I would like your opinion about IVF for an overweight woman. When I was 100 pounds lighter, I conceived but chose to abort. That was eight years ago. In the last year, I have had Clomid alone and three times with insemination. I have had no success. I asked my RE about IVF, and he said I am not a candidate because of my weight. I have lost 50 pounds so far, and he knows this. Could you explain why I might not be an IVF candidate?

-- Sena

Obesity can create a problem for women undergoing ovulation induction or IVF. They are at risk for problems during pregnancy such as hypertension, gestational diabetes and pre-eclampsia. In addition, the process of ovulation induction is often complicated by a less predictable response to the medications and difficulty monitoring follicle development and performing egg retrieval using transvaginal ultrasound.

In my own practice, there is not a particular weight that I use as a cut-off for determining IVF candidacy. I need to evaluate each woman's weight as one component in determining the safety of IVF and the likelihood she will be successful.