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 :)

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.

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.

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

thanks for this. Congratulations on your babies <3 x

thanks for this, I wish you all the best in your journey. It's refreshing to know that you fell pregnant with a BMI almost at 40 x

thank you, this is how I feel too

Thank you everyone for your replies. Now that I know that the Dr isn't making this rule up, I will continue to work on my weight loss. 15 pounds down so far so fingers crossed .

@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.

hello, yes i've just turned 38. I could probably afford the tests but not private IVF at the moment. I have a lot to think about.

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.

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

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.

thank you for this !

This is really good to know, thanks :)

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.

Sorry @AlienSuperstar I said boots and I meant ASDA. Having a Prat moment

Oh I really feel for you. I was stuck in the age/weight dilemma too. I was 38 when I had my TFMR and my rainbow baby is due on my 40th birthday!

I posted the below on another thread where we talked about what we were doing to boost our fertility. I truly believe the fertility lubricant really helped. I also really liked using the LH strips and doing temping to time everything correctly. It's a lot of info but hope it might give you some inspiration. I posted this on the 5th Feb and we got pregnant that month - our fourth cycle after the TFMR.

Vitamins everyday:
Ubiquinol 600mg & Omega 3, 6, 9 (Just over 2 months of taking this so far). (for egg quality)
Her9 pre/during/post natal multivitamin inc things like Omega 3, folate, choline, vit D, iron, zinc, selenium etc.
Prescribed 5mg folic acid as my BMI is over 30 and I'm 39.

Foods: Long term vegetarian, Mediterranean style diet, lots of wholegrains, vegetables, full fat Greek yogurt, nuts, chia, eggs, tofu, lentils and chickpeas. I still like crisps, wine gums, etc so not an angel but my meals are all nutritious. I'm also really into fermenting at the moment, making my own sauerkrauts etc. Good for the gut! I had just started making my own before the TFMR so I was glad to have them in my diet after the IV antibiotics I had in hospital.

Exercise: Dog walks, kettlebells once a week. Struggle to get many steps in at work and in the winter, could really be doing with doing more.

Other: Preseed. We used this for a few months before falling pregnant before and husband is convinced it helped. Have just ordered ConceivePlus for this month for a change to see if that helps.

Testing: Ovulation strips from day 10ish onwards until a peak is found. Now on third month of taking my BBT too.

We're trying to do the Sperm Meets Egg Plan too, although tend to start at day 10/11. Haven't managed the 'one for luck' at the end yet either as we always run out of steam. Will try this month.

I know I need to lose weight. It's sooooo hard. I've always been a 16 my whole life, and currently an 18. I've lost weight over the years, I was 4 st lighter at one point. Just find it so so hard now.

I also love wine and coffee! Since Christmas I've made a real effort to cut back, stopped drinking during the week. I have a proper coffee every morning and a couple of instant coffees throughout the day. When I was pregnant I cut out the instant and had a watered down proper coff.

thank you so much for this, and, congratulations!

yes, I am currently testing for ovulation this week, once I get a peak, I will book in for bloods. Interesting you were offered an ultrasound with a similar BMI as
me.

What does the ultrasound confirm/look for?

The ultrasound looked for any signs of PCOS (as I have irregular cycle) and basically anything untoward that might have been causing issues.

@AlienSuperstar I'm sure it was initially around 34 then 32 at fertility clinic and my GP had a higher weight from when I was heavier on file from initial bmi of 34 so was able to show I had lost weight. I know it's really difficult and stressful but keep at it and you will get there 🥰🥰

Why would it? It didn't for me.

Harsh though it seems there is little for your gp to do.
a tft check, day 21 progesterone and that’s about it.
even in the acceptable bmi range the fertility clinic will not accept referral until 1 year of trying unless your aged over 38 here.
Fingers crossed you’d don’t need to go that far.
taking charge of your fertility is a good book as well

You could get pregnant naturally after losing the weight.

Me and 2 friends all had BMIs of 40+ we all lost weight together and got to a normal BMI
They both had been TTC for years and both were pregnant within 6 months of hitting our target.

Your BMI is probably contributing to your fertility issues (I say this as someone who is also having fertility treatment and also previously had a high BMI, so I am not saying it without empathy)

If you lose weight you might well get pregnant naturally and not need any intervention, so it would be a waste of time and resources.

A high BMI can impact many of the things that they will test for, so really the best course of action for you is to lose weight and then get tested.

You probably won't need to quite hit 30 either. They did my initials at a BMI of 31/32.

There is really not much point being tested if you can't be treated, and you can't be treated on the NHS unless your BMI is below 30.

Your current BMI is going to skew your test results so it really is best to just get some of the weight off first.