Obese about to make appt with GP

[Lalala1985]

So I'm 35 and we've been trying 6 months and no sign of a BFP. My bmi is 37 which I know is too high, I am losing it slowly, as fearful of losing it too fast as the only time I've lost enough to be a healthy weight my periods stopped altogether. Currently my periods are fairly regular 27-29 days, but I just want things checked ( for me and DH). I'm just curious as to what usually gets checked if you are obese or if they just send you away and tell you to lose weight?

The GP will initially do blood tests (should be done at specific cycle days - I think day 3 and day 21? many GPs do not seem to know this, dont let them just test at random!) and also should refer to the fertility assessment clinic BUT not most healthboards wont offer fertility interventions for anyone of BMI>30; so you would be best placed to keep losing weight whilst waiting on the appointment (varies by area but wait can be up to a year).

Wishing you all the best

I agree with daydream, pretty much what I would say. Bloods checked on day 3 to check hormones, at my request as GP had no idea. Then day 21 to check you have ovulated.

It's good you have regular cycles, I didn't have that so not sure what would be next for you, but keep losing the weight. IVF in my area had to have BMI under 30.

Does the GP do sperm analysis or is that done through the fertility clinic as well?

I'm not feeling super concerned about progesterone/estrogen/LH/FSH/ thyroid as I have these checked regularly anyway - they were normal less than a month ago, and my endocrinologist is confident that this shouldn't be stopping me getting pregnant.

Hoping to get AMH, sperm analysis and possibly hycosy now but if that's going to take a year, and need to be under 30 bmi then I might go private directly and skip the GP appt as I don't want to waste time at my age.

@Lalala1985 that's the fertility clinic. If you can afford it, I'd go private. Around £600 for all tests for both partners

Gp refers for sperm analysis. DH had to ask his GP for it and got given an appointment to drop it off to the lab, once results back gp then refered us to fertility clinic.

They wouldn't refer us without his SA done first.

Everything takes ages and we did end up going private for AMH, Hycosy, also another SA was included in the price, was £460 for us

Thank you all . It turned out I didn't need it in the end as got my BFP on Saturday!

Have you been taking the high dose of folic acid

@Pissinthepottyplease I haven't, just the pregnacare conception tablets until now. I called my GP today to find out next steps and he seemed very uninterested and told me just to take iron tablets ( which contain folic acid), I assumed that comes later once you see a midwife? Or should I be calling him back to check whether I need to get a prescription immediately? He basically told me to carry on as normal for the next few weeks unless I had any drink or drug problems.

You need to ring and ask for a prescription of high dose of folic acid. You need it now because you stop taking it at 12 weeks. You need the higher dose because of your BMI.

@Pissinthepottyplease thanks, feeling a bit annoyed at them now - they have my weight on file as I only just registered with them in January. Now I'm hoping there's nothing else I should or shouldn't be doing. He seemed surprised I was calling at all.

Everything else you need to know is on the NHS website. Drink lots of water because your blood supply increased so you need more water and dehydrated makes you feel sick.

They knew my high BMI from the booking appointment and I didn't need high dose folic acid, I did have to have daily aspirin until birth though due to my BMI.. congratulations!

Just to say you absolutely do need the extra folic acid so don't let them fob you off. I had to argue with my GP for them as I wanted to start TTC and they told me to lose weight first. I did manage to get them prescribed but I don't think GPs understand how important this high dose is for obese women. It's SO much higher than over the counter pregnancy vitamins.

Been passed from pillar to post, GP said to call the midwife, midwife said to call the GP.
Midwife said if GP refuses, taking it from 1st appt at week 6 is fine provided I take the standard dose now.
Still want to get it, I'd be so pissed if something went wrong because I didn't have enough folic acid. I tried calling the GP all afternoon, no answer. Going to try again in the morning.

Can you try a private gp?

It's so unreasonable of your GP to fob you off. Hopefully you can get through today, say your midwife won't give it to you and that you are trying to do the best thing for your baby. They can prescribe it so I don't see why they won't.

And if the GP refuses do ask them why. My GP, once I finally got them to understand I was going to start trying anyway despite the horror warnings they gave me, said I should be taking it when TTC.

I would write to the GP and state that NICE guidance is that women with a BMI over 30 should be offered 5mg of folic acid and state what your BMI is. Unfortunately not all GPs are up to date with the guidance, particularly as they don’t do very much post conception care. In the mean time you can buy folic acid on its own- they tend to be 400ug tablets so you would need to take 12 tablets a day to get to the right dose. You need to make sure it is the tablets that are folic acid only- not pregnicare or other supplements that contain other vitamins alongside folic acid. Not ideal but may reassure you while you try and get it sorted.

You can also buy 5mg folic acid over the counter/ on Amazon if you're desperate?

Congratulations! (Seeing as no-one else has said that!)

Great advice from @Tjsmjs

And also congratulations! Sorry I didn't say that initially.

Or in the interim take the 4mg and top up with folate in your diet

@darcey87 yeh the midwife said they can't do prescriptions, but sometimes they do have to intervene when the GP's are clueless. I've also been looking up some info about medication that I'm on - my consultant said I might need to continue throughout pregnancy - and it says in studies that those people were taking higher dose folic acid, so will ask him when I call him later to find out what I'm doing about that as he can push the GP to give me a prescription.
It's wonder what people did in the days before the internet, there's no way I would have known these things.

@Kipkay35

You can also buy 5mg folic acid over the counter/ on Amazon if you're desperate?

Oh yeh... you can! I'll give the GP a last push as id rather have it on my medical record, but if not I'll just buy them from Amazon :)

All sorted, GP is doing prescription, should be able to pick it up tomorrow. Anyone know if there's another multivitamin that I can supplement it with for things like b12, iron, vitamin D etc? I know you have to avoid vitamin A.
Ive had episodes of anemia in the past so kinda want to make sure I have everything I need.