Overweight on NHS IVF

Thank you
It is indeed

That makes sense to look at the tubes. For DD1, they offered this if letrozole wasn't working after 3 cycles. For DD2, you had to have this done before treatment could start, so different places obviously have different approaches.

Good luck - it's a hard road 💐

I'm on Fertility Network UK, someone posted similar there. The answer from one of the partners was (see screenshot shot). There will be many other's in a similar position to you and will have great advice and support.

Metformin helped me lose weight, but I did have to work really hard at it. I still had the occasional treat but the rest of the time I lived off plain salads and things like chicken and veg or cod and veg plus exercised twice a day 5-6 times a week. With metformin you don't want fatty greasy foods otherwise you end up with really loose bowel movements. I stopped taking it late 2019 early 2020 mainly because I was awaiting a referral to the recurrent miscarriage clinic and also wanted to give me body a rest before ttc again. After I stopped taking it my periods went absolutely haywire again and stayed like that for another 3 years. Then last year whilst on holiday I cut out all gluten and wheat. I only intended cutting it out for a week but in that time I lost nearly a stone in weight. Had a period not long after I got back home. I decided to give it a couple more months and see what difference it made. I've been gluten free for just over a year now. Yes I'm still overweight but I eat far more shite than I should do, but in the last 13 months I have had 13 pretty regular periods in that time. I say pretty regular because some months I can be maybe a week late. I'm also trying to eliminate as much dairy as possible because neither is good for PCOS

Thanks so much 4 info

I ovulate each time
( we check progsterone and its over 30)

Clinic dont offer monitoring...

They are suggesting tube flushing... soon

Next chat is mid sept ..

We did concieve naturally in past
But was early miscarriage - maybe due to low progsterone then due to pcos

Now im 37.5

My eggs are old..

Pcos may of wrecked them

Letrozole brings fwd my ovulation and regulates my pcos cycles

Was referred by gp for nhs ivf. BMI was too high and I was near the age limit so no real way round it as I wasn’t gonna lose enough in the space of time I had.
Could have went for private IVF but decided in the end not to.
good luck!

We did 3 cycles. First cycle I didn't ovulate (2.5mg), second cycle increased to 5mg and I did ovulate but no pregnancy and then third cycle stayed at 5mg and we were successful. The plan if the third cycle didn't work was to up to 7.5mg and introduce a trigger shot but obviously we didn't need to do that one in the end. I was allowed to do up to 6 cycles before discussing moving to IVF (this was NHS in London).

Dya mind me asking how many letrozole cycles you did ?

I ask out of curiosity as we are starting letrozole cycle 3

I have PCOS - did letrozole for DD1 when BMI was under 30 but had gone up to 32.5 when I wanted to try for a second child. I was already taking metformin (2000mg). GP agreed to refer and had the initial appt with fertility clinic. They said that they were happy to do the bloods, ultrasound and semen analysis but no treatment would start until my BMI was under 30. They set the appt for 12weeks time.

I did the Michael mosley fast 800 diet (although probably did around 1000cal per day). Lost 12kg in 12 weeks. Got my BMI down to 29. Agreed that treatment could start and then found out we had conceived naturally.

Fast 800 has an app, website with recipes that creates a shopping list for you so makes it really easy. After the first week, I found it quite easy to stick to.

Good luck

NHS is 30 OP, that’s what’s in the NICE guidelines and unfortunately I’ve never seen an nhs trust offer up to 35. Private clinics pretty much always offer up to 35 and some beyond that if that helps. My understanding is the NHS will tell you to come back when you’re within the weight range and won’t really offer any help other than guidance on healthy eating.

Can you pay for weight loss injections to get you down to below 30? Really sorry you’re going through this.

Oh and I cut carbs out completely. This was the hardest part hands down, and wasn't a sensible thing to do, but I knew it wasn't going to be forever

Private clinics will allow a higher BMI because they want your cash, frankly.

I know someone who had weight loss surgery before private IVF. I know someone who had PCOS etc who basically starved herself to get NHS IVF. Both were successful.

If you want to lose weight you could start something quite extreme and do it. But if you're not going to bother go straight to private IVF. I found NHS IVF a waste of time after I finally got there - and it took forever. Good luck

Hi op, we had IVF 5 years ago and I was told all the way through that my BMI was over the threshold and I had to try and get it down else I would be refused and my top of the waiting list appointment would be moved back down to the bottom. I honestly can't remember how overweight I was, I think possibly 12lb or so (I am now three stone over than now!) so for the month leading up to the appointment I was living on alternate breakfasts of 2 scrambled egg with spinach, or 2 scrambled egg with heck low fat sausages, lunches of an apple and an orange, and dinners of either fish and veg or chicken and salad - no condiments, no sauces, no sugar in any hot drinks, and I was walking the dog twice a day. It did work, but the headaches were crippling, likely due to my blood sugar.

At my appointment she weighed me (I asked if I could strip to my underwear just to make sure!) and as soon as you hit the magic number, that's the last time you are weighed and your treatment is authorised (or at least this was the case back then).

Best of luck op, I know how hard it is

As a medical negligence solicitor, I've seen numerous cases where the mother's high BMI affected the clinicians' ability to provide care.

Obese mothers are less likely to feel fetal movements so often need additional antenatal appointments to reassure them that baby is OK.

