Canadians debate denying fat women fertility treatments
Earlier this week, the Globe and Mail, arguably Canada's newpaper of record, published an article called Canadian MDs consider denying fertility treatments to obese women.
Canadian doctors are considering a policy that would bar obese women from trying to have babies through fertility treatments – provoking debate over whether the fat have the same reproductive rights as the thin.
One obvious issue is, of course, Polycystic ovary syndrome (PCOS), which according to Wikipedia, affects 5-10% of women of reproductive age. PCOS is associated with fatness and also tends to make women infertile. As is the case with every health concern associated with fatness, many people assume that fatness causes PCOS. Having known several women with PCOS, I think it's pretty clear that the causation runs in the other direction; PCOS causes women to gain weight and makes weight loss extremely difficult.
We have a discriminatory (and proud of it!) jerk in Ottawa:
“We’ve had many angry patients say to us, ‘This is discriminatory’ and I say, ‘Yes, it is’ But I still won’t do it,” said Arthur Leader, co-founder of the Ottawa Fertility Centre. The facility where he works will not treat women with a Body Mass Index (a measurement of weight relative to height) of more than 35. A BMI of 30 meets the clinical definition of obese.
...and we have a voice of reason in BC:
“You’d be denying half the reproductive population access to fertility treatment,” said Anthony Cheung, a fertility expert at the University of British Columbia and Grace Fertility Centre. “These people already know they have a problem – are you going to make it worse, add to feelings of social injustice, low self-worth, depression?”
“We don’t say, ‘Oh sorry you smoke, so we can’t treat you – it could result in pre-eclampsia, or small babies.’ It doesn’t mean we have this blanket policy where we say we can’t treat (smokers)”
Dr. Cheung says it makes him wonder about the “biases of our own society around treating women with high BMI…if it reflects a paternalistic view around obesity.”
Evidently, this is a worldwide debate:
The Canadian Fertility and Andrology Society, which recommends practice standards for the country’s fertility doctors, is not the first professional body to consider a treatment ban based on weight. The British Fertility Society recommended a ban in 2006, as has New Zealand, and it was the hot topic of debate at the European meeting on assisted reproduction in Sweden this summer.
Wow. A treatment ban. No exceptions. No case-by-case evaluation. Instead, a BMI cutoff for fertility treatments.
Arya Sharma, Canada's obesity czar, is with us on this one. However, he doesn't mention PCOS in his short post on the topic.
I think that one thing we can do to fight this is to tell our stories. I changed my mind about whether or not fertility treatments should be considered basic health care (for anyone) because a friend of mine shared the story of her and her mother's struggle with PCOS and fertility, and the fact that she wouldn't have been conceived without fertility treatments. Maybe we can change others' minds, too.