Overweight! Help! Dr not helpful!

[cookielove]

I am posting for advice for a friend!

She is overweight, probably obese!

She has been ttc for a few years, she has been sent to a gynaecology specialist who has said she needs to loose weight. (Understandable) but there is nothing else wrong, despite the fact that she has very inconsistent periods, ranging from 50 to over 100 days.

She is using opk's but it is very hard to pin point ovulating when her periods are so long!

I have said she should ask for day 21 tests, and ask for clomid, should she look for a referral to an actual fertility clinic?

Please let me know what else she should do!
She is already losing weight and is a stone down, with a few more to go!

Tia

Some NHS trusts won’t refer until BMI is under 30. 25-30 is actually overweight but they don’t block treatment. 30+ is obese and they will.

Are you sure you know the whole story? If she’s seen a gynaecologist - this may have actually been under a fertility clinic. I doubt a gynaecologist would declare “nothing wrong” without the basics of d21 progesterone.

And as above - depends on what funding is available locally for Bmi

I’m sorry your friend didn’t like the advice she was given but from what you’ve said, it’s entirely appropriate although I appreciate I don’t have the full information and am just going on what you’ve said in your post.

What’s her BMI? They probably won’t prescribe clomid unless her BMI is under 30 and she is still not ovulating. If she isn’t ovulating now, weight loss may resolve the problem. If she is ovulating now (which is unclear from the information you’ve given) then clomid won’t help anyway.

There’s no point in her having a day 21 progesterone level done. The “day 21” test is actually more accurately a “7 days before the expected date of a period” test. It should only be done on day 21 if you have a 28 day cycle. With her cycles being so variable this is likely to be useless and even if it was done at the correct time and it suggested she isn’t ovulating, weight loss would be the first step in addressing this anyway.

I appreciate that’s not what you wanted to hear, but your friend has done really well to lose some weight so far.

High bmi alone can (in some cases) cause long and irregular cycles because fat is a hormone (endocrine) disruptor... disrupted hormones = disrupted cycles.

Even modest weight loss can improve cycles (and thus fertility).

This is why the bmi limits for treatment exist. Hormone (fertility) treatments are less likely to work if carrying excess fat. It's not being prejudiced against fat people.

Thank you ladies!!

I do know all the facts we are close and i have been supporting her through this tough times as well as going through my own ttc issues.

The weight is a definite issue, and she has definitely only been seeing a gynaecologist. I agree she needs to loose weight to help

She is feeling so lost, especially since the gynaecologist has basically just said loose weight and then you will be eligible for ivf.

So it sounds like she already has her answer, I’m not sure what more you feel the doctors should do ? I’ve also been through infertility so I know how low it can make you, but I feel it’s really unfair if you to say the doctors are being unhelpful.

she has definitely only been seeing a gynaecologist.

But in an infertility clinic she would “only” see a gynaecologist too as fertility specialists are gynaecologists, they just have an interest in infertility.

I agree with @bobbypinseverywhere it’s unfair and unhelpful if you say the doctors are being unhelpful as it is likely to maker her feel worse and lose trust in her doctor when it sounds like the advice has been given is entirely appropriate and there is a plan for going forward.

Sounds like she has the advice she needs: lose weight and they will help. You can’t get a better incentive than that!

There’s not much anyone can do except support her through her continuing weight loss. Even if she’s perhaps looking for some magical solution that doesn’t involve losing weight. There isnt one unfortunately.

Is she willing to try and lose some weight? Maybe you could help her by going out for walks together?

If she does lose weight it would help her if she does conceive as a high BMI can cause complications with the birth.