Denied Clomid because PCT say I am overweight

[heartmoonshadow]

I am really upset my GP thinks Clomid is the answer to my infertility. Shesent me to an infertility clinic who took one look at me and said go away and lose 4 stone come back in 6 months. I had a bit of an arguement with the doctor asking him about equal opportunity laws - he said it is PCT decision. Which reading between the lines means it is a way of saving money. Anyone know a PCT who will allow Clomid to overweight women. If so I will ask doc to refer me to them.

thanks

I know it isn't a personal attack, I just disagree that IVF should be refused to overweight women. As I have said figures and charts don't take into account the whole picture. Surely something like childbearing should be based on a holistic picture. If I hadn't managed to conceive my DS naturally he might not be here, as I might have been refused treatment. Can you possibly argue that someone (and I don't just mean me personally but all women in similar situations) who is fit, has a generally healthy lifestyle, is a good parent in a stable marriage with a good home and who is a size 14 (so not obese) should be refused the chance to childbear? I actually doubt very much I would be refused treatment because I don't look as much as I weigh IYSWIM. Would people be stopped from adopting because they are overweight? Could the NHS not take other factors into consideration? What about the health risk of depression associated with not being able to childbear (a basic human/womanly need)? I am just worried about such narrow criteria based on figures alone.

So facts are facts, but it dosen't make them morally right. I am a nurse BTW, so perfectly aware of health risks associated with being overweight but my training and experience has taught me to look at the WHOLE person, not just BMI.

Yes, you're right - there's a lot more to people than their BMI.

But if you are a nurse then you do have to acknowledge that there are risks if you're overweight.

IVF is hugely expensive and, sadly, the NHS can't provide everything free to everyone. Therefore it is rationed - like a lot of healthcare - to those women who are 'safer' risks. I'd love to say this is unfair, but it's a commercial reality.

Why are you so resistant to the idea of losing weight? It's better for your general health, not just in terms of fertility/conceiving. You may be fit and have a healthy lifestyle (well done for that, it is a great achivement) but you are still overweight.

for the OP - I noticed you said you cannot exercise easily because of hip problem - I would really advise hiring a personal trainer to advise you on an exercise routine that is safe and comfortable for you to follow. There are many strength building exercises you could undertake safely and even some forms of aerobic exercise, perhaps seated

I don't know whether you are going to follow the recommendations to lose weight or not, but regular exercise would obviously improve your fitness levels and would hopefully help with depression also

I am currently 41 weeks pg with SPD, but am still able to enjoy attending the gym, as I have had advice from a personal trainer who has tailored an exercise plan specifically for my physical limitations. I was sorry to think of you being unable to exercise if you would like to be able to.

I was just trying to defend the original poster using my own personal experience that is all. I apologised earlier if I had jumped the gun. No need to tell me to "sort yourself out". I won't be posting anymore. It has gone too far

OK, I am Roseability's husband (nice username btw wife!). Just arrived home expecting a nice Friday night in with a bottle of wine to find her very upset and preparing some carrots and steamed fish for tea. I see this post is the cause of my Friday night being ruined.

First, this is ridiculous - my wife is indeed those dimensions. However, how many of those who criticised her can run 8 miles in under an hour? How man of you do this twice a week plus a circuits class? How many of you do this with a demanding 2 year old to look after as well? How many of you eat home grown veg most nights cooked by as fair a hand as mine? Very few I imagine.

Second, it would appear the issue is that someone has been denied fertility treatment on the grounds of weight where no consideration has been given to the reason for being overweight. It is widely recognised that BMI is dubious to say the least. I'd love to know the BMI of the Williams sisters for example. Anyway, it can only be wrong to discriminate on the basis of BMI without taking into consideration, crucially, PCOS. My wife has PCOS and one of the main symptons is struggling to keep off weight. So, how can you deny a treatment for PCOS based on a symptom of PCOS?!

And before you start, I did a charity 54 mile endurance event last week and exercise regularly.

Im off for a moan on dadsnet

To your first point, yes, your wife is undoubtedly very fit. This is great.

To your second, your wife suffers from PCOS. I posted a link to a site which helps PCOS sufferers (as well as others who are dealing with weight and health issues).

Nevertheless the situation is that under current guidelines she is considered overweight for IVF treatment.

Sorry if she is upset, and sorry if your Friday night is ruined. People on this thread were trying to help the OP.

