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 :)

Everyone claiming there is no point in pursuing tests should stop as it's both wrong and a bit judgy.

OP, look up the NICE guidelines/ your local trust position.

For example, it is legitimate to ask for PCOS/ general hormone tests even if any result could be improved by a lower BMI. The former has potential cardiac and diabetes implications (even if someone has a BMI under 25) that any GP should be prepared to look into. It may be, for example, that clomid use could be pursued privately if there is an indication it's needed. There are options other than IVF. I think the suggested BMI for that is under 35, so it could provide a target.

I have had various NHS blood tests over the last few months for my general info. Despite being entitled to NHS IVF if it comes down to it, I'd also be able to use the NHS tests to date to save money if I chose to go private.

Thank you so much. Some comments have come across as harsh ! But all still valid points

Thank u, however , I have been pregnant before at this weight and my losses were not due to my weight ( so I was told)

Thank you so much

Thank u , I am 38 now

With absolute respect, as a person who had the same BMI, 43 is morbidly obese.

It absolutely will affect your fertility.

It’s just a bit bonkers to ask for fertility tests when your BMI is so high. Great that you got pregnant before - so sorry for your losses, it’s heartbreaking, isn’t it. I had multiple miscarriages too.
I was at the other end of the scale and too thin to conceive, took me a while to get the weight on.
Why don’t you invest in Wegovy/ask your GP for it? Be much quicker and easier? Surely you’d qualify for it on NHS at that BMI?

With respect, if this was the medical advice/ evidence that a BMI of 43 was OK for pregnancy, then they wouldn't hesitate to test you.

Just because you've been pregnant before doesn't mean that it isn't having an impact.

The best thing to do is lose the weight.

thanks to everyone for their replies.

Let me be clear, I am under no illusion that I need to loose weight, I have gone privately and obtained Mounjaro and have lost 15 pounds, regardless of what people think, I am taking this seriously.

My post was simply to try and clarify if me being rejected was the correct procedure and was it worth getting a second opinion at all. I wanted to hear about other people's experiences in regards to asking for fertility testing.

I came on here looking for a safe space to express my concerns and query certain NHS procedures.

Some of the comments have been awful, suggesting it's bonkers I even ask for tests in the first place etc, just because i'm fat does not mean that my dreams of being a mother should be taken away from me, there is ABSOLUTLEY a point in my asking questions and getting the ball rolling etc.

On the flip side, some comments have been really helpful and I have taken some of the suggestions and advice on board.

Please think about what are you are saying when typing behind a screen, you have no idea how one comment can affect a person's mental health who has already been struggling for 5 years to have a child and feels they are trying their God dam best everyday.

You know I was coming here to say I am so disappointed with how cutting some of the comments have been on here.

As someone who has been a size 16-18 most of their life, I know how hard it is to lose weight. I did get to a BMI of 25 once but it was bloody tough to maintain. I always say, if it was that easy to lose weight and maintain it, I would have done it years ago.

I am so sorry you've had such a harsh response. I really know how you feel with the battle to lose weight but also the ticking clock as you head towards 40.

I hope some of my non-weight related tips help you x

I think not offering you tests at all is madness. An underactive thyroid will make it harder for you to lose weight. PCOS and insulin resistance makes it harder to lose weight. Thyroxine and metformin could be helpful here.

I find the idea that PCOS should only be investigated and treated if you are seeking, and eligible, for fertility treatment incredibly short sighted and shows a contempt for women's health that pervades medicine. Can you imagine men only being prescribed viagra if they are TTC for example

OP I would push your GP for testing for things like an underactive thyroid etc because these tests should not be depended on whether or not you are eligible for fertility treatment. And has others have responded perhaps seek the fertility investigations privately.

I still don’t get the point of having tests now though. Even if you’re sub fertile they won’t refer you til your BMI is less so why bother? You’re losing weight brilliantly so maybe just continue doing that, have loads of sex and test in a few months time.
I would have your OH tested though, agree that’s a good idea.

@itstheendoftheworldasweknowitnow Have you actually read this whole thread? Maybe better to pipe down.

There are plenty of valid general health reasons to understand your hormone profile. PCOS, for example, is not just to do with fertility. And you still have PCOS even if you lose weight. It's worth knowing about.

And the OP may wish to pursue private options down the line after a bit of weight loss. The initial tests may save her some money.

I’m a medic, so yes.
If the OP is tested now, it will be likely an inaccurate picture because some results will be skewed by the obesity. From a medical perspective not worth having results now as they could be vastly different after the weight has gone. Even 5% weight loss can improve PCOS, for example and the GLP-1 that the OP is taking is extremely effective for weight loss in women with PCOS.
It’s much more sensible to have an accurate set of blood results when the BMI is within a range that is amenable to fertility interventions.

I’m sorry so many people on here have been so harsh, I really feel for you xx