GP refusing Fertility Testing Referral due to BMI- Scotland

[AlienSuperstar]

Hi all,

I am currently on cycle 9 of trying ttc my first baby with my new partner. I'm 38 and since 2019 I have had one Ectopic Pregnancy and 2 early miscarriages (all with my ex hubby).

Due to my previous losses, I have had some tests done, albeit around 4 years ago now, and apart from only having one remaining fallopian tube after the ectopic, all my tests came back normal (I haven't had a hycosy test on the other tube though).

Because of my age this time round and the fact we have been trying for over 6 months, I got the ball rolling with the GP and asked for some tests to be carried out , just to make sure everything is in working order. I was told this was a straight no due to my BMI, I think in total I would need to loose about 5 stones, I've already lost 1 so far.

The only tests my GP is willing to carry out is the day 21 blood test to confirm if i'm ovulating or not (even this test I had to push for).

Is this correct practice? I understand that the actual fertility TREATMENTS are all based on a healthy BMI, but refusing to even test me is a bit harsh?

I would love to hear from anyone else who has experienced this.

Thanks :)

I think the GP is limited in what tests they can do. From memory it would be a blood test at the start of your cycle, day 21 and then a blood screening to check for thyroid issues etc. My BMI was too high also but because I had lost some weight, my GP agreed to do the referral to the clinic. I was still too overweight when the referral came through but again had lost more weight so the clinic agreed to do the initial testing but I wasn't able to be added to the waiting list for actual treatment until my BMI was under 30.

thanks for this. All I have been offered is the day 21 tests, I guess I should push for more?

I will continue with the weight loss also , BMI is currently at 43 so a long way to .

Do you remember what your BMI was when your GP finally agreed to your referral?

I'm sure bmi has to be 30 and below x

Thank you, yes I've read this, which is understandable, I just didn't realise you would have to be a certain BMI to even have the tests done :(

I completely understand the BMI criteria for the treatments though.

Yeh unfortunately for my gp to refer to fertility clinic for more testing I had to have my bmi under 30 ☹️ it's so hard I basically had disordered eating throughout it all! So hard to deal with when you're an emotional eater/binger. I would maybe ask ur gp what their bmi limit is? It may be different x

Yes, this has happened to a couple of girls I know, BMI had to be under 35 I think for them even to get testing. Mine was 34 so I got testing but and a referral to IVF but then told I needed to get under 30 to get on the list for treatment. In the meantime I fell pregnant, but at my 12 week scan it became apparent baby had a chromosome problem and we had to terminate. I'm now pregnant naturally again but my BMI has crept to 35.1 and this means i've crossed the line for a few more tests etc.

A friend has gone to this company for investigations to get the ball rolling as the NHS won't treat them due to BMI. he website is transparent with pricing.

https://tfp-fertility.com/en-gb/tfp-gcrm-fertility

I also know people who have used hertility to get testing.

But surely your current weight will affect the test results, so no point even testing.

This was standard when we had fertility treatment, it’s common practice for them to ask for BMI to be under 30, the treatment is less likely to work if you’re overweight so they need to know you’re in a place for it to be most effective before starting anything at all.

It's a difficult one.

It's because the treatment has a lower chance of success at higher BMI so it's not 'worth' testing in the first place. As harsh as that is

I have been pregnant before at the same weight 3 times, all I want is to know i'm still ovulating and nothing is blocked etc. So for me, there is every point in testing so I know what my chances are, or decide whether to just move on with my life

I haven't decided if I want treatment yet, was just wanting an MOT to see if everything is working, then I will decide how to move forward.

This is pretty standard yes, BMI needs to be below 30 for treatment and so their view is there is no point running the tests when they couldn’t do anything about it anyway. Some private clinics will allow below 35 but of course there is a reason NHS say below 30 x

thank you, yeah I'm going to double check how much I need to loose

You can pay privately to have a fertility MOT type of thing done but this isn’t something the NHS would routinely offer

congratulations, wishing you a happy and healthy pregnancy x

Yeah I'm looking into this, thank you :)

Thank you, I have already been in touch with them and it is one of my options :)

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.

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

thanks everyone, I will continue to loose weight and think about the private tests in the meantime.

I have been quoted £565 for a couples MOT x

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.

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!).

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

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.