First nhs fertility app . Worried about bmi and health conditions

[Kris123499]

Hi everyone , I hope someone can help.
Have a fertility appointment next Wednesday.

about me : Gp referred us to fertility clinic
We have been trying to get pregnant now for 6 years With no luck.
I have been diagnosed with pcos about 1 year ago. Just turned 38. We have no children.
My partner 39 had sperm tests which came back on the low side and high abnormality so it was recommended we are seen by fertility clinic.
Previously, we saw a doctor at our hospital, She done initial tests, partners sperm test, I had blood tests full female hormone profile and bloods to confirm I'm not ovulating. We were sent away with 3 months clomiphene , which sadly didn't result in pregnancy.

We were then left to ourselves . After 5 months we had no further appointments so we went back to gp and complained who said he will send us to fertility clinic.
After 9 weeks , They rang today to offer an appointment for Wednesday.

By the way this is nhs fertility app.
Now my question is,
What will our first appointment be like ?
What kinda questions will be asked in your experience?
I've read they are very strict with bmi. I'm currently over 30. To be under 30 i need to lose 1 stone 1 pound. No way am I going to lose 1 stone in a few days lol
Since we've had the initial tests done do you think our first appointment will be the deciding factor if we will be eligible? Or will that be another app.
I'm worried about my weight.
I'm contemplating should I cancel the appointment to next month so I can lose the weight?
. I would hate to go to the appointment and sabotaged our chances of being eligible Regarding the weight
Or will they let me lose weight ?
I read normally you have an initial consultation, then go do tests and a second consultation again to discuss options and see if tour eligible, but as I said we've had most of those tests haven't we ? So will we still have a second consultation?

I'm just not sure what to do. I'm so anxious. I just don't know should I go being over or lose the weight first.
Has anyone been through this ?
I hope someone can provide some clarity

Secondly can anyone tell me how invasive the health questions are ? Is it just general health? Generally everything is fine but I was diagnosed some years ago with mild m.e ( chronic fatigue)
and ibs irritble bowel lol embarrassing
will that be brought up ? Would that be a eligibility issue ?
I've seen on here some people being asked very invasive questions like their job ect . I'm not even sure why their job matters

My BMI was over 30, I was given metformin to try to shift my weight but I had a bad reaction to it. I then had an HSG test to check the state of my tubes & then put on Clomid for 6 months.

The NHS wont offer IVF unless your BMI is less than 30. This is because research has shown that when BMI is in the obese range, assisted fertility including IVF is less likely to work. They will suggest tackling the weight first. There are a few options, where I work we (tertiary weight loss centre) are routinely referred women with obesity who have been seen in the fertility clinics for help with weight loss. This is with the help of a trained bariatric dietician. You could explore Semaglutide injections but if you don't have diabetes or pre diabetes then will need to pay privately. The weight loss trajectory with this class of medications is really good - similar to bariatric surgery but obv once you're off the drug then the weight is likely to come back. No trials have been carried out in pregnant women so teratogenicity is unknown in humans although there have been women who have become pregnant on treatment. You will need to use proper contraception whilst on it. Metformin is sometimes prescribed for weight loss but trials have shown it doesn't lead to significant weight loss in people with a BMI over 30. I think your best option is referral to a tier 3 weight loss centre. We know that modest weight loss of even 5% improves menstrual cyclicity etc.

Hi, yeah I'm already on metformin for pcos and I've shifted a stone during the summer super easily. I dont seem to have the problem with difficultly losing weight like some pcos sufferers. I am pre diabetic from the pcos but losing weight isn't a concern, I'm fairly confident I can shift more weight if needed. I just haven't been trying as it was never mentioned to me before that if it came to fertility treatment there would be a bmi cap. I've only found the information online yesterday which is freaking me out. That's why I just don't know if I should go to this appointment if they will put me on any list and give me a chance to go lose weight before any ivf treatment starts or if they will straight up refuse me because of my bmi at this next appointment. I'm really torn between going to this appointment or changing it to next month when I am confident I'll be a healthy bmi

If you genuinely think you'll be able to lose enough weight to drop below 30 then perhaps change the appointment for a later date. I'm not sure about IUI and other forms of assisted treatment but IVF cut off is 30. You could still go and make sure you are confident about losing weight. You'll also have a better idea about what they can offer you. I havent been to a fertility clinic so was giving advice based on the patients I would see for obesity. Good luck :)

I went through this process earlier this year and at my local clinic cut off is 30 for all fertility treatment and I was above this so got told to lose weight and come back to get the treatment

Ask about the loci clinical trial for PCOS for ovulation induction, I did this as an alternative and got pregnant 2nd cycle currently 25 weeks :) bmi limit is 35 for this. You get either clomid or letrozole and either metformin or a placebo, blind trial so you don't know which but might not be your cup of tea!

Also for myself I had to lose the weight before I got any investigations done, but as the appt's were all remote / online video I fibbed about my weight as I knew by the time the appt letter came through the weight would be gone. Risky but worked for me 😊