Koning Aafke M H, Mol Ben Willem, Dondorp Wybo J
Gelre ziekenhuizen, afd. Obstetrie en Gynaecologie, Apeldoorn.
Ned Tijdschr Geneeskd. 2014;158:A7258.
Obesity can lead to anovulation and subfertility. Around the world fertility treatment is withheld from women above a certain BMI, ranging from 25 to 40 kg/m2. The proponents of this policy use three different arguments to justify their restrictions: risks to the woman, health and wellbeing of the future child, and importance for society. In this article we critically appraise these arguments. In conclusion, we think obese women should be informed about the consequences of their weight on fertility and pregnancy complications and encouraged to lose weight. If, however, a woman is unable to lose weight despite effort, we feel there is no argument to withhold treatment from her. This would be unjustified with respect to the treatment of other women with a high risk of complications.
肥胖会导致无排卵和生育力低下。在世界各地，对于体重指数（BMI）高于特定数值（范围从25至40千克/平方米）的女性，生育治疗不予提供。这项政策的支持者使用三种不同的论据来为其限制措施辩护：对女性的风险、未来孩子的健康和福祉以及对社会的重要性。在本文中，我们对这些论据进行批判性评估。总之，我们认为应该告知肥胖女性其体重对生育和妊娠并发症的影响，并鼓励她们减肥。然而，如果一名女性尽管努力却仍无法减肥，我们认为没有理由不给她提供治疗。相对于治疗其他有高并发症风险的女性而言，不给肥胖女性治疗是不合理的。
