Infertility when Overweight - Please Help!

[taylor1027]

Hi! I'm pretty new here and to infertility. I'm looking for advice and general help with the experience of others. I had a hard time meeting with the gynaecologist a couple weeks ago. Here is a bit of back story.

We have been trying for baby for 15 months now. I am very overweight and I realise that (I do go to gym a few days a week and try to eat well but it just isn't coming off). My af can be difficult to pin down, ovulation tests seemed to never work and temp was never easy to track. I finally went to GP when af was at about 60 days without showing up which is pretty bad for me, even with irregular. After all was said and done, the only abnormality in testing was it showed I wasn't ovulating and ultrasound couldn't see my ovaries. PCOS was my original reason for going in and it hasn't been confirmed or denied but I do believe it is the issue.

Fastforward a few months and finally in at Gynaecologist. I expected an exam of some sort and a bit of a plan. Instead, the Gyno walked in said I was too overweight to do anything and probably no one would help me because I'm 'high risk'. He wouldn't listen to me at all and I completely shut down. I was referred to someone else, I don't even know what the appointment is for but it's in 2 months, repeat scan and repeat blood test.

I'm wondering about other peoples experiences being overweight and having issues. Is this how appointments go? I just got so down and cried the whole way home. Please help :(

It does sound as though the doctor didn't have the best bedside manner - sorry you had this experience!

If you don't mind me asking - how overweight is overweight? I too have struggled with weight issues and PCOS. My BMI was 40+ and I did get it to 24 but at the moment I can maintain a BMI of 27-28.

Being overweight really does affect the chances of any help they can give you working and gives an increased risk of miscarriage and pregnancy complications. Some of the medication also puts you at risk of a serious blood clot and being overweight further increases that risk. My theory is try and be in the best health so you know you've done everything you can for your own health and for a future pregnancy.

We need IVF/ICSI and we only get one NHS funded treatment - if the first go doesn't work then it's going to cost around £6000 for a full cycle (FET Costs less). In my area you qualify for help with a BMI less than 30 for IVF (think it's less than 35 for clomid).

So being in similar shoes as you I would concentrate on losing weight - join SW/WW and make a real conscious effort as your natural chances of conceiving will improve along with the likelihood that fertility treatment will work if you need it. Good luck OP x

Hi taylor1027,

Unfortunately, I was in similar situation and i just had to lose weight. Next month is my first appointment in IVF clinic. during my first appointment doctor told me that until my BMI is that high (38 at the time) they wont even talk to me. To be accepted for IVF through NHS your bmi must be 30 or lower. And funny thing is we need ivf because my husband has got azoospermia, I am completely healthy. Ive been told to lose weight fast no matter how. Ive lost weight and my bmi is now 29. I used Cambridge diet. Weight is constant battle for me always was. I hope you will find the way to lose weight that works for you.
m xx

Thanks, my BMI is 40+ as well. I've been going to the gym for almost a year now and not lost or gained and now I have a foot injury. Just feel very lost and like everything is going wrong.

I never found the gym helped me! SW worked wonders for me & walking! I lost 6 stone on SW without exercise then did walking for the extra pounds I couldn't shift.

id use your next appointment as a goal & show them each time that even if it's slowly - the weight is coming off & they will take you much more seriously! Good luck x

I'm sorry you feel like the medical appointment wasn't helpful but I'm also amazed that you didn't know your extremely high BMI would be a barrier to fertility treatment.

In your shoes I'd make a huge effort to drop some weight before the next appointment. While going to the gym is great for your fitness levels when it comes to weight for most people it's all about the kitchen.

There's plenty of support over in in the weight loss threads or if you'd like to keep all of your thoughts in one place we could perhaps offer advice here?

I just thought there would be more options I guess. And I do realise my extremely high BMI is an issue and have been trying.

Taylor don't worry we've all been there doing what we think is best when it isn't helping despite how our best efforts! I'd strongly recommend SW and staying to the group sessions and stick at it! You just need the right tools to get you on track!

Sorry @taylor2017, your doc sounds really unkind and pretty unprofessional. Hope you're not feeling too down. I realise it must seem like a long road. But you'll get there!

This might not be that helpful, but someone once said to me that losing weight is 15% about exercise and 85% about what you eat. From my own experience that's absolutely true, in that I used to run and run and run and eat endless biscuits and crisps and never lost any weight. But changing how much I ate always made a big difference.

