# Weight requirements for IVF - NHS -v- Private



## Angel4 (Nov 25, 2004)

Hi Girls

This may have been posted elsewhere but I can't find anything on it.  I wanted to know why the NHS require you to be a certain weight when having IVF and Private clinics don't put such a pressure on the weight issue.

I am 5kgs over the maximum weight allowed for IVF (I have lost 10kgs already).  The NHS hospital won't see me until I lose the 5kgs but when I called Hammersmith Hospital and said I wanted to come in as a private patient, they said that it would be nice if I could lose another 3-4kgs but it didn't matter.

Is it to do with NHS stats?  Really confused and becoming very despondant as I can't seem to shift the extra pounds now!

Has anyone else experienced an IVF treatment (when they were over the weight requirements) which has resulted in a pregnancy/birth.

Thanks


----------



## Dobby (Oct 23, 2005)

Hi Angel4

A subject dear to my heart... since I am very much more than 5kg over the weight for NHS treatment.

The reason why most PCTs (but not all, apparently) restrict IVF to only those who are of an ideal weight for their height is to do with the NICE (National Institute for Clinical Excellence) guidelines for fertility treatment, on which most NHS fertility services are based.  Obviously, being NHS treatment, they want to provide treatment which is not only cost effective and value for money but has the best chances of success.  Charmingly, adipose tissue (the medical word for fat!) produces oestrogen, which can mean that ovulation is restricted in ladies who are very overweight - and if they lost weight, ovulation would return.  So in order to avoid treating people for whom this is the situation (because fertility would return naturally if they just lost weight) NICE recommends that people be the ideal weight for their height prior to starting treatment.

However, a number of clinical studies recently have apparently found that weight and the fat-producing-oestrogen thing is actually far rarer than first thought.  And in women who are ovulating normally each month and have fertility problems for another reason (or even unknown reasons but not ovulatory) Body Mass Index has far less effect than they initially estimated... in many cases, it apparently has no effect whatsoever.

I did read somewhere that this aspect of the NICE guidelines may change, or become less restrictive, but this won't happen until the guideline is reviewed in 3 years or so.  Until that time, it is likely that NHS treatment will be restricted to those who have a BMI of 30 or less.

However, I have had 2 IUIs and now IVF at a private clinic who have never once mentioned weight issues - and I am a not-so-svelte 6-stones-at-least overweight... and so are a fair number of people I see in the waiting room who are ladies of not-so-svelte proportions!!

Having said that, although I am overweight, I am really quite healthy in general.  I am sure if my weight had actually been affecting my health they may have said something.

I think the decision as to if to lose weