Summarizing the Experiences of Individuals Who Have Obesity or Larger Bodies Seeking Fertility Care: A Scoping Review.

Females who have larger bodies or obesity may be at an increased risk for experiencing infertility. Problematically, both weight or body size and infertility are stigmatized, harming quality of care. We conducted a scoping review to understand the lived experiences of patients who may be subjected to intersecting stigmas of weight and infertility in healthcare. Searches included six databases (Medline, Embase, CINAHL, PsycInfo, Scopus, and Proquest Theses and Dissertations). Data were narratively summarized. With a team of interest holders, including lived experience experts, we identified future directions for research, clinical practice, and policy. Searches yielded 2724 articles, and 13 were included. Four themes were derived: 1. Lack of education/information on the link between infertility and obesity provided to the patient and focusing on weight alone; 2. Restricted access to fertility care; 3. Lack of weight management support; and 4. Self-blame. Directions forward for research include ensuring missing perspectives are studied (i.e., partners, gender diverse individuals, and healthcare professionals), examining the impact of stigma on behavioral responses (e.g., weight loss attempts), and comparing the use of body mass index versus other comprehensive measures of excess adiposity on fertility outcomes. Shared decision-making tools to guide patient-centered discussions about fertility and body weight are needed.