GP refusing Fertility Testing Referral due to BMI- Scotland

Hi OP, I guess this may be depending on the NHS Trust you're under but I had Day 3 and Day 21 blood tests, thyroid test as well as an ultrasound as I'm struggling after a year of TTC (secondary infertility) and my periods have suddenly become irregular over last 6 months. My BMI is 40.

Are you going to go ahead with the Day 21 test you were offered? I do think it's really helpful to know at this stage that you are ovulating if nothing else.

If you do decide to have private treatment please look at the cost of the drugs directly from boots. They don't make profit on IVF drugs. My clinic charged £8 for some tablets that boots gave me for less than £1. The only thing they couldn't supply cheaper was injectable progesterone.

A fertility MOT isn't that expensive. Check how much the clinic charge directly.

The logic is that they can’t offer you the treatment, because of your BMI, so therefore there is no point in doing a test. Because they can’t do anything with the result.

@AlienSuperstar if you can afford to go privately, I would do that. If you do manage to get your BMI below 30, then it'll take time and you'll be older. That might then be a problem for the GP (did you say you were 38?) and they might not treat you because of that instead. Plus, the impact on your fertility of being 39/40 might be worse than the gain from the BMI points you lose.

I think this is the reason. Your test results could change once you have a healthy BMI.

I've had fertility investigations with a BMI of 31 (not that they even know my BMI, weight hasn't been asked for/mentioned once!), in my area the limit of 30 applies for treatments, not for tests, although I imagine being only just over means they are ok with doing the tests as it's not as hard for me to lose the weight (I'd need to lose 6kgs to be at 29.5 BMI so still not insignificant). As pp has said, it's really unfortunate that they use BMI as it's actually not a great indicator of success of treatments, but if your BMI is over 40 then losing some weight would probably be good for health overall, even if you didn't drop below 30.

Unfortunately it's based on flawed data that women 'cant' get pregnant when they have a high BMI. It's just a pretty standard barometer used for many treatments on the NHS even not related to fertility treatments. BMI is a bit of a blunt stick anyway but you are unlikely to get anywhere with the NHS with a BMI of over 35 and anything over 30 you are likely to have to fight for.

Its also interesting that someone's cited not being able to see the ovaries/eggs during IVF with high BMI. 4 cycles of IVF with a BMI over 40 and I'm yet to have a private sonographer have ANY issue seeing my ovaries during my treatment and I assume as I've had 2 healthy pregnancies as well as 2 miscarriages from those, they've managed to get eggs.

My clinic was a bmi under 35 (I paid privately but it's also an nhs clinic) for both testing and treatment (it's 30 for nhs though).

I was told the reason for it is that it's harder to see things on the scan, they have in the past had to stop scans because they just couldn't see ovaries etc. Same for IVF - you need to a healthyish BMI so they are able to see the eggs during retrieval.

I'm not really sure how weight affects fertility as I've had the opposite experience to NHS advice- I had a bmi close to 40 when I conceived my first easily and had a healthy pregnancy. It's now around 35 and I'm struggling to conceive. When I've been a healthy weight - under 25bmi - my periods stopped for 3 years. I'm honestly debating gaining weight to see if I conceive! But also worried that I need to lower it in case I need IVF.

The doctor is just trying to assess whether your statement "I will do anything to have a baby" includes losing weight.

I think this is nonsense and you should be able to request day 3 hormone bloods and also thyroid/ cholesterol tests. Potential hormone imbalance/ insulin resistance is worth knowing about for general health management independent of fertility considerations and they should be prepared to help. Press them on this. If they agree to do those and have also agreed to do progesterone then that's a decent start. AMH you'd need to do privately. It's possibly your results would change if your BMI does but that's a follow up conversation down the line.

If you can afford the private option that's also fine obviously but I don't agree they should turn you away when you're just after general health info to assess your options (and maybe provide motivation!).

Unfortunately, they simply won’t spend the money on people who have a lower chance of treatments working when it isn’t a life saving treatment. It’s a waste of money. You can pay privately if you want the tests or you can lose the weight.
I’m not having a dig; my bmi was just into the “morbidly obese” part of the graph when I started getting hip pain. I knew it was my weight. The GP wouldn’t do anything because they also said, it’s just my weight. I had to lose 4.5 stone. It was very difficult but had to be done. The NHS won’t waste treatment.

Yeah these prices sound about right & some offer follow ups following planned weight loss for reduced price. My colleague and her husband did this and paid £750 which included a recheck after she completed weight loss to reach BMI threshold x

Yes I was about to suggest this. They're typically in the region of £250-300 for one partner and £400-500 for a couple.