How to see a future without children?

[Ilovewheelychairs]

Sorry, this is long! My husband and I have been trying for 5 years. Multiple chemical pregnancies in that time but otherwise, no pregnancy progressing last approx 5 weeks.

I am overweight. I am therefore not entitled to any form of treatment or investigations. Myself and the GP suspect endometriosis due to chronic pelvic pain and heavy and extremely painful periods, but I've been rejected for a laparoscopy by the gynaecologist because of my BMI. All the tests I'm allowed to have have come back normal; I'm ovulating, hormones are perfect. No issues relating to my weight that anyone can find either- blood pressure and cholesterol, everything are either low or ideal. Husbands sperm analysis came back fine. I eat healthily, just probably too many treats due to depression (ironically, hugely caused by infertility and chronic pain, which also makes exercise extremely difficult). IVF or other treatment is obviously out due to BMI limitations, both NHS and private.

We've just been rejected for adoption because of my weight too. For age related reasons as well as past eating issues bordering on disorder, losing weight in a healthy way is not going to happen fast enough. I could do a VLCD such as Exante or the Tier 3 weight management solutions suggested by the NHS, but these are not a healthy or sustainable solution, and I know that once I come off them I will gain the weight back, plus more.

So, we are facing a future without children. For me, this is just not worth anything. There is no point in being around without being able to have a child of our own. I'm not suicidal exactly, just exhausted of being in pain, and feel I have nothing in my life that I can look forward to. Have never really been interested in travelling particularly, I'm quite a home bird. I'm a teacher, and I'm told a good one, but to be honest spending all my time with children with parents who are struggling or who are actively abusive is getting even tougher when I am unable to have a child myself. Everywhere I turn, friends are getting pregnant. A lot of them 'accidentally' or first time, or in relationships that I feel are not sustainable.

My husband is a wonderful man and I truly adore him. But he deserves to be a father. Do I split with him and let him go and find somebody else who can provide that with him? I feel I am dragging him down and stopping him living his life as he would like to.

Is there a way for you to come to terms with not having children? I've had counselling which I found unhelpful tbh, and with the rise in cost of living, fairly prohibitively expensive.

Apologies for the length.

TL:DR we can't have children, any suggestions on how to come to terms with this and find a way forward?

So could you lose the weight enough to be eligible for private IVF which has a higher bmi limit?

I only ask because when faced with this exact question myself the answer depended on whether I was at peace with the decision to stop and could I face the day knowing I tried everything I could - did I genuinely have no regrets? Was there something I could have done but didn't? Losing weight is one of the few things which affects fertility that you can have control over?

There is no scientific basis for weight causing infertility. The only actual evidence is that excess estrogen in some cases may stop ovulation, and in those cases, losing weight may help start ovulation again and help people conceive. This is not the case for me as I am ovulating normally, and clearly, can get pregnant. It's staying pregnant I have an issue with. I have tried progesterone creams in case it's an issue of low progesterone and that has done nothing other than to make my bleeding excessive. I have also been taking 150mg aspirin from ovulation to my period starting. No cigar.

I would probably need to lose about 6.5 stone in order to get private clinics to even consider me. Mentally, this is a huge hurdle and starts me wanting to binge and purge again. Vicious cycle.

Sorry, forgive me, I'm not in a good place mentally and that was a stroppy response to what was a kind and considered post. You are right. I have to get myself into a place mentally where I can jump through the hoops necessary to prove myself worthy of being a mother. I think it's the anger that I shouldn't have to do that that holds me back and I am sabotaging myself (and my hundreds of weight loss attempts) in the process.

I think if there was no scientific evidence that weight affected fertility then there would be no BMI limit either on the NHS or privately....the fact there is suggests there is indeed a causal link? I believe there is also a link between high bmi and recurrent miscarriage albeit studies are not huge but the ones that have been done do suggest a higher rate of miscarriage in groups of women with high bmi

Other than the chemical pregnancies have you had ovulation/tracking to confirm you are indeed ovulating? Blood tests etc may suggest your hormones are at the right level to ovulate but did ovulation actually take place? You can get tracking done privately - I did it a few times after i lost a tube to an ectopic

Progesterone creams are not affective as the suppositories - are you able to get a private prescription for those? Have you asked for a referral to the recurrent miscarriage clinic based on your chemicals? Some doctors don't count them but some do and may refer you on that basis?