Good luck. X

I should apologise - reading that back the word extremely sounds very unkind. That wasn't my intent. Having said that, if you have genuinely been trying to drop the weight for a year (by which I mean restricting your calories below your BMR every day) I'd assume you have a further health issue and would urge you to go to the doctors.

Unfortunately the options are limited. I'm two years into infertility, normal BMI (could still stand to drop a pound or two though) and have paid to go onto clomid (cycle 2 - and it's not working). If it doesn't work next month we will probably look at the next steps. We should be entitled to NHS fertility treatment but so far we're struggling to get a referral so we're pushing it while we pay for this step.

You might get some action if you pay to go private, but the reality is most fertility treatment is crap to go through at the healthiest you can be, and the closer to ideal you are (age, weight, health, etc wise) the better the chances.

Taylor1027 did you talk to your GP? Some London boroughs sponsor gym classes or slimming clubs (it may be the case where you live). They send patients on Momenta program. Program itself its basic understanding of nutritions but at the same time you can meet people that also are trying to lose weight. It is good support system.Good luck x

Belle723 - Thanks, I have looked at SW but just can't afford it unfortunately. I was successful at losing weight by tracking cals previously I think I am going to have to get strict again.

ScatteredThoughts - Thank you :) I am not feeling the best about things, but tomorrow is a new day and a new start!

Catinthecorner - No worries. I've been good with exercise but off and on with the eating, so it probably comes down to that. I hope your clomid does the trick :)

margasid1 - My GP hasn't said anything about any program but I might look into it, I've never heard of it, thank you! I'm up north so not sure if that makes a difference?

Taylor keep bothering your gp. Sometimes its the case of don't ask don't get. Good luckx

I was told to lose weight for IVF, BMI was originally 37. I used Slim&Save, it costs about £120 a month but replaces all your food. It is tough, but the opportunity to have infertility treatment is a great motivator. Going to the gym alone has never helped me to lose weight. We had 2 failed cycles but then we were lucky enough to conceive naturally and I'm sure the weight loss made the difference. It also means my pregnancies have been classified as low-risk, midwifery-led. It sounds like the doctor was very blunt but a BMI of 40+ will put you in the high risk pregnancy category and may limit your birth options e.g. the birthing pool at my hospital is only available to women with a BMI of less than 35.

Have you tried a low GI diet? It can bring pcos under controlling by preventing the blood sugar spikes. Getting your weight down and blood sugar under control could potentially get you ovulating again and "cure" the infertility.

The gym is great for fitness but unlikely to do much for weight loss. For that you need a sustained calorie deficit.

I got a fertility clinic referral (I have PCOS and wasn't ovulating) because I was able to show I was losing weight, having got down from a BMI of about 38 to about 33. Once the appointment came through, they were really clear that we wouldn't be given any treatment whatsoever until my BMI was below 30, although they did do investigative tests in the meantime. I had one appointment where I was 3lbs over the target weight and they still wouldn't - 30 was the magic BMI number with no leeway.

It was a massive kick in the teeth at the time, and left me feeling incredibly guilty - that I was the one preventing my husband being able to have a baby because I was too fat.

But in the long run, I got there and when I eventually got pregnant I was starting from a much healthier place than if I'd been able to get pregnant when we first started trying - so it was a good thing for me really.

I'm even more determined to lose weight after the baby is born, to put me in a better position again for any future pregnancies.

If it's an option, I'd give up the gym membership and use the money to pay for Slimming World or similar. Exercise is obviously good for you, but it sounds like weight loss is what you need to focus on and diet is always the way to do that rather than exercise.

Often you can get a GP referral for your first 12 weeks of SW or WW, that could be long enough to lose a decent amount of weight and be able to demonstrate it to your doctor.

I concur with others and say use your next appointment as a target to see how much weight you can lose by then. Obesity does play a role in infertility - it could be your BMI that is stopping you ovulating.. You never know, the more weight you lose, the more chance you have of conceiving naturally. Alongside the bigger pregnancy risks, that is one of the reasons that IVF isn't funded below a BMI of 30.. Just try and use this as your motivation.. Good luck.

