Why Women With Larger Bodies Are Being Denied Fertility Care—And What Needs to Change

Women with larger bodies seeking fertility treatment report experiencing stigma, shame, and denial of care from reproductive specialists—including formal restrictions that bar them from accessing IVF based on weight alone. A qualitative study from the University of Michigan examined the experiences of 33 women with a body mass index (BMI) of 30 or higher who sought fertility care within the past two years, revealing a troubling pattern of weight-based discrimination that goes far beyond what these patients experience in general healthcare.

What Barriers Are Women With Larger Bodies Facing in Fertility Care?

The research uncovered several interconnected barriers that women encounter when seeking help with infertility. Many fertility clinics in the United States enforce BMI cutoffs that formally restrict access to treatment. According to the study, approximately 65% of surveyed fertility clinics report enforcing BMI restrictions, with cutoff thresholds ranging from 35 to 45 kg/m² (roughly 245 to 315 pounds for someone 5'10"). This means that despite infertility affecting one in six individuals globally, a significant portion of women are turned away before treatment even begins.

Beyond formal restrictions, the study identified several troubling patterns in how these patients are treated:

• Stigmatizing Language and Shaming: Many participants reported receiving judgmental and shaming comments from fertility providers throughout their healthcare encounters, with some directly stating this treatment influenced their decision to pursue or continue fertility care.
• Abbreviated and Substandard Diagnostic Evaluations: Participants frequently reported receiving rushed or incomplete diagnostic workups that missed critical diagnoses, suggesting providers were not conducting thorough evaluations.
• Dismissive Attitudes Toward Patient Knowledge: Women demonstrated significant awareness of how weight affects fertility and had complex histories of weight cycling, yet providers often failed to address these concerns or engage with patients' own understanding of their bodies.

Is Weight-Based Restriction Actually Medically Necessary?

One of the most striking findings from the research is that the medical justifications for BMI cutoffs don't hold up to scrutiny. Clinics that enforce these restrictions often cite concerns about technical limitations—specifically, difficulties performing transvaginal ultrasounds (imaging used during fertility evaluation) and managing airways during sedated procedures in patients with higher BMIs. However, scientific evidence contradicts these concerns. Studies demonstrate that egg retrieval procedures can be safely completed in women with higher BMIs when performed in appropriate clinical settings with proper equipment and trained staff.

This disconnect between stated medical concerns and actual safety data suggests that BMI restrictions may reflect provider bias rather than genuine clinical necessity. The study's authors note that despite evidence supporting the safety of fertility procedures for women with larger bodies, these patients are routinely denied access to care in the United States.

How Does Weight Stigma Compound the Stress of Infertility?

Women seeking fertility treatment already face significant psychological burden. Infertility is associated with substantial physical, financial, and psychosocial stress, and research shows that infertility itself carries both external and internalized stigma linked to decreased mental health and overall quality of life. When weight-based discrimination is layered on top of this existing stress, the impact becomes compounded.

The study found that participants with larger bodies experience pervasive weight stigma throughout their healthcare encounters—a pattern that has also been documented in prenatal and postpartum care settings. One in five pregnant and postpartum women report experiencing weight stigma during their care, with obstetricians identified as the most common source of this stigma. For women seeking fertility care, this means facing discrimination not just from general healthcare providers, but specifically from reproductive specialists who should be their advocates.

Some participants reported being told to "leave and return after losing weight," experiencing shame from reproductive providers, and even facing denial of basic reproductive services like intrauterine device (IUD) removal based solely on their weight. These experiences create barriers that extend beyond access to treatment—they can discourage women from seeking care altogether.

What Would Better Care Look Like?

Despite these troubling findings, the study also identified a path forward. Participants reported that quality care is achievable when providers offer humanizing and individualized treatment. The research emphasizes that there is a clear need for personalized, patient-centered care for women with larger bodies seeking fertility treatment.

This population represents an increasing percentage of fertility patients, making this not just an ethical issue but a practical one for reproductive medicine. The study's authors stress that the harm experienced by these patients is not inevitable—it reflects choices made by healthcare systems and individual providers about how to treat vulnerable populations. Moving forward, fertility clinics have an opportunity to examine their BMI policies, train staff to recognize and address weight bias, and commit to providing the same quality of diagnostic evaluation and treatment options to all patients, regardless of body size.

For women navigating infertility with a larger body, this research validates experiences that may have felt isolating and confirms that the discrimination they face is a systemic problem—not a reflection of their worth or their right to pursue parenthood.