What about IUI? How about approaching a clinic to see if they would treat you privately with IUI instead of full IVF?

6.5stone is a significant target......I take it surgical options are off the table? How old are you? Do you have time to lose the weight and then do IVF?

Hi.

No, I don't have the time. Surgical options are off the table; financially and time wise. We don't have the money to do it privately, and NHS wait times are too long. Plus, although it is the only way to sustainably lose weight long term, it is not a healthy way to do it and can cause a barrage of other health issues.

BMI is a useless tool. Yes, there is a correlation between BMI and fertility issues, but if you take out the fact that it takes overweight people many years extra to be treated or seen, aside from the difficult ovulating seen by a percentage of obese patients (also seen by a percentage of lower weight patients, particularly in patients with PCOS), there is no evidence at all. The wait to be seen and treated for conditions that for the most part are totally irrelevant to a persons size is what causes the long standing infertility for most overweight couples. The BMI limits are in place for anaesthesia rather than any other reason. And they would be happy to break this policy if it were for bariatric surgery. Just not to get me out of pain. I am a less valid person because I am big and less worthy of being treated and of being a mother.

Anyway, my GP says any referral for repeated miscarriages will be rejected because of my BMI. I have contacted every private clinic within 200 miles and have been rejected for even standard blood tests until I lose weight. So no option for IUI or IVF (which we actually have no idea whether or not I need, because of the refusal for other testing- there may be a perfectly simple and easy remedy but they refuse to find out).

Rejection for adoption was the last straw. To be told that I can't look after and love a child who needs a home because of the way I look is devastating. It would be okay if I smoked, even though there are multiple scientific studies that PROVE conclusively smoking causes cancer, not only in the smoker, but the people around them, as long as I promised to only smoke outside and not in the house. But if you're fat? Nah, unfit parents.

I know I have to get over this anger towards the medical profession who are actively stopping me being a parent. I need to stop sabotaging myself and lose what weight I can and then try again persuading people to help. But when you have been outright told by multiple medical and other professionals that my miscarriages are my fault. That I will never be a parent because of the way I look because that makes me unsuitable to be a parent. When I spent all day, every day safeguarding the lives of young people who are with unsuitable parents or carers who are damaging and ruining their lives, and am told I am excellent at caring for those children. But not fit to have one full time. It is depressing and difficult to remedy in your head.

I am unfit. I am not worth anything. I would be a terrible mother. This is the message I am getting constantly. Now try losing weight. My mental state is rock bottom.

There are a couple of clinics in the UK that don't have BMI limits. They assess on a case by case basis. Have you looked into Newlife fertility in Surrey and/or Concept in Putney?

It sounds like you are very well researched in why you believe a high bmi has no bearing on fertility however that doesn't take away from the fact that rightly or wrongly there is medical cuts offs in place so what you have read whilst not irrelevant you've just got to put aside because it makes no difference?
Being refused for adoption wasn't on how you look but on the basis that you are 6.5stone overweight being indicative of an unhealthy lifestyle. You're right that it isn't fair that smokers can adopt but what can you do? No one is actively stopping you being a parent - you hold all the power here? How old are you? Under 40 are you able to lose say 3 stone in 12 months and approach clinics again?

@Ilovewheelychairs First of all, I am sorry you feel this way. There is a lot of anger and resentment in your messages and it is understandable. Infertility is difficult to cope with, and even more if you get no help from the doctors.
I think first of all you need to honestly answer the question of whether you are looking for ways to cope with this/accept the situation or actually you are not ready to give up the fight yet.
If the first one, it is a grieving process which can be very tough to go through on your own. In this case a grieving therapist might help.
If the second one, apart from looking into ways to lose weight, could you look into IVF and adoption options abroad? Rules
differ greatly country by country and there might be no BMI restrictions at all. Not to mention that so many kids would be happy to find loving parents in you and your husband!
In any case, stay strong and good luck with whatever path you choose. xxx

@Ilovewheelychairs ohhhh honey I am so sorry you going through so tough time ! I really am ! I understand perfectly what it feels like to have infertility !
bit about me :
im 31 , bmi is perfect ! Healthy and no problems at all .
have had 7 early misscarriges in the last 7 years .
no children to show for it .
recurrent misscarrige tests on nhs have all come back normal , as well as womb scan .
I am left here with no explanation on why it’s happened . They offered me ivf , so I had one cycle and got pregnant again and lost it again . Now they are scratching their heads not knowing what to do !
I am infertile and can’t carry pregnancy as far as I’m conserned . I am looking at life as childless and it’s making me crazy ! I cannot accept this . I just can’t !
so you’re not alone in this lovely !
I think it’s so so bad that they won’t offer you at least testing for recurrent losses panel . You’re not exactly asking them for ivf ? Just to run some blood tests to see if you might have a problem holding onto a pregnancy ? You might have low progesterone , so if that was the case then all you’d need is this and try and get pregnant naturally yourself again and try this , I don’t understand why they won’t test to see where the problem is . You might find a problem you might not but at least you’d know .xx it could be something very simple to fix ! Good luck lovely with whatever you decide to do next xx

My BMI a year and two months ago was 44. I've only just gotten it down to 34.5. I've been referred now to the fertility clinic but I know IVF will be refused until my BMI is 30. I spent a lot of time where you are. Angry that I'm deemed not fit to be a mother because of my weight when people less healthy than me get pregnant easily. Why does the NHS get to dictate who can be a mother and who is worthy based on BMI? Why can my friend who has no money, no stable set up in life, who drinks and eats whatever she likes and never gets off the sofa, get pregnant and have loads of babies but I'm not allowed help for something that isn't my fault? It makes no difference to where I am and what I need to do. No amount of crying over it is going to change it.

It's taken me this whole year of steadily losing 1lb a week, having my ups and downs and feeling lost, to accept that it isn't about me. It isn't about me not being worthy or how worthy I am. It's not about how much salad they think I eat or if they think I live on KFC or how I look in my jeans. It isn't about if I can run a 5k or if I'd have to crawl it. They don't think "you're fat it's your fault". They think "NHS rules won't let me treat you" and that's all most of them think. They're not allowed to treat you, no matter how much they want to. I believe it's almost all about budget. They can't afford to give everyone fertility treatment. It doesn't matter what the evidence does or does not show (and you can look at it and argue one way or the other until you pass out, it makes no difference). Some evidence does suggest over a certain BMI fertility treatments are less likely to result in a live birth. Some evidence suggests that's bollocks. So my mantra is that it's just a budget exercise. Which still makes me angry but at least makes it feel less personal, less about being "worthy". And that helps when I'm losing weight. I'm not doing it to be a better person or a more worthy parent, I'm doing it because someone set the budget rules that way so I'm cracking on. It's possibly also because having a high BMI in pregnancy is riskier and they don't want to be creating those risky situations, but I struggle mentally to accept that so I don't think about it.
For what it's worth most CCGs won't allowed referrals for smokers either until they've stopped for at least six months.

You can lose weight. 6.5 stone was exactly my target at the start. You don't have to do it in a mentally damaging way, although I know it's triggering for binge purge eaters, it's not impossible. You don't have the power to change the rules, but you do have the power to meet them.

You are of course allowed to decide you won't do it and search for a way to learn to live without children. But it doesn't sound like you want to do that.

I hope you come back OP. Even if you just rant, often getting it out there is so helpful.

Hi Lovely,

I really really feel for you.
You are right BMI should absolutely not be used for an individual measure, in that respect it is rubbish and if they do have to put a cut off for fertility treatment it should be based on something else.
The only reason the studies show worse fertility/miscarriages etc for higher BMI is because women with PCOS will most likely be in a higher BMI and this skews it all. The medical profession is hung up on BMI and its just fat phobic now.
You are healthy, your vitals are healthy and so it is desperately unfair for you.

I would recommend following fatpositivefertility on instagram and maybe contacting her (Nicola Salmon).
Also I have seen online women in higher BMI's going abroad to have IVF successfully and it is a lot cheaper there also. Perhaps with some saving this could be a potential option? Though I have no idea about your finances so I apologise if this is an insensitive suggestion.

I am so sorry you are experiencing this, it is utterly appalling that they use BMI as a measure of who can and can't have a child when women in higher BMIs get pregnant ALL THE TIME healthily and plenty of "healthy" BMI women struggle immensely.

Sending you so much strength xxx

@Ilovewheelychairs

I think what others are diplomatically trying to put across to you is that all hope isn't necessarily loss.

Appreciate weight loss may be a challenge, and doesn't promise the prospect of a child, but it is certainly not an irrelevant factor.

