Importance of surrogate mother's body mass index (BMI) for surrogacy

A surrogate mother helps another family realize their dream of having a child, and her health is directly related to the safety of the baby and the success of the pregnancy. One of the most important indicators to check your health is the body mass index (BMI), which reflects whether a person is too light, moderate or too. A BMI that is too high or too low increases the risk of pregnancy complications and may affect the success of embryo attachment. In this article, we will discuss why BMI is crucial in surrogacy. Not only does it affect the pregnancy process, but it may also have long-term effects on the baby's health, such as an increased risk of neural tube malformations or asthma. We will also explain how to optimize BMI through proper diet and lifestyle modifications to improve surrogacy success and safeguard the health of mother and baby. Surrogate mothers can take these steps to better prepare their body conditions for a healthy pregnancy journey.

What is BMI and how is it calculated?

I. What is BMI?

BMI stands for Body Mass Index, a number used to measure whether a person has a healthy weight. It reflects how fat or thin a person is and how healthy he or she is by combining the ratio of weight to height. Doctors widely use BMI to determine whether a person is underweight, normal weight, overweight or obese. Although BMI is a simple and effective tool, it does not differentiate between muscle and fat ratios and therefore may not be accurate enough for certain special populations, such as athletes or the elderly.

Second, how to calculate BMI?

To calculate BMI, doctors use the following formula:

Weight in kilograms ÷ Height in meters squared.

This formula was proposed by the Belgian mathematician Adolphe Quetelet and is recommended by the World Health Organization (WHO) as a standard for assessing obesity. For example, if you weigh 70 kilograms and are 1.75 meters tall:

BMI = 70 ÷ (1.75 × 1.75) = 22.9.

This means your BMI is 22.9, which is in the healthy weight range.

Despite the simplicity of the BMI calculation, it does not apply to everyone. For example, pregnant women, children and muscular people (e.g. athletes) may be biased due to specific physiological conditions. Therefore, when assessing an individual's health, doctors usually combine it with other indicators (e.g., waist circumference, body fat percentage, etc.). Overall, BMI is a quick screening tool to help people know if their weight is within a healthy range. However, maintaining a healthy lifestyle is the key, including a balanced diet, moderate exercise and regular medical checkups.

BMI Classification

Below is a breakdown of BMI:

• Underweight:Less than 18.5.
• Normal weight:18.5-24.9.
• Overweight:25-29.9.
• Obesity:30 or more.

Each classification has its own specific health risks, especially during surrogacy.

Why is BMI important for surrogate candidates?

1. Medical qualifications

Surrogacy agencies check the BMI before accepting a surrogate mother, as a healthy BMI is an important indicator of how well a pregnancy is going to go.BMI reflects the ratio of a person's weight to height, and a healthy BMI means fewer risks during pregnancy, such as a reduced likelihood of complications such as gestational diabetes and high blood pressure. Most surrogacy agencies require surrogate mothers to have a BMI of less than 36 to ensure that she is able to handle the physical burdens of pregnancy. In addition, too high a BMI may affect the uterine environment, which may reduce the success of embryo implantation [[1]].

2. Pregnancy risk

A high BMI can lead to the following problems:

• Gestational diabetes:Women with high BMI are more likely to develop insulin resistance during pregnancy, leading to gestational diabetes. This not only threatens the health of the mother, but may also increase the risk of obesity or metabolic diseases in the fetus after birth.
• Pre-eclampsia:Pre-eclampsia is a serious pregnancy complication that is common in pregnant women with a high BMI. It can lead to high blood pressure and organ damage, and in severe cases can even endanger the lives of mother and baby.
• Cesarean section:High BMI increases the likelihood of cesarean delivery because obesity can lead to difficult labor and prolong surgical recovery.

3. Low BMI can also be dangerous

Low BMI may lead to nutritional deficiencies or preterm labor. Underweight surrogate mothers may not be able to provide adequate nutritional support to the fetus, which may interfere with normal fetal development. In addition, a low body fat percentage may interfere with hormonal balance, further increasing the risk of preterm labor or other complications.

