The management of eating disorders in a fertility clinic: clinical guidelines.

Although the wish for a child may be ambivalent in women with anorexia or bulimia nervosa, the prevalence of eating disorders in fertility clinics is probably underestimated. Motivated by the wish for a child, these couples may be reluctant to reveal a history of an eating disorder and/or show resistance to some therapy for this disorder. Nevertheless, in our opinion, the eating disorder must be in full remission before any fertility treatment can start, if treatment is still necessary at that moment. Illustrated with some case examples, we will discuss the major problems and clinical strategies in the management of these complex cases, based upon the experience in our own fertility clinic.