It's much harder to detect fetal heart rate on a CTG through a significant layer of fat. It also affects the clarity of imaging.

Sorry to be so negative but there's good reason for a doctor to recommend weight loss when TTC.

NHS requirements are under 30. Private clinics will often take up to 35. There may be clinics that go higher. The limits also relate to the riskier egg collection sedation/ general anaesthetic.

Work out a couple of really healthy meals you love, so they're never a chore to eat and try to walk as much as possible and/ or get some home weights to do with a youtube tutorial so you can do even 20 minutes here and there.

Good luck!

I have Pcos

I lost half a stone due to metformin and myo inostol .

Its hard with pcos
Re insulin resistance

Have you taken daily myo inostol ?

Are you drinking lotsa water ?

Have you reduced carbs ?

Have half a plate of veg with each meal

Dont eat late
Snack less

Dont eat after dinner - NHS dietician told me that

I have PCOS and went through fertility checks. I ended up conceiving whilst taking metformin which can also assist weight loss with the right diet. Have they explored using metformin for you? Try a low carb, high protein diet which often work well for weight loss with PCOS.

Just my two cents but in my current experience BMI needs to be under 35 for my private clinic and under 30 for NHS (I’m undergoing testing right now and am in the North West).

Sadly it’s not arbitrary. I say this as someone with a 32 BMI. Hoping to drop a stone in a month 😬

With PCOS and a thyroid issue (hashimotos) the only way I was able to lose weight was to cut out most carbs. I just stopped eating all bread pasta cake biscuits rice etc. nothing else worked

Hello! Fellow PCOS cyster here! I’m also losing weight in anticipation of IVF. I was diagnosed with PCOS in May 2023 and my doctor put me on 2000mg of Metformin per day. It has honestly completely transformed my life. I’ve been able to lose weight for what feels like the first time in my life. I’m 1 stone 8 pounds down and got another stone to lose to get to the 30 BMI threshold.

I also go to the gym 3 x a week for 90 mins per session (30 mins cardio, 60 mins weights) and do 4-5 mile walks twice a week.
I also swapped all white carbs for brown carbs and I take MyoInositol supplements.

I was referred and knew my BMI was an issue. They did all blood work etc but had advised I had to lose weight before any fertility treatment.

I had 6 monthly appointments planned to see my progress and was referred to the NHS weight loss team which was pretty good.

At my 1st appointment however, I was prescribed metformin to help with my PCOS symptoms / help regulate my cycle (very infrequent periods / ovulation) .. also to help with the weight loss. And I actually conceived whilst taking this (within the first 3 months) and I am currently 31 weeks (after 8yrs ttc) .

This meant by my 2nd app, I was discharged.

Is metformin something you have discussed / asked for for help with the PCOS symptoms? Worth trying in my opinion - doesn't work for everyone however, helps to manage insulin resistance in someone with PCOS. Only thing that's ever worked for me. Also helped with the hair growth / hunger levels etc.

I'm currently in the process of losing weight to qualify for IVF on the NHS (having all the pre tests done and my other half's test is late September so expecting an appointment soon after). I know from friends that if their BMI was over the top limit their funding request was rejected. I don't like BMI being used as a health measure in general but unfortunately it's a statutory number I need to hit. I have started calories counting and eating in a deficit again (which I've done successfully before) and I've lost nearly 2kg in 2 weeks without starving and still eating all the foods I like just in smaller quantities and not all the time! It is possible on sertraline (speaking from experience) you just need to figure out what your deficit is. You don't need to spend money on fancy diets.

OP, I’m not in the UK, but where I live, I have a couple of friends who were in the same boat as you with PCOS and high BMI.
Their ivf clinics refused to start till they had dropped below 35. They tried VLCDs (Very Low Calorie Diets). They’re basically nutritionally balanced (not protein!) shakes in different flavours, savoury and sweet. You have 1 for each meal, and they give you a list of foods and drinks you can have as snacks or if you’re still hungry.
My friends both dropped enough weight in 2 and 3 months respectively, and went on to have lovely babies. It’s not a long-term solution, but something to get kick-started and get to a healthier weight. Perhaps worth discussing with your GP if they’re available in the UK?

It is fairly strict for a reason, the drugs just won’t work with a higher BMI and although overweight ladies can have babies, the chances of a successful conception/pregnancy do decrease when BMI is higher. Also things like thyroid levels, hormone levels and blood sugar levels are all grossly affected by being overweight - all of which are so important for TTC.

I don’t wholeheartedly agree with BMI being an accurate measure. I have PCOS and also on sertraline, however I swim a lot and to cross fit, so I have large shoulders and legs - always have. I’m a healthy size 12 but my BMI is always high due to my muscle mass. Even the fact I was clearly healthy and fit, this still wasn’t taken into to consideration when needing NHS help for fertility. It really is strict.

The only option I had was a trim down. Healthy eating and portion control is a great start. Exercise definitely helps.

I understand what you’re saying about sertraline and anxiety, however there is no possible way you can’t lose weight with a calorie deficit and regular exercise. It’s really hard to get started, but if wanting a baby isn’t motivation enough to get you to do, I don’t know what is.

Wishing you the best of luck!

Don’t take this the wrong way…. But can’t you just eat whole lot less than you do? This is coming from someone who lost 14kg last year for IVF. I knew I wanted a baby so the starvation was worth it… not healthy perhaps, but so worth it.