You’ve done your research and you’re ready to get going! Unfortunately, you’ve calculated your Body Mass Index (BMI) and find yourself outside the acceptable range for your chosen surrogacy agency. Why do agencies have these guidelines?
Most agencies will work with women who have a BMI between 19-32. They choose the range based on the requirements of the reproductive endocrinologists (REs) with whom they most often work. Rarely, an RE may allow a BMI up to 33 if the surrogate is otherwise healthy and has had recent, uncomplicated pregnancies. We at Heartland Surrogacy accept applications from surrogates with a BMI between 19-32.
What is Body Mass Index?
BMI is a universal tool used to measure body fat based on height and weight. It is calculated by dividing weight (kg) with height (meters square). BMI is generally a good indicator of health and is one factor that helps doctors decide whether a woman is healthy enough to be a surrogate.
Why is BMI important during a surrogacy pregnancy?
You might think, “I’ve never had any problems with my own pregnancies, so what’s the big deal?”
When choosing surrogacy, many intended parents (IPs) have often already struggled in getting pregnant or having a successful pregnancy. The path to surrogacy can be emotionally and financially draining. Surrogacy is often a last resort and everyone involved wants to minimize possible complications. For this reason, optimal health of the gestational carrier (GC) can help minimize potential risks in pregnancy and delivery.
While body fat is necessary for the pregnancy process, having too much or too little body fat can have adverse effects.
Risks associated with a higher BMI
Gestational diabetes
The risk of diabetes during pregnancy is a common issue many women face; however, a high BMI increases the risk. If a woman has gestational diabetes, the baby is more likely to suffer a number of complications: excessive birth weight, premature birth with associated respiratory problems, low blood sugar at birth, Type 2 diabetes later in life. [MC]
Preeclampsia
The risk of preeclampsia is greater in overweight and obese women. [NCBI] Preeclampsia is a blood pressure-related disease that not only affects the surrogate’s organs, such as the kidneys and liver, but it also affects the blood flow through the placenta to the baby. Because conceiving through IVF also increases the risk of developing preeclampsia, high BMI is especially undesirable in surrogacy. Women who develop preeclampsia often have to be induced and the baby may have to be delivered early.
Increased Cesarean Section Rates
Overweight women have longer labors, which can lead to an increase in C-section rates. [NCBI2] Macrosomia, a condition in which the baby is larger than normal, can also lead to an increased rate of C-sections or injuries during the labor and delivery process. [ACOG]
Other risks
Studies have shown that there is also an increased risk of pregnancy loss and stillbirth, as well as a higher rate of birth defects for babies born to women with a higher BMI. [ACOG]
Thankfully, BMI is one of the factors that you can control as a candidate for surrogacy. For your health and that of the baby/babies you would carry, having a healthy weight/height proportion will be an important part of your journey. If your BMI does not currently fall within our acceptable guidelines, we recommend taking it slowly and focusing on healthy eating and exercise. Studies have found that very-low-calorie diets have a negative effect on IVF—so crash dieting could be a bad idea. [FS] Your doctor can help you find the best weight loss solution for you, and finding additional forms of support may help you reach your goal of a healthy BMI.