title: Survey assessing obesity policies for assisted reproductive technology in the United States.
abstract: OBJECTIVE
  To determine what assisted reproductive technologies (ART) policies, if any, have been instituted in response to an increasingly overweight and obese patient population.
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  University-affiliated IVF clinic.
  
  
  METHODS
  Women in the overweight and obese body mass index (BMI) categories seeking ART treatments.
  
  
  METHODS
  Anonymous survey sent to medical directors at 395 IVF centers listed in Society for Assisted Reproductive Technology database.
  
  
  METHODS
  Assessment of recommendations, policies, and restrictions for patients who are overweight/obese and who desire treatment for infertility, including in IVF, IUI, and donor egg cycles.
  
  
  RESULTS
  Seventy-seven anonymous responses were received (19.5% response rate): 64.9% of centers have a formal policy for obesity, and 84% of those have a maximum BMI at which they will perform IVF, while 38% of those have a maximum BMI for performing IUI; 64.6% of respondents reported anesthesia requirements/concerns as the primary criteria for patient exclusion. Other primary considerations included safety during ongoing pregnancy and ART outcomes.
  
  
  CONCLUSIONS
  Centers that have policies regarding obesity and access to ART consider efficacy, procedural safety, safety in pregnancy, and overall health status. Policies vary widely. The patient's autonomy must be balanced with nonmaleficence and the avoidance of interventions that may be unsafe both immediately and long term.
authors.affiliation: Center for Advanced Reproductive Services, Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Connecticut Health Center, Farmington, Connecticut.
authors.forename: Leah
authors.initials: L
authors.lastname: Kaye
authors.affiliation: Center for Advanced Reproductive Services, Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Connecticut Health Center, Farmington, Connecticut.
authors.forename: Carolina
authors.initials: C
authors.lastname: Sueldo
authors.affiliation: Center for Advanced Reproductive Services, Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Connecticut Health Center, Farmington, Connecticut.
authors.forename: Lawrence
authors.initials: L
authors.lastname: Engmann
authors.affiliation: Center for Advanced Reproductive Services, Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Connecticut Health Center, Farmington, Connecticut.
authors.forename: John
authors.initials: J
authors.lastname: Nulsen
authors.affiliation: Center for Advanced Reproductive Services, Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Connecticut Health Center, Farmington, Connecticut. Electronic address: benadiva@uchc.edu.
authors.forename: Claudio
authors.initials: C
authors.lastname: Benadiva
mesh_terms: D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005260:Female; D005298:Fertility; D019538:Health Care Surveys; D006291:Health Policy / Q000331:legislation & jurisprudence*; D006801:Humans; D007246:Infertility / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D009765:Obesity / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D061214:Patient Safety; D018579:Patient Selection; D011050:Policy Making; D011247:Pregnancy; D027724:Reproductive Techniques, Assisted / Q000009:adverse effects / Q000331:legislation & jurisprudence*; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014481:United States
keywords: BMI; Obesity; assisted reproductive technology; policy