I'm sorry doc wasn't more sympathetic - he is Obv one of the blunt ones

Most areas won't do NHS ivf if bmi is over 30. Some are 25. Till you have got to down to that you won't be put on waiting lists etc

Does sound of you have a hormone problem if been trying to lose weight for a year but can't and not having the af

Yes bmi of 40 is very high risk and possibly why you aren't getting preg naturally

You say you can't afford sw? Tbh I'm not sure of cost but assume £7/10 a week - I don't mean this to sound the way it does - so will be blunt as well - but if you can't afford £10 a week how will you afford a baby if you aren't working and on mat leave

Buy the books off eBay and do it at home

Talk to doc. Some will do free referral to slimming clubs if over a certain weight

You might also want to investigate info inofolic which is meant to help with pcos and to help lose weight for people with insulin resistance (which may or may not be you but is very common with pcos).

Thanks all for comments and ideas.

Blondeshavemorefun - its nice that you are concerned about my finances but this wasnt about that at all. I didnt ask for financial advice but thank you. You know nothing about me or my situation. Have a great weekend.

Hi Taylor - your GP should offer help in losing weight e.g. with your BMI you might be eligible for orlistat which, combined with diet and exercise, can be enormously helpful. Have you been evaluated for insulin resistance? Depending on the results of that they may also prescribe metformin, the side effect of which is weight loss.

In terms of free things to try, NHS Choices website has a really decent weight loss section with a supportive forum and help meal planning etc. BBC Good Food resources for lower cal meals are also amazing and unlike much 'diet' food they taste completely amazing. I used to run weight management randomised controlled trials for people with BMI over 30. Anyhow, our research team used the NHS and BBC resources a lot to support people alongside our behavioural support, because they are accessible and well designed. I do appreciate how difficult and emotionally charged all of this is, so hugs.

SchnitzelVonCrummsTum - Thank you! I will look into everything you said! As far as I know all my blood tests were fine, I know they checked for diabetes and thyroid and all that good stuff and nothing was abnormal.

Did you get the PCOS test? Because if you have PCOS and are struggling with your weight, your GP should be able to put you on metformin. It is NOT a magic pill but I find it a LOT easier to lose weight while I'm on it.

As someone with PCOS who really struggles with weight loss, here's what I've been doing. The weight loss has been fairly slow but it's consistent. Also, when I am super strict about my "Rules" I definitely lose more.

The key point is that if you have PCOS, it's SUGAR you need to be obsessive about. And finding ways to make sure that the carbs you eat don't become sugar.

1. More exercise, particularly walking or swimming. I try to walk briskly for a minimum of 35 minutes at least 3 times a week. Someone told me once years ago that you don't start burning fat until at least 20 minutes. I have no idea if that' true, but I do find that exercising lightly for 40-45 minutes seems to be the sweet spot. Obviously, an hour would be even better. But I never have time for that.

1. Cut almost all "treats" e.g. cakes, biscuits, chocolates. (the focus here is sugar, not fat). I allow myself a plain digestive in the morning. Now and again I have a small hot chocolate at night, but I try not to.

1. No carbs at night. I realised that the easiest way to cut calories was to reduce my carb intake. Carbs give energy and I don't need energy to sit on the sofa watching TV after 8pm. I have beans and veg etc, so it's not Atkins style. But I don't have bread, pasta, rice, potatoes etc after lunch.

1. Limit carbs during the day. e.g. no crisps, single sandwich (no crusts) or very small pasta/ potatoes options at lunch.

1. (which I NEVER do, but I really should) - get 5 minutes of exercise after every meal. I discovered this when I had gestational diabetes. It really seems to help the food to digest and not turn straight to fat and bloating. But unless I eat breakfast before the school run, I struggle with this one.

Good luck!

Incidentally, my gynaecologist, who also had PCOS, told me her secret was that she changed her routine so that every morning, she gets up 30 minutes earlier, throws on jogging clothes and does a short 25 minute jog. She told me she lost a lot of weight and felt a lot better on it (I assume she was also being careful about eating sugars, but we didn't discuss that).

taylor sorry to hear about your fertility struggles. If you said you've done well with calorie counting in the past, and you manage to exercise regularly, have you tried the myfitnesspal app? You can log what you eat, and your exercise and can keep track of everything. If you can see it written down, it might help you spot where you could make a couple of changes that would kickstart the weightloss.