Ask Monica is a Q&A video series hosted by Nurse Practitioner Monica Moore.
In this article:
Hi everyone, I'm Monica Moore.
This edition of Ask Monica is probably one of my favorites, because I get to wear two hats. I get to use my nurse practitioner hat and my health coaching hat! Today, we're going to be talking about BMI and BMI requirements.
BMI (or body mass index) uses body weight and height, and it is a simple measurement, but it is not the most effective or best measurement for health. There are a lot of other better ones, and we can get into that in another episode, so why are there BMI requirements at a clinic?
Some clinics have BMI requirements for surgeries or procedures, and that BMI requirement is really dictated by the anesthesiologist at that center.
There can sometimes be some adipose (fatty tissue) that is situated or centered around the neck that might potentially cause some breathing difficulties [during surgery]. Those breathing difficulties are better handled at a hospital-like institution (as opposed to a freestanding clinic), which many infertility centers are now.
The BMI requirement can differ, but under that anesthesiologist or anesthesia group's experience, BMIs above a certain level might generate more problems or challenges in terms of airway management, which is really the foremost concern for an anesthesiologist during an egg retrieval.
So, if you go to a certain fertility center and you are told there's a BMI requirement to meet before you can have a hysteroscopy or an egg retrieval, that's why.
If you need help getting under your clinic's BMI requirement, (which is not easy, I know as a health coach and that's also what the data shows us), we do have a lot of options at Illume Fertility to be able to help you. You can talk to health coaches like me, our nutritionists, or your nurse about next steps or options.
BMI and why there's a requirement (in terms of proceeding with a conception cycle) is a little bit different. The basis of that is the studies that were done: these were population-based studies, meaning they compare a certain population to another population. They're not comparing that person to themselves.
Population studies of people in the high obesity categories (class one, two, or three obesity) compared to population studies in the normal or overweight category in terms of BMI show that higher levels of BMI might be detrimental both to fertility and carrying a pregnancy, as well as maternal complications during that pregnancy.
We are your first prenatal provider. We will end up sending you hopefully pregnant to your OB. We feel that we have a responsibility to help you achieve a pregnancy at your healthiest level.
Again, it's not that BMI on its own can determine whether you're healthy or not for pregnancy, but if there is an excess of adipose (or fatty tissue) as demonstrated by an elevated BMI category.
It simply means we might need to work with you to make sure that you're metabolically (or internally) as healthy as possible. There are certain ways we can measure that, like blood tests, blood pressure, etc.
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If you exceed Illume's BMI requirements, in terms of just being able to go through a cycle, then what we would do is have you talk to a team of us and see what we can do to help you lower your BMI in a safe, sustainable way.
We're here to help you achieve the best possible health prior to pregnancy and be successful, so don't hesitate to ask for support and guidance.
I hope that's helpful. This is a very (as it should be) emotionally-charged topic.
Losing (and even gaining) weight for some people is very difficult.
So we don't take this lightly, and that's why we have a dedicated team for this. If you have any questions about BMI requirements or you'd like to talk to me (or another member of the Illume team) about this or your particular situation, as always, feel free to reach out to us.
Thanks so much for tuning into this edition of Ask Monica.
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