Should In Vitro Fertilization Policies Use the Body Mass Index?

Current guidance from the American Society for Reproductive Medicine (ASRM) and the American College of Obstetricians and Gynecologists (ACOG) indicates that body mass index (BMI) ought not be used alone for in vitro fertilization (IVF) exclusionary policies, but the reasons for using BMI alongside other criteria are less clear. This article aims to fill a gap in the literature on this point and follow the findings to a logical conclusion regarding the role of BMI in IVF policies of the future. The article discusses why BMI might be useful in IVF policies, explores evidence that other metrics may be sufficient to estimate population-level risk, and addresses whether policies ought to continue to use BMI. Because BMI has a morally problematic history, results in disproportionate outcomes along racialized lines, and has the potential to reinforce negative stereotypes, the article suggests that providers ought to replace BMI with other metrics.