We recently heard of someone (in another state) who died from complications of egg retrieval. This is an extremely rare event (the risk is about 1 per 100,000 cases; compare this to the risk of maternal death with pregnancy, about 1 in 10,000). Although the details aren’t entirely clear, it sounded like the patient’s obesity played a role in her demise. It made us wonder, should we have a weight limit for egg retrievals?
Our procedure table for egg retrievals has a weight limit of 500 pounds, but rather than just setting a weight limit, a better way of considering obesity is by looking at the body mass index (BMI), calculated by dividing the weight in kilograms by the square of the height in meters. Individuals with a BMI of 25 to 29.9 are considered overweight; individuals with a BMI of 30 or more are considered obese, and those with a BMI of 40 or more are considered morbidly (or extremely) obese. According to recent surveys, about a third of all adults in the US are obese, and about 5 to 10 million people in the US are morbidly obese.
Obesity is associated with increased risks of a number of diseases, including hypertension, type 2 diabetes, coronary heart disease, stroke, and … infertility. Obese patients have higher complication rates from anesthesia and surgery, especially those with morbid obesity. Therefore, we have decided not to perform egg retrievals on women with a BMI of 40 or above.
MPS
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I have to say I completely understand your decision to restrict egg retrievals to patients with a BMI of less than 40. Not only is it cautious in terms of surgical risk, but I would think it would be crucial to maintaining a healthy pregnancy. It only makes sense (both in terms of cost and time) to ensure that the patient is in the best state of health possible to endure pregnancy and essentially promote the live birth of a healthy child.
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