4. Fertility treatment

BMI can affect the effectiveness of fertility treatments like IVF. High BMI reduces success rates because obesity may alter the environment of the uterine lining, affecting embryo implantation. Studies have shown that women with a BMI higher than 30 have significantly lower success rates with IVF treatments, along with an increased risk of miscarriage. A low BMI may also make conception more difficult. Being underweight may lead to irregular or complete cessation of ovulation, which can affect fertility. Surrogate mothers need to maintain an appropriate body fat percentage to ensure that their bodies are able to support the pregnancy process.

5. Maternal and child health

A healthy BMI protects not only the surrogate mother but also the baby. High BMI increases the risk of birth defects and stillbirths. For example, obese mothers are more likely to give birth to babies with congenital heart disease or neural tube malformations. In addition, a high BMI increases the probability of macrosomia (birth weight over 4 kilograms), which can lead to difficult deliveries and neonatal health problems. Low BMI poses the same threat to the health of the mother and baby. Surrogate mothers who are underweight may cause intrauterine growth retardation (IUGR), which increases the risk of neonatal mortality and long-term health problems. Therefore, maintaining a healthy BMI range (usually 18.5-24.9) is key to ensuring a successful surrogacy.

How does BMI affect pregnancy success?

1. Live birth rate

Women with a normal BMI have a higher rate of live births because a healthy weight provides an optimal physiological environment for embryo development. Studies have shown that high BMI significantly reduces live birth rates, especially in in vitro fertilization (IVF) treatments. For every unit increase in BMI above 24 kg/m², the miscarriage rate of fresh embryo transfer increased by 11.11 TP3T and the cumulative live birth rate decreased by 6.31 TP3T.This may be related to endocrine disruption, endometrial inflammation, and decreased egg quality triggered by high BMI. In addition, low BMI also affects live birth rates, as being underweight may lead to abnormal ovulation or erratic hormone levels, which can interfere with embryo implantation and fetal development.

2. Risk of abortion

While high BMI does not directly increase the risk of miscarriage, it increases the likelihood of other complications that may indirectly contribute to miscarriage. For example, women with high BMI are more likely to develop gestational diabetes and hypertension, problems that may threaten placental function and increase the risk of miscarriage or preterm labor. In addition, obesity may lead to chronic uterine inflammation, which can interfere with the stable development of the embryo. For women with low BMI, malnutrition or hormonal imbalances may also increase the probability of miscarriage. Thus, both high and low BMI may negatively affect pregnancy outcomes through different mechanisms.

3. Embryo implantation

High BMI may make it more difficult for embryos to implant in the uterus because obesity causes changes in the microenvironment of the endometrium, such as reduced blood supply or increased inflammatory factors, which can affect the success of embryo implantation. Higher BMI was found to be associated with lower embryo implantation potential, especially more pronounced in younger women with low prognosis. In addition, high BMI may interfere with endometrial tolerance, a key factor in successful embryo implantation. In women with low BMI, the endometrium may thin due to nutritional deficiencies, further reducing the likelihood of embryo implantation.

In summary, BMI affects pregnancy success in several ways: a normal BMI helps to increase the rate of live births, while too high or too low a BMI may reduce pregnancy success by increasing the risk of miscarriage and impeding embryo implantation. Maintaining a healthy weight is not only an important task for the surrogate mother, but also a key measure to safeguard the health of mother and child.

Surrogacy Agencies and BMI Requirements

Common BMI limits

Most organizations set BMI limits:

• Highest BMI:Usually 33-36.
• Minimum BMI:Approximately 18.5-20.

Why BMI Matters

Agencies focus on BMI because it reduces risks to surrogate mothers and babies. A healthy BMI helps reduce the incidence of pregnancy complications, thereby keeping mother and baby safe. For example, women in the normal BMI range are significantly less likely to develop high blood pressure or diabetes during pregnancy, which directly enhances live birth rates and infant health.

Exception

Some facilities allow higher BMIs if the surrogate mother is otherwise healthy.This flexibility is based on individual differences, but additional medical monitoring is often required to minimize potential risks.

