A retrospective cohort study examining the outcomes of patients who present for fertility care and exceed a set body mass index threshold for treatment

Objective

To evaluate the characteristics of patients who exceeded the body mass index (BMI) threshold for fertility treatment at their initial visit and identify those for whom treatment would be constrained.

Design

Retrospective cohort study.

Setting

Academic medical center.

Patient(s)

All new patients who presented for infertility treatment at an academic center between January 2020 and December 2022 and had BMI measured and recorded.

Main Outcome Measure(s)

Likelihood of weight loss and treatment initiation for patients who exceed a set BMI threshold of 40 kg/m².

Result(s)

Of the 1,268 patients who had their BMI recorded at initial visit, 48% identified as non-Hispanic White, 15% as non-Hispanic Black, 13% as Asian, 11% as Hispanic, 0.2% as Native American, 4% as other; 9% were of unknown race/ethnicity. Overall, 6% of women exceeded the 40 kg/m² cutoff. Among Latino women, 7.5% exceeded the cutoff; among non-Hispanic Black women, 12% exceeded the cutoff. These percentages were greater than the percentage of non-Hispanic White women who exceeded the BMI cutoff (4.8%).

Conclusion(s)

Body mass index thresholds disproportionately affect the ability of ethnic minorities to use fertility treatment and could potentially be worsening barriers to care these population of patients already face.