The question then becomes, how badly do you want a child? The is no shortage of threads in the section of the forum of women who have shed several pounds in order to get closer to this aspiration.

All the best

I have read and appreciate greatly every one of your replies. Thank you to you all too for being so kind and empathetic, far more than I deserve I think! I have tried really hard with my eating this week and haven't done too badly, so fingers crossed I will be able to lose some weight, and definitely be healthier even if I don't lose a lot. All I can do is keep going, keep trying and try to find some effective counselling to help support me too I think.

Thank you all again for sharing your experiences and advice x

"Thank you to you all too for being so kind and empathetic, far more than I deserve I think!" Of COURSE you deserve kindness and empathy. It's bloody shit and it's not easy. You haven't asked for this and you don't deserve it. But here we are! Well done, it's amazing that you've been able to make some better choices with your eating this week 😊 I believe you can do it!

I feel for you so much OP. I can only imagine how you must feel.

BMI may be indicative of an unhealthy lifestyle but most of us have any number of unhealthy behaviours that are not nearly as stigmatized as being overweight. I don't think it is unreasonable that medical professionnals encourage weight loss, but that shouldn't be a reason to withhold treatment - especially when age is a much bigger factor than weight when it comes to infertility.

But at the end of the day saying it is unfair solves nothing. While trying to lose weight, I would research foreign clinics specialized in recurring miscarriage and see if they also have weight requirements, and how much they cost. Maybe you have already done that though.

I hope you find someone who can and will help you regardless of weight.

I've been where you are OP (although I couldn't get pregnant so didn't have miscarriages). My GP sent me away to lose weight, and over a year I lost 5 stone. Then I got a referral, had some more tests, had to lose some more weight, and was accepted for IVF. I now have two wonderful DCs. It hasn't been an easy road, and I'll always struggle with my weight, but it was worth every bit of struggle.

Don’t delay the start of your weight loss journey OP. Once you’re on it and losing the pounds you’ll get into the right mindset and regret all those years wasted not losing weight. Even if you don’t believe it will impact your fertility do it for yourself and your mental health. My advice is join myfitnesspal.

as an aside I don’t think they do let smokers adopt.

@Drame they do sadly. You are not allowed to adopt a child under 5, and have to promise not to smoke in inside areas around them. But yes, they can adopt whilst being a smoker if those conditions are met.

As for not delaying the start of my weight loss journey- as if I haven't tried probably hundreds of times?! Literally hundreds. Every diet you can think of. Problem is I am ALWAYS hungry and always knackered so nothing lasts for more than 2-3 months. I have tried Saxenda which was like a miracle drug for a few weeks- I have never not felt hungry before, and it was the most peculiar sensation! But sadly it then caused my stomach to stop digesting anything at all, and I was having several days a week where I was throwing up everything I was eating.

No easy solution. Weight loss is NOT easy, especially when you have been overweight since the age of about 8. To do it sustainably would take me several years and I don't have that time. It would be markedly easier if I didn't feel so angry about not being treated like a slim person by the doctors.

I’m sorry you’re struggling. It’s shit, there’s no way around it, bmi is a tick box exercise for the CCG’s.

There’s a thread in the infertility board, losing weight for IVF and we’re a friendly bunch if you want to support with your weight loss.

I’m currently trying to lose weight for an IVF referral. Like you, I’m ovulating regularly, other half’s SA was normal (though my hormones are a bit off - borderline thyroid too low to treat by docs but too high for ideal fertility and elevated prolactin levels which no one is doing anything about because I’m ovulating). I’m lucky enough to have had tests (ultrasound and H.S.G) but need to lose the last bit for an IVF referral as my bmi needs to be below 30.

It is overwhelming- the pressure you put on yourself is exhausting. I struggle with binge eating when I’m not in the right frame of mind, but I just have to try and keep going.

Not really sure what I’m trying to say here, apart from the fact that I understand how hard this is. I’ve been trying for nearly 3 years and I’ve never had a positive test. it also makes me angry when you see people who really shouldn’t be parents have children or get pregnant again but you just have to feel your feelings and try to control what you can control. You can’t control the CCG requirements, you can’t control the adoption requirements, you can’t control other peoples fertility regardless of how unsuitable they might be, I know it’s heartbreaking and frustrating and makes you angry and overwhelmingly sad at the same time but you do have some control over your weight however impossible it feels at the moment.

Wish you all the best.