Health risks associated with high or low BMI in surrogacy

1. High BMI risk

High BMI may result:

• Pre-eclampsia:Women with a BMI of 35 have twice the risk of developing pre-eclampsia, which can be life-threatening.
• Gestational diabetes:High BMI increases insulin resistance, leading to a higher risk of gestational diabetes.
• Cesarean section:Obesity increases the complexity of the procedure and prolongs recovery time.

2. Low BMI risk

Low BMI may result:

• Nutritional deficiencies:The fetus may be stunted due to maternal undernutrition.
• Premature labor:Underweight mothers are more likely to have preterm labor, which affects the health of their newborns.

3. Long-term effects

A high or low BMI may affect an infant's health later in life, including metabolic disorders and cognitive developmental problems. For example, a mother with a high pre-pregnancy BMI or excessive weight gain during pregnancy increases the risk of obesity, diabetes and cardiovascular disease in her offspring as adults. Low BMI, on the other hand, may lead to underdevelopment of the infant's nervous system, affecting cognitive ability and academic performance.

Maintaining a healthy BMI is therefore crucial for mothers and babies. A healthy weight not only reduces the incidence of pregnancy complications, but also optimizes the growth environment for the fetus and reduces the risk of birth defects and long-term health problems. Surrogate mothers should focus on weight management before and after pregnancy to ensure the health of mother and baby through a balanced diet, moderate exercise and regular medical assessment.

Steps to improve BMI

Here are ways to achieve a healthy BMI:

• Balanced diet:Includes fruits, vegetables and protein.
• Exercise regularly:Take a walk, swim or do yoga.
• Stay hydrated:Drink lots of water.

medical assessment

Doctors monitor BMI before and during pregnancy.This helps detect potential problems, such as gestational diabetes or high blood pressure, early. With regular checkups, doctors can adjust treatment plans based on BMI changes to ensure the health of mother and baby. In addition, for surrogate mothers with an abnormal BMI, doctors may recommend a personalized diet and exercise plan to reduce pregnancy risks.

In conclusion, optimizing BMI requires a scientific diet, regular exercise and adequate water intake, combined with medical monitoring for successful surrogacy.

Demonstrating the Misconceptions of BMI in Surrogacy

Myth 1: BMI is the only health indicator

BMI is important but not the only factor. Other things like diet and exercise are also important.

Myth 2: High BMI always means failure

Some women with a high BMI can have successful pregnancies. Careful monitoring will help.

Myth 3: Low BMI is always safe

A low BMI can also cause problems. It is best to aim for a healthy range.

Frequently Asked Questions

• What is the ideal BMI for a surrogate mother?

The ideal BMI is between 18.5 and 30. This range is thought to reduce the risk of pregnancy complications while providing a healthy environment for the fetus to grow.

• Can I be a surrogate mother if my BMI is slightly above the limit?

Some agencies allow exceptions if otherwise healthy. For example, women with a slightly higher BMI may still be accepted if there are no other health problems and they have been assessed by a doctor, but more stringent pregnancy monitoring is required.

• How does BMI affect the health of infants?

High BMI increases the risk of birth defects and stillbirths. Obesity may lead to problems such as fetal neural tube malformations and congenital heart disease, and affects placental function, threatening fetal survival.

• Are there exceptions to the BMI requirement in surrogacy?

Yes, some organizations allow a higher BMI if the surrogate mother is healthy; however, this usually requires additional medical testing to ensure a safe pregnancy.

• What steps can I take to improve my BMI for surrogacy?

Eat a balanced diet, exercise regularly and stay hydrated. For example, reduce the intake of high-calorie foods and increase the proportion of vegetables and proteins, while getting at least 150 minutes of moderate-intensity exercise per week, such as brisk walking or swimming.

reach a verdict

BMI is very important for surrogacy. Not only is it a key indicator for assessing the health of a surrogate mother, but it can also significantly impact the success of a pregnancy and the health of the baby. By maintaining a healthy BMI, which is usually recommended to be between 18.5-30, surrogate mothers can reduce the risk of complications such as gestational diabetes and preeclampsia, and increase the rate of embryo implantation and live births. If you are considering becoming a surrogate mother, consult with your doctor. They can help you understand your BMI and how to stay healthy. Your doctor may be able to provide personalized diet and exercise recommendations to ensure you are in the best shape for your surrogacy journey.