IVF rejection - BMI

[MrsACC]

Unsure where to start here, apologies if I waffle.

my OH and I have been trying for 4 years now, no success, overall in my past long term relationships (x2) I have never been able to get pregnant.

We sought support through IVF, got rejected before we got anywhere due to my AMH being low at 5 and my BMI being 40.

I am consistent in the gym, 4x a week, in a calorie deficit, lift heavy weights (which I enjoy), have PT support and unfortunately stand at 4ft11. We are unable to access IVF or any fertility treatments via the NHS as my OH already has 2 kids, we are fortunate enough to be able to afford to pay privately.

I can’t help it but I feel so so super low since that appointment, when we left the clinic, I left feeling like I was the size of a whale by the way the consultant spoke to me. She suggested a cocktail of supplements, some of which I was already taking, as well as the name of a recommended weight loss surgery consultant and the name of an website where she recommended I purchase weight loss injections.

Is there anyone else out there going through similar issues?

I do understand that the chances of conceiving are higher at a BMI of less than 35 and the risks of pre-eclampsia, gestational diabetes and so fourth are much less, but I am now at a point of no hope and severe depression. I am 37 now and feel like I’m rushing against a ticking clock. I’m exhausted of constantly wondering if I will ever be a mum or will I forever just be the “Aunt” to all my younger friend’s and siblings kids. Completely feel like a failure.

So I had to lose weight for IVF (to get my BMI under 30 for NHS referral). Honestly, if your BMI is 40 then for your overall health it would be worth looking to lose some weight.

How did you work out your deficit? If you're in a true deficit then you would be losing weight (the gym is awesome btw, so keep at that - but fat loss really happens mainly in the kitchen). Different people may have different reasons why their deficit needs to be bigger or smaller but the thermodynamics is still there.

I used Mounjaro to lose a chunk of weight quickly before slowing it down and losing with a calorie deficit only, would that be something you'd consider? It has also generally made me just feel a whole load better, reduced inflammation etc too.

@MrsACC it could be worth spending 6 months to a year taking the injections and continuing your good work at the gym in order to reduce risks to your baby. Plus sharing a breakdown of your typical daily intake with a nutritionist to see what easy sustainable changes could be made.

I've seen that the Lister doesn't have a BMI limit btw - they review patients on a case by case basis.

Hi, I would recommend fat positive fertility ( https://nicolasalmon.co.uk ) and the heavyweight midwife ( https://theheavyweightmidwife.com )
for some reassurance around higher weight and fertility/pregnancy. The fat positive fertility website also has a list of clinics that will treat higher BMIs. The clinic I used, Thérapie Fertility, doesn't have a BMI limit at all, is more affordable than a lot of UK clinics and we had an amazing round with them this year. I am not a medical expert (but the heavyweight midwife IS) but I wouldn't recommend waiting and losing weight first as we will never be younger than we are now and as far as I know age is the biggest factor more so than weight. A 20 year old with a BMI of 45 probably has a higher success rate than a 40 year old with a BMI of 25.
But of course you can discuss your exact situation with these professionals. Good luck! 😀

Hi @Moosey898
I think I may have gone into this with a silly understanding that they would review my case based on an understanding of my height.

I have lost 2 stone in the last 6 months, however I think I may have reached a plateau. I worked it out with my PT at the start of taking my weight loss seriously. Previously I used the gym mainly for my mental health due to the type of job I do (it’s needed!) I am pretty good with my food intake, high protein, good fats etc, being lactose, gluten and wheat intolerant has been helpful towards the weight loss too.

I am worried about taking Mounjaro as I have a few friends and colleagues who have drastically lost weight and suffered severe side effects, I think I am just quite scared of those effects. But I am now considering it.

@sirensong that is a consideration I am now thinking of taking. Is it also silly of me to say I feel panicked, I almost feel as though 6 months is too long a wait, maybe I’m just being impatient. Seeking nutritionist support is a great idea.

Ah unfortunately BMI "takes account" of height. I should also have prefaced that I hate that BMI is used as a hard "no" for treatment, I think it's daft.

Wth my BMI, the low end of my supposedly healthy range is 4kg less than my lean mass alone 😂 so I know realistically my "healthy" BMI could be 27/28.

Congratulations on your two stone loss, that's awesome. Did you adjust your deficit after the loss? Sadly lower weight means you need lower calories (seems exceedingly mean but there you go). I also love the gym for mental health, it's so good.

If it helps at all, I have had zero side effects of Mounjaro and a sensible weight loss. I just had to really prioritise my protein and fibre in my meals, and plan my food in advance so I don't leave anything to chance. That way I continued eating properly, just less.

@MrsACC it's not too late for you at 37/38. You are doing exactly the right thing by making a plan of action now and it will help you to feel less panicky by getting started and seeing yourself make progress.

You could pursue everything in tandem to get everything lined up and use time well - get your full fertility details if not already known, get your partner's semen analysis done, see if your GP will do a total bloodcount and fasting glucose & insulin/cholesterol panel to check for anything out of whack, ditch all processed carbs and have half a plate of vegetables every dinner, do injections for a few months, continue at the gym and do your steps every day etc.

