GP refusing Fertility Testing Referral due to BMI- Scotland

I’m sorry so many people on here have been so harsh, I really feel for you xx

I’m a medic, so yes.
If the OP is tested now, it will be likely an inaccurate picture because some results will be skewed by the obesity. From a medical perspective not worth having results now as they could be vastly different after the weight has gone. Even 5% weight loss can improve PCOS, for example and the GLP-1 that the OP is taking is extremely effective for weight loss in women with PCOS.
It’s much more sensible to have an accurate set of blood results when the BMI is within a range that is amenable to fertility interventions.

@itstheendoftheworldasweknowitnow Have you actually read this whole thread? Maybe better to pipe down.

There are plenty of valid general health reasons to understand your hormone profile. PCOS, for example, is not just to do with fertility. And you still have PCOS even if you lose weight. It's worth knowing about.

And the OP may wish to pursue private options down the line after a bit of weight loss. The initial tests may save her some money.

I still don’t get the point of having tests now though. Even if you’re sub fertile they won’t refer you til your BMI is less so why bother? You’re losing weight brilliantly so maybe just continue doing that, have loads of sex and test in a few months time.
I would have your OH tested though, agree that’s a good idea.

I think not offering you tests at all is madness. An underactive thyroid will make it harder for you to lose weight. PCOS and insulin resistance makes it harder to lose weight. Thyroxine and metformin could be helpful here.

I find the idea that PCOS should only be investigated and treated if you are seeking, and eligible, for fertility treatment incredibly short sighted and shows a contempt for women's health that pervades medicine. Can you imagine men only being prescribed viagra if they are TTC for example

OP I would push your GP for testing for things like an underactive thyroid etc because these tests should not be depended on whether or not you are eligible for fertility treatment. And has others have responded perhaps seek the fertility investigations privately.

You know I was coming here to say I am so disappointed with how cutting some of the comments have been on here.

As someone who has been a size 16-18 most of their life, I know how hard it is to lose weight. I did get to a BMI of 25 once but it was bloody tough to maintain. I always say, if it was that easy to lose weight and maintain it, I would have done it years ago.

I am so sorry you've had such a harsh response. I really know how you feel with the battle to lose weight but also the ticking clock as you head towards 40.

I hope some of my non-weight related tips help you x

With respect, if this was the medical advice/ evidence that a BMI of 43 was OK for pregnancy, then they wouldn't hesitate to test you.

Just because you've been pregnant before doesn't mean that it isn't having an impact.

The best thing to do is lose the weight.

It’s just a bit bonkers to ask for fertility tests when your BMI is so high. Great that you got pregnant before - so sorry for your losses, it’s heartbreaking, isn’t it. I had multiple miscarriages too.
I was at the other end of the scale and too thin to conceive, took me a while to get the weight on.
Why don’t you invest in Wegovy/ask your GP for it? Be much quicker and easier? Surely you’d qualify for it on NHS at that BMI?

With absolute respect, as a person who had the same BMI, 43 is morbidly obese.

It absolutely will affect your fertility.

Everyone claiming there is no point in pursuing tests should stop as it's both wrong and a bit judgy.

OP, look up the NICE guidelines/ your local trust position.

For example, it is legitimate to ask for PCOS/ general hormone tests even if any result could be improved by a lower BMI. The former has potential cardiac and diabetes implications (even if someone has a BMI under 25) that any GP should be prepared to look into. It may be, for example, that clomid use could be pursued privately if there is an indication it's needed. There are options other than IVF. I think the suggested BMI for that is under 35, so it could provide a target.

I have had various NHS blood tests over the last few months for my general info. Despite being entitled to NHS IVF if it comes down to it, I'd also be able to use the NHS tests to date to save money if I chose to go private.

Your BMI is probably contributing to your fertility issues (I say this as someone who is also having fertility treatment and also previously had a high BMI, so I am not saying it without empathy)

If you lose weight you might well get pregnant naturally and not need any intervention, so it would be a waste of time and resources.

A high BMI can impact many of the things that they will test for, so really the best course of action for you is to lose weight and then get tested.

You probably won't need to quite hit 30 either. They did my initials at a BMI of 31/32.

There is really not much point being tested if you can't be treated, and you can't be treated on the NHS unless your BMI is below 30.

Your current BMI is going to skew your test results so it really is best to just get some of the weight off first.

You could get pregnant naturally after losing the weight.

Me and 2 friends all had BMIs of 40+ we all lost weight together and got to a normal BMI
They both had been TTC for years and both were pregnant within 6 months of hitting our target.

Harsh though it seems there is little for your gp to do.
a tft check, day 21 progesterone and that’s about it.
even in the acceptable bmi range the fertility clinic will not accept referral until 1 year of trying unless your aged over 38 here.
Fingers crossed you’d don’t need to go that far.
taking charge of your fertility is a good book as well

Why would it? It didn't for me.

@AlienSuperstar I'm sure it was initially around 34 then 32 at fertility clinic and my GP had a higher weight from when I was heavier on file from initial bmi of 34 so was able to show I had lost weight. I know it's really difficult and stressful but keep at it and you will get there 🥰🥰

The ultrasound looked for any signs of PCOS (as I have irregular cycle) and basically anything untoward that might have been causing issues.

Oh I really feel for you. I was stuck in the age/weight dilemma too. I was 38 when I had my TFMR and my rainbow baby is due on my 40th birthday!

I posted the below on another thread where we talked about what we were doing to boost our fertility. I truly believe the fertility lubricant really helped. I also really liked using the LH strips and doing temping to time everything correctly. It's a lot of info but hope it might give you some inspiration. I posted this on the 5th Feb and we got pregnant that month - our fourth cycle after the TFMR.

Vitamins everyday:
Ubiquinol 600mg & Omega 3, 6, 9 (Just over 2 months of taking this so far). (for egg quality)
Her9 pre/during/post natal multivitamin inc things like Omega 3, folate, choline, vit D, iron, zinc, selenium etc.
Prescribed 5mg folic acid as my BMI is over 30 and I'm 39.

Foods: Long term vegetarian, Mediterranean style diet, lots of wholegrains, vegetables, full fat Greek yogurt, nuts, chia, eggs, tofu, lentils and chickpeas. I still like crisps, wine gums, etc so not an angel but my meals are all nutritious. I'm also really into fermenting at the moment, making my own sauerkrauts etc. Good for the gut! I had just started making my own before the TFMR so I was glad to have them in my diet after the IV antibiotics I had in hospital.

Exercise: Dog walks, kettlebells once a week. Struggle to get many steps in at work and in the winter, could really be doing with doing more.

Other: Preseed. We used this for a few months before falling pregnant before and husband is convinced it helped. Have just ordered ConceivePlus for this month for a change to see if that helps.

Testing: Ovulation strips from day 10ish onwards until a peak is found. Now on third month of taking my BBT too.

We're trying to do the Sperm Meets Egg Plan too, although tend to start at day 10/11. Haven't managed the 'one for luck' at the end yet either as we always run out of steam. Will try this month.

I know I need to lose weight. It's sooooo hard. I've always been a 16 my whole life, and currently an 18. I've lost weight over the years, I was 4 st lighter at one point. Just find it so so hard now.

I also love wine and coffee! Since Christmas I've made a real effort to cut back, stopped drinking during the week. I have a proper coffee every morning and a couple of instant coffees throughout the day. When I was pregnant I cut out the instant and had a watered down proper coff.

Sorry @AlienSuperstar I said boots and I meant ASDA. Having a Prat moment