treatment based on a person’s weight.”

According to Statistics Canada, 23 per cent of Canadian women are obese. A woman with a body mass index of 30 or more is considered obese.

Obese women not only have more difficulty getting pregnant with IVF, they are also at higher risk of complications during delivery.

“Surgically, when you have to do a caesarean section, it’s very difficult and very dangerous because the blood loss, infections — all your complications are more common,” said Dr. Mark Walker, a high-risk obstetrician at The Ottawa Hospital

“You’re operating through a much more challenging operating field.”

Some pregnant women now have BMIs into the 60s, 70s and 80s, he said. The phenomenon is forcing obstetricians to re-fit their weigh-in rooms with scales that can accommodate women weighing more than 350 pounds while maternity wards are buying extra-wide chairs and beds and stronger operating tables.

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