Hey, no major advise but i just wanted to say i'm so sorry they made you feel like that. BMI is such an outdated tool and yes losing weight may help fertility and how your body copes with pregnancy however it’s not the majority. Welldone for all the hard work you have done with PT.
Have you looked into going abroad for treatment? There’s a lovely lady on tiktok who had a high BMI & maternal age and went aboard for her treatment ( i’ve attached screen shot of her account) and had success. Really recommend looking at her page for support. Good luck x

Her name is KatelVFMumOver40 won’t let me add the pic x

@Waitingforday6 thank you for the suggestions, I will have a look into those. I definitely agree that age has a higher factor. I feel quite overwhelmed as well as under pressure. We spent the weekend with OH’s family this past weekend, I felt so out of place as everyone had their kids there and I was left out of conversations surrounding parenting, pretty much felt like the odd one out, more lonely too.

I do think weight loss will help very much further along, in terms of having a healthy outcome if we are to be successful. I’ll have a look into all your suggestions.

@Moosey898 I loath BMI, it’s something we bang on about in my job so much it’s exhausting. Realistically if I had my father’s genetics my BMI would be 30-32 🥲 but alas my mother’s genetics said not a chance!

Thank you, it’s been a tough but enjoyable journey, still have a long way to go but I am trying to be positive. I haven’t adjusted it yet, my current deficit based on activity is 1600-1750. Possibly need to lessen it to 1500-1600 now.
I love shutting down in the gym and having a blank mind even if it’s just for an hour.

It helps to hear positive things, I guess if I continue being as sensible and healthy with the addition of Mounjaro I hopefully won’t have any side effects.

@sirensong I do try to remind myself that it’s not too late, however the pressure I feel from work colleagues, my mother and society in general is exhausting. I must admit, it also doesn’t make it easy seeing friends who try for a week/ month and get pregnant just like that when I’m staring at 4 years of exhaustive effort. I try not to be jealous, however I am only human, but I will say I am always supportive and pleased for everyone.

Getting my full fertility details has not been easy, my GP is a bit rejective as she is aware my OH has kids already, so they are immediately rejectful of anything to do with fertility for myself. We attended a clinic and payed around £1500 in total for semen analysis, pelvic scans and bloods, I don’t think they did a complete blood panel for me as the consultant couldn’t even tell me much when I asked questions. My OH’s semen analysis wasn’t great, his sperm motility is low. We felt robbed. We both came away quite defeated.

No problem, I found the resources quite eye opening in a good way (and we've all covered how ridiculous BMI is as a tool in the first place).
37 is definitely not running out of time territory in the IVF world (or in the non-IVF world) although I understand the pressure! I just meant you might find there was no reason to postpone particularly because it sounds like you live an active and healthy life. 🙂 If you do feel you would like to lose weight first but are nervous about timings you could also do a freeze all cycle and transfer whenever you feel ready, that might be the happy compromise. 😀

@Readingiscool92 thank you. I think weight is made to be such the central focus and it almost feels as though once I am down to the right BMI I will magically get pregnant, the impact it appears to have on couples is unhealthy.
Thank you. My OH is not keen on going abroad, he lacks trust, plus working out annual leave in my job would be a nightmare, but I have a couple of clinics that have been suggested by colleagues in mind. I think it’s worth a try and much cheaper than the price we are facing here in the UK.
I’ll have a look at her page, thank you xx

@MrsACC your GP will do a total blood count, lipid panel and fasting glucose/ HbA1c if you say it's for general health checking. Your partner can improve his sperm quality through a healthy diet, limited alcohol and antioxidant supplements for several months (something like Wellman Conception is fine). Do you know if you definitely ovulate?

@sirensong apologies for my delayed response.
Thank you for that suggestion, I will request that. We have both been trying to improve our selves with supplements and a good diet for the last 6 months. Maybe we need a little longer?
yes I do ovulate, it was confirmed at the clinic, my egg reserve is however very low, apparently of a woman aged 46-54 🙃.

My husband and I have been TTC for 3 years (I'm 36, he's 38). After a year, we went to the GP and found out that he had 0 morphology - we also have to do at home insemination because he can't ejaculate with intercourse (but can in other ways).

We were referred to a private fertility clinic Summer of 2024 and I was told that our BMIs would need to be below 29.9. I went on the 1:1 diet and lost nearly 5 stone - DH has lost about 1.5 stone. We were weighed in February 2025 and then had to keep it off for 6 months - reweighed in August and then had an appointment in September to submit all the paperwork for NHS funding. It was approved in 3 weeks. We had push some appointment back as we were on holiday in October - we then decided to wait until January as both of our jobs were busy and stressful in November and December.

I'm due on my period on Friday and will be starting a short protocol.
Losing and keeping the weight off has been hard and I've put on a few pounds over Christmas 🙈 which I need to lose.

I definitely would not recommend weight loss surgery - if you're removing so much of your stomach, how are you going to be able to eat enough to get the nutrients to your baby! If you're wanting to lose weight quicker, I think reduce your calories even more. I did 800 calories per day, on a meal replacement (1:1) - previously I had done Lighter Life which is 600 calories per day meal replacement and it dropped off me (I was in my mid twenties at the time mind you).

From all the tests I've had done, no issues have been identified with me. But IVF, specifically ICSI is going to be the only way I'm going to get pregnant because of his morphology. It's been hard going - every single one of my friends has fallen pregnant and given birth in the time I've been TTC.

Good luck - you'll get there in the end. Keep trying every month anyway - you never know when it will happen x