How can I get my GP to help?

[EmTTC]

Been trying to conceive for over a year and a half now, and all my GP says is 'try loosing weight and see after that' but I know my weight isn't my limiting my ability. What can I do to get my GP to take me serious and actually looking into the route cause of all this. I'd like to try medication but don't even know how to go about this. I'm actively trying to loose weight, but how long till they do something?? Starting to loose a hope now.

How old are you op? Is it possible for you to speak to another GP at your practice? How long have you been trying to get help from the GP?

Have a google of the assisted conception policy for your local ICB (integrated care board). That will stipulate requirements before you are able to access more help. Typically it's a certain BMI, not smoking etc

I'm 27, 28 in March. I've been trying since February to get some help, they sent me for an ultrasound which they found a small cyst on my right ovary, but that's all I was told. I request another appointment after that to which they just said loose weight first. My GP really only has locum doctors, so I'm unsure if I even see the same one twice

For under 35's where I am you need to have been actively trying without success for 3 years to access NHS help I'm afraid. Might be different where you are but check your local policy

If you're under 35 and have a BMI over 30 you may be better off seeing someone privately and asking to be prescribed clomid.

Otherwise you're unlikely to get anywhere with the NhS for a couple more years.

I believe that because you are only in your 20s and have “only” been trying to conceive for 18 months (I am using only in its loosest terms as each month without a positive seems like a knife to the heart), they will go down the lifestyle route first. So things like weight, health habits etc. You say you know that your weight isn’t affecting your ability to conceive…is that because you aren’t overweight? A couple of my friends were only a couple of stone over their recommended NHS weight and struggled to conceive. They both lost the weight and conceived within 9 months. Of course, for every story like that, there will be others where it has no effect.

Until you have been trying for longer or have made the lifestyle changes recommended by the doc, that then don’t have any effect, the NHS won’t get involved yet. If this is an urgent process for you, you might need to consider a private consultation.

This is what I was afraid of. How would I get seen privately? Is this just something I can book for myself at any private clinic?

What's your bmi or weight?

How overweight? If a lot it would be inappropriate to help you conceive due to the additional risks to you and the baby. Is your partner older? The Dr's will not be interested if you are in your 20s unfortunately.

@EmTTC just use google and search for clinics near you and find out how you access their services.

There are very strict criteria for who the GP can refer for support conceiving on the NHS, including BMI, age, how long you have been trying. These differ by area so check what they are in your area. Your GP may not be able to offer anything further until you have lost weight, but maybe should have communicated that more clearly.
However even if they can’t refer I’d expect them to do some bloods including thyroid if you are struggling to conceive - have you had this done or asked directly? Has your partner had sperm analysis done - this may need to be privately if you don’t qualify for NHS fertility treatment.

Honestly at your age and just ttc for 9 months, you're unlikely to be referred by any Gp until 18 months minimum.

In the mean time don't underestimate the benefit of loosing even a small amount of weight. I wasn't massively overweight but when I finally got in the headspace of losing some weight I conceived the first month even though I had lost about 10pounds.

I don't know about your areas guidelines but here high bmi does not stop a referral to nhs fertility services but does limit treatment option we was trying for over year and just turned 30 my bmi is above 35 my Gp referred is but we both had to have individual appts with our Gp prior to referral. We were seen by fertility and all testing was carried out on both of us inc blood sperm sample and ultrasound we had no significant finding and was told unexplained infertility therefore would only be appropriate for ivf but I would need to have a bmi of less than 30 so that was the plan anyway after 3 years of trying we go a shock in august as we are now 19weeks pregnant no ivf needed

Do you have pcos?

Just go private.

I've been tested (very briefly) for PCOS, all my bloods came back fine and an ultrasound showed only one cyst, so no evidence of multiple cysts.

My cycles are a mess though, they fluctuate between 19 days and 35 days, and have been like this since Feb.

I know my weight doesn't affect my fertility as I have previously been pregnant but unfortunately wasn't in the right mind frame and was very young. I know I need to loose weight, but hate that nothing will be done until I'm a 'certain weightI'

Weight does affect fertility, otherwise your Dr wouldn’t have recommended it.

you haven’t said what your weight or BMI is, but people with a BMI of 30 or less get pregnant more easily than those above.

good nutrition also makes a huge difference, so over to you what you decide to do

I don't know my bmi, I don't weight myself as I don't have a healthy relationship with myself doing that. But I was a lot heavier when I fell pregnant then compared to now, so wouldn't think that it would effect me TTC as much as it has.

I also have what I would say as a good nutrition, I'm vegan so I am very aware of my health and nutrition, ensure I get enough protein and take supplements to help as well.

I'm currently on antidepressants which a side effect is weight gain, but I am trying to loose weight.

Has your partner had any testing OP? Such as sperm analysis.

NICE guidelines say that investigations should start after 12 months of regular intercourse, and I think they recommend what your GP should do before referring you.

I know locally you won't be accepted for IVF etc unless your BMI is less than 30, but that doesn't mean they shouldn't do the investigations regardless

Does the GP know you've been pregnant before?

Previous pregnancies will also slow the referral process.

Was that with the same partner? Does your current partner have children?

Given your age and that you say you're overweight you are going to have to lose it to get any help with fertility.

Did you know your weight at the time you saw your GP? Otherwise I’m confused why they would tell you to lose weight without knowing this.

I went to my GP after around 6 months of trying, but I do have PCOS and so that is what is recommended (had also tried for almost a year a few years before but stopped due to job change). I have a high BMI. I wanted to try Clomid. I had been using ovulation strips but never had a peak. GP said first plan of action was for my partner to have his sperm checked before anything else would be discussed. Little did I know I had actually conceived a few days before my appointment and was pregnant.

I would definitely try and focus on losing some weight and exercising (if you don’t already). I had been exercising in the few months leading up to me falling pregnant and lost around a stone. I believe both helped me to conceive. Even some private clinics will have criteria such as BMI having to lower than x amount. I know you said you had an unhealthy habit of weighing yourself but if you do refer yourself or get any further with your GP they will ask you for your BMI unfortunately.

good luck!

Just because you fell pregnant when (a lot?) younger and more overweight, it doesn’t mean that the combination of your age and weight now isn’t contributing to your fertility issues.
I don’t think there’s anything you can do to get your GP to help if you’re not in a place where you can find out your weight, share it with them and take steps to reduce if needed. Even if your BMI isn’t the cause, you still won’t be eligible for referral if it’s over the criteria so there isn’t a huge amount the GP can do.
It might be worth having a chat with them about your antidepressants though - do you have a plan for if you become pregnant? Especially given how long it can take to get a GP appointment that would be something to discuss before you become pregnant, not just after.
Also be aware if your BMI is over 30 you’ll want nigh dose 5mg folic acid, presume you are already taking pre-natal over the counter dose.