First fertility appointment 1yr wait - avoiding weight questions PCOS high bmi

[ethelinEd]

Please read and share you experiences!

I have my first fertility appointment coming up in a couple of weeks at a London hospital. I’ve been waiting years. I’ve had pcos since I was 22 ( officially diagnosed but most likely had it always) and have just turned 30. Irregular cycles since I started my period at 15. Months without a period followed with months with regular periods. Put on weight and became obese in 2020 , however was trying to conceive since early 2019 when I was at my slimmest though not “ seriously”

Fast forward to 2022, I asked to be referred to fertility clinic and was denied due to my high bmi. Worked to try and bring it down and lost some weight but not the amount needed for bmi to be below 30. End of 2023 I told my GP my bmi was officially just above 30 ( I lied) and without checking I was referred. Unfortunately there was a big mishap and the hospital I was referred to didn’t have a fertility clinic anymore - after a whole year of waiting I was back on ANOTHER waiting list. Finally May 2025 I’m having my first appontment, however I have put on weight since and my BMI really is above 35. Out of fear of being rejected, I changed my appontment to a telephone consultation instead which to my surpise was granted.

For those who’ve been through the process, is being weighed in person a non negotiable during this process? After the first appointment ( which I’ve changed to a telephone appointment) what happens next? I’ve already had ultrasound scan recently so guessing blood tests? What my naive self wants out of this is essentially ovulation induction meds , letrozole
or clomid because I just know my issue is lack of regular or any ovulation at all. I was slim for years and still my period would be awol. Never had a positive OPK and I’ve tested religiously for years. My question is am I being extremely unresponsible and deluded that my weight won’t be found out and am I doing more harm than good? Just don’t want to be waiting - I’ve been back to losing weight but really do have months to go before I’m considered “ healthy” in the eyes of the NHS.

I had my first round of fertility treatment at Guys in 2020 and my second round at St Georges in 2023 both for PCOS. Both were non negotiable about the weight criteria. After the initial appointment, which is mostly medical history, the process for me was blood tests, scans, Guys were happy to proceed straight to treatment but Georges needed an HSG first. DH obviously needed a sperm analysis as well, which happened after the first appointment - he had to wait something like 8 weeks just for his appointment to get that booked in. I can't remember at Guys but at Georges I was definitely weighed at every appointment.

For the first round, my BMI was 28 and DD1 was conceived on the third round of letrozole. However, at my first appointment for the second round my BMI was around 32/33. The doctor said she would book my second appointment for 12weeks time and if I could get my weight below 30 in that time, they would proceed. I did the Fast 800 diet with intermittent fasting, lost 12kg in 12weeks and got my BMI to 29.8 or something by the second appointment. And actually, that process in itself helped me to ovulate and I had a natural conception for DD2 and my first natural conception in 5yrs total of ttc both babies. The doctor said that losing up to 10% of your body weight can kick start ovulation, even if it doesnt take you under BMI 30. I obviously didnt need to complete the fertility treatment and was moved over to maternity. So you can't say that you know for sure that your weight won't make a difference - i thought the same, especially as I needed letrozole at the lower BMI, and clearly I was wrong.

I think if you dont want to commit to the weight loss, you probably need to look at private options. Lots of hospital fertility clinics have a private arm so you dont just have to go via private IVF clinics - i know Guys do for sure as we considered using them, and St Helier as well. They may be more relaxed on the BMI front. But having a higher BMI also pushes you down the higher risk category if you do fall pregnant, so I think for more options in terms of your pregnancy care, and a healthy pregnancy overall, you should consider getting your weight down if you can.

We are already in the final week of April. May begins in 8 days. What is the reason for your serious weight gain? Is there a health condition that causes it? As your initial consultation is by phone, I presume they won’t see you or weigh you so you might be fine.

If I were you and I desperately wanted a child and I am looking to go done the IVF route, I would seriously consider trying to lose some weight not only for my future child but for myself aswell.

You want to try to be in the best shape as possible.

hope it all works out for you, good luck!

Oh and I forgot to add that with a BMI over 35, you definitely don't want clomid. It doesn't work as well. Letrozole is more effective for higher BMIs.

The hospital will weigh you. They don’t just ask for your weight.

I have PCOS & had to lose weight to be referred although, for me, I conceived naturally shortly after my first appointment.

Surely if you need ivf you would have spent time previously trying to get to a healthy weight

Thank you @CrispAppleStrudels !

I most definitely do want to commit to the weight loss. I’ve lost around 4kg since Feb and plan to continue losing. My worry was, because they have the wrong weight down ( obviously my doing), and since my first appointment is now a telephone appointment will they discharge me later down the line if they find I’m not actually at the correct bmi. It’s encouraging to hear they offered you the chance to lower your weight and glad you didn’t need it in the end!

@Lulu89x you're absolutely right! With my pcos, if I’m not actively strength training and focusing on movement I put on weight just like that. So from 2024-till around early jan my weight just went through the roof. I’m not planning on IVF but of course who knows if ovulation meds will work for me ( if and when I am given them)

@hyggetyggedotorg thats what I wanted to know. The fact that this is now a telephone appointment, will they expect me back soon to actually weigh me in person. What are the time lengths from the first till the second appointment?

I believe you’ll be weighed if it’s funded. If you are privately paying it’s a bit more flexible. We had to self fund as not eligible due to being a same sex relationship & I wasn’t weighed, I just told them my weight.

