I have a high bmi, can the tubal reversal still be done?
This is a question that we received in an email this weekend.
The answer is yes. Unfortunately, just because I can do something, it does not mean that it should be done.
The question should not be not only about whether a tubal reversal is a difficult or risky procedure for a patient with a high BMI, but should address the subsequent high risk pregnancy that may result.
Please google “Obesity and Pregnancy Risk” “Obesity and Surgical Risk”
I spend a significant amount of my time counseling patients about the importance of good health before elective procedures, IVF, and pregnancy. This is only because there is a large amount of scientific data supporting this. It is difficult to tell a lady that her BMI is too high. I try to be sensitive and bring up my own struggles with weight. Nonetheless, some patients don’t listen and some are sometimes offended.
Regarding elective surgery like a microsurgical tubal reversal, it is in the best interest of the patient to help to make the procedure as safe as possible. Obese patients have a higher risk of many surgical complications. It makes sense to try to become more fit for the surgery and the subsequent pregnancy.
Regarding IVF, many studies have shown a lower chance of pregnancy in obese patients and a higher risk of many subsequent complications in the pregnancies that are achieved.
As many of you know, I am a fan of a low carbohydrate lifestyle. I often recommend it. I also inform patients about Weight Watchers programs. I am not a fan of “bariatric surgery.” In may opinion, the main problem leading to the obesity epidemic is our over-indulgence in a high energy diet full of sugar, flour, and all forms of Carbs.
Sincerely,
Julio E. Pabon, M.D.
Sarasota and Bonita Springs Florida