BMI is dubious (note my point re the Williams sisters), there is a lot of research suggesting this and as a nurse my wife is up to date with such things. You cannot make such a statement without even seeing my wife, who clearly does not look obese at a size 14. She just weighs heavier than she looks and the point is (I am sure due to her athletic background), I am sure a lot of women are the same. Even on our wedding day my wife was a size 10 at 10 stone 9 pounds and only just within so called recommended BMI guidelines. I also thought she looked too thin as a size 10, it is not her natural size. I am absolutely sure our GP would not refuse treatment and when my wife was pregnant her weight was never mentioned by the midwives etc. We now have a beautiful and healthy boy, conceived naturally despite PCOS. My wife also made a very good point about depression caused by infertility. This is also an important health issue. I'm off to enjoy my evening. Goodbye

Go private for goodness sake, it doesn't cost that much! Yes the NHS lottery is unfair, yes it sucks, so do something about it. Get a loan, borrow money from your parents, do overtime, get a weekend job.

If I hadn't spent £500 on private investigations and treatment for PCOS I wouldn't have DS. Simple as that.

oh dear...this post has got a bit hairy!
HMS my specialist told me to loose some weight before I started IVF, I lost a stone and started ovulating again (i have pcos and hadn't had any signs of ov for over a year). Just a bit of weight off can make a big difference.
Good luck with it all x

PCT's are part of the postcode lottery I had clomid to conceive my DS after I lost 2 stone. I managed to get my BMI down to 34.

Check this website www.fertilityfriends.co.uk you may find a bit more support from ladies who do understand infertility/pcos

Oh goodness I did not realise that this would cause such a furore. I would like to say thanks to Roseability for your comments - you put so eloquently what I was trying to say.

Although my BMI is very high I feel that this is a one size fits all fix that does not work. I am overweight and I will try to sort this out - I am off to my GP next week (first appointment I could get) to see what I can do to help myself.

However I have had conversations with my previous GP (I moved 6 months ago) where we discussed my weight and the distribution I have on my body. He said that to be overweight is bad but that I do not store it around my middle (ie apple shaped) and therefore the risk to my organs is diminished in relation to a lighter apple shaped woman who stores her weight there. I agree a holistic approach should apply and this will be my arguement to my GP.

Also I think you would agree that genetics is also a factor and my mother (sadly deceased due to terminal illness) ate little more than 600 calories a day for the last 2 years of her life and was still no smaller than a size 18/20, the women in my family are large, we have 104+ (78 females) in the family and no child bearing related illnesses so I ask why can this not be taken into account?

I have also contacted the PCT under my maiden name and found out that no such rule applies that restricts the specialist so I now feel that he has given me medical advice and that if I make the effort to lose a couple of stones he may take me on. After all to say come back in 6 months with the inference to lose my excess weight is unrealistic.

I will let everyone know what happens in December if you are still around.

Thanks for all the supportive advice most posters gave.

heartmoonshadow

i do hope you get somewhere, and that you have your much longed for baby

If you're under an endocrinologist at a hospital try and get them to prescribe Metformin. I was in a similar situation - had PCOS (and thyroid disease) and was v overweight. I lost a couple of stone but my consultant also put me on Metformin - not sure which did the trick but I fell pregnant within 3 months (after 18 months of trying beforehand).

Good luck - maybe try your best to lose some weight so they can see you're having a good go at it, but push for Metformin in the first instance. My consultant actually told me to come off it as soon as I was pregnant, but to go back on afterwards as it reduces the risk of developing diabetes.

HMS - sorry didn't mean to hijack your post and certainly didn't want to make it about me! I am absolutely for losing weight if this is what you want to do, and I am sure it can help ovulation. But I also hope you get treatment should losing weight prove too difficult or you still don't conceive. It sounds promising that you don't store weight on your middle, I unfortunately do! Don't give up hope. I have every PCOS symptom under the sun and I am overweight but I still conceived my DS and recently conceived again (although sadly it was a chemical pregnancy). Thinking of you x

roseability

You are a woman after my own heart. I think the BMI system is crap. In fact, I read a report on the web ( for the NHS ) where a study by medical students was held on how accurate a yardstick BMI is and basically they concluded that it can merely be used as a rough idea/guide as it does not take into account things like:

1. Body type
2. Frame size
3. Genetics

And so on ...