No shade - I am bigger than I want to be right now so get it; but if it’s being funded, they’ll want you to give yourself the best chance at success & part of that is having a healthy BMI. Go to the appointments, be honest that you’re not where you want to be and schedule your next appt for 10/12/14 weeks time or whenever you think is a reasonable time scale to shift the weight you need to. It’s such a good motivator!

As naive as it sounds I never considered needing ivf. When I mentioned fertility meds I was specifically talking about ovulation induction I.e letrozole. Regardless your point stands - I did lose significant weight but unfortunately put a significant amount back on whilst the referral was taking place

@ethelinEd ah okay. Well it’s never too late to start! So more healthy eating options now and more exercise - it can’t do any harm 🙂 good luck!

@Btowngirl thank you! My fear is once I am weighed they’ll look at me and know I’ve been lying and potentially discharge. My own doing of course- but I am in the process of losing weight so if they are that lenient I’ll be relieved. Guess I’ll see in due course 🫠

I’m pretty sure your GP should have physically weighed you for the referral so I wouldn’t worry too much that it will be on you. It’s only causing you stress because you know you’ve lied, but really you could have gained weight, the GP could have recorded it wrong, you could have rusty old unreliable scales. None of it ideal but they can’t prove you lied and you definitely won’t be the first woman to go through their doors who has told a porky to get there!

It’s also worth noting, if you do proceed with treatment there may be a weight gain. I gained quite a lot through 3 rounds and am now just managing to start shifting it so the healthier you can get your BMI, the better that will be too!

The wait for IVF might be about 6 months for your appointment. It's enough time to bring it down- although hard work! Currently in the process of exactly this. You don't say how old you are (I think!)- they might bypass the meds stage depending on your age.

Private clinics are under 35 BMI, NHS are under 30. I was told by the consultant that this was non negotiable (not that I tried!)

It's a small thing, but I've found not blaming myself (or telling anyone but Mumsnet about my high BMI) but telling people I want to be in the best possible shape just to give myself the best fighting chance.

The weight loss chat for April has been great!

My BMI was 31 when I first saw a consultant, and I was not allowed treatment until I returned and it was under 30. My DH was also weighed for the IVF and had to fit the same criteria.

That's interesting @Yellowtulipsdancing. My husband has been told nothing like that and hasn't been weighed.

Were your husband's sperm tests ok if you don't mind me asking? Just trying to work out if there's a reason my husband hasn't been weighed! Aka panicking slightly.

@HollyGolightly4 Just turned 30 this week- guess I also didn’t consider that ovulation meds aren’t always the first line of treatment. I’m confident I can bring it down in a few months but hope it won’t be too late by that point. Best of luck to you!

I was weighed at mt first appointment with the fertility consultant. She went through all the treatment options with me but would book me in until my BMI was under 30. I had to be weighed at the hospital for them to confirm I could proceed so I wouldn't worry too much about your weight at the first appointment but I would be very surprised if they let you progress further without losing the weight. The consultant recommended I take vitamin D and inofolic which can help to lose weight (fat absorption and stabilising blood sugar i think) so it's worth asking the consultant if they can recommend the best way for you to lose the weight.

Hi, yes soerm motility was an issue and we needed ICSI.
his issue was being underweight!

Thank you for replying @Yellowtulipsdancing !

Thank you @ethelinEd . I'm sure they might go down the meds route. Best of luck to you too!

Would you consider something like ozempic short term to shift some weight whilst you’re waiting, I think you have to wait 2 months after coming off it, but it would be a quicker way to lose weight faster so you’re in a better position? My BMI is just over the limit for NHS, and despite healthy eating and exercise it won’t shift, so I’m considering that if nothing changes. I’ve seen a few friends and family members have really positive results and no side note effects

My clinic weigh everyone, they said to me even if they can see you are slim or that your bmi will clearly be fine they are required to input the exact weight and bmi

I’d second this def look into the injections and good luck !

If OP's appointment is in May though, she won't be able to come off the injections with the two months needed before TTC.

Why don't you have the first appointment, be honest that you trying to lose the weight and ask for a 3-4month gap before your next appointment to give you chance to meet the deadline. Then if you wanted to try weight loss injections, you would at least know when you need to stop them. But if you go down the diet route, you also have a fixed timetable to aim for as well, which might help with the psychology of it all.

If you arent already on metformin for PCOS, you should talk to your doctor / GP about it as well, as i found metformin worked well in the run up to taking the letrozole.

Can I ask where is this chat?

I have been weighted and my BMI was too high. They wouldn't start anything until my weight goes down. They didn't weight my husband.

At the end we've been recommended at home insemination as my follicles count is good and husband sperm too. Even though that will pish me over the 40 year old limit (you're allowed 3 cycle of ivf under 40 and 1 after 40 - if you haven't had one before).

You have time, so i would focus on losing the weight. I found most of the staff very understanding and you could say that you were hoping to have your weight under control, and have lost x since, to show you are motivated.

I would look at ozempic - i would if we were not trying for a baby.

You will be actually checked before any meds or treatment is done, and without being cruel you will have to see someone in person and it will be obvious that your BMI is too high.

Also worth mentioning that the reason BMI is so crucial is that most fertility treatment is far less effective and in fact has higher risks at a higher BMI. Even ovulation inducing medication is less effective the higher your BMI is.

You’d be better off focusing on the weight loss rather than looking at fertility help just yet. It will all work far better at a healthy weight.