I am the same as you - At my slimmest ( size 12) I was 11 stone. According to my BMI range I think that still put me just into Obese. MADNESS ! Like you said a size 12 or 14 is NOT obese.

I was also diagnosed with PCOS last year.

Anyway, I won;t start a new rant.

Just wanted to say YOU GO GIRL!!!!! and I LOVE YOUR HUBBY! He is ssoooo supportive it is wonderful.

All the luck and hugs to the both of you!

dottydot

I am trying to get my GP to refer me to the endo here who believes in perscribing metformin for PCOS.

Were your periods regular before you started metformin and lost the weight?

I have regular periods, and seem to ovulate most of the time but something isn't right as we have been ttc for 17 months with no luck!

I feel some of the posts are a little unhelpful. Weight can inhibit pregnancy - either too much or too little weight. But it is a marginal factor and I do feel that it is being used to screen out the number of people eligible for expensive help.

It's the same in adoption - factors which have a marginal effect on your ability to be a good parent are being used to screen out possible adopters because there are just too few children for too many parents. So the decider becomes something that would be irrelevant for people who aren't in the queue for adoption (eg, not being married, occasionally smoking, being overweight).

For those who don't really have a problem with fertility (myself included) weight did not stop me conceiving. Simple observation tells you it's a marginal issue not a major factor. Most people who are overweight won't have a problem conceiving. But it's a way to screen the applicants and therefore it has become a major requirement in fertility treatment.

In my case, I was ovulating. If you are ovulating (which you might be with PCOS - I was), clomid won't be much help to you anyway.

I think it does sound like a more sympathetic gp would help to get to the bottom of what exactly your fertility isue is.

I should add that I completely agree with those who posted re BMI being unreliable.

There is a very clear genetic factor in weight issues but it's an unfortunate fact that those who don't know a lot about it prefer to believe that that is not the case.

My mother has suffered from a lifetime of intestinal disease and has a diet of around 1000 calories a day. She is completely consistent in this and I know she doesn't sneak any extra food because she can't. She is averagely active. She weighs 18 stone.

Dottydot

Had a look at your pics..you look fabulous! I can't believe you were EVER very overweight!

And your 2 boys are so cute....

I'd really like to pick your brain a bit more about the whole metformin and PCOS business!

M&J - question here www.mumsnet.com/Talk/1368/546557?ts=1216129722387&msgid=11602208

If you have PCOS,Have they tried Metformin tablets with you? With PCOS alot of women are overweight and it is difficult to shift the weight due to the condition.

IMO as the weight gain can be connected to your fertility problem,its a bit much to suggest you lose weight to get the clomid.

Bit like Diabetics that are overweight,its difficult for them to lose weight as their body is not able to cope with their sugar/carbohydrate intake anymore,they don't get "refused" treatment,or told to lose weight first.Often the treatment for PCOS will help you to lose weight.

If you dont want to be pregnant,the "Treatment" is the Pill,if you do its Clomid.

By the way at 5ft 4in your upper range of healthy BMI is 10st 4 lbs,which would make you 2 St 5lbs overweight.Not so obese to warrant some of these exagerated hurtful comments IMO.

Heartmoonshadow - you mentioned about drinking diet sodas, I really recommend that you stop with that.

they are loaded with Aspartame (a chemical sweetner) which can cause your hormones to go haywire and can impact on fertility. it's also been linked to cancer - so all in all it's very grim stuff.

Fizzy drinks in general are bad news but if you have to have them - have the regular variety.

As somebody that was overweight 10 years ago I do understand how hard it is to slim down. But it can be done.

Please don't get too hung up on the supposed genetic link (I used to cling to that one too - as I had a fat mum, gran and sister!) however obesity isn't inherited.

Weight Watchers really worked for me and I made some great friends there too - good luck to you. x

To anyone here who has been trying over 12 months to conceive, i would definately suggest asking to referred to a fertility specialist. There are other facters and tests to be considered which only a fertility specialist will send you for

Clomid is precribed to woman who ovulate on thier own to boost ovulation

Also if you are having 21 day blood tests this will assume you ovulated on day 14 which isnt always the case espcially if you have irregular periods. One an egg is released it last 12-24 hours where sperm will last up to 5 days so its all about getting the timing right

Dresdenfiles

Interesting what you said about clomid!

My fertility consultant said she thinks I ovulate therefore she cancelled out clomid all together!

I told her I had heard of others taking it to give their ovulation a 'kick' but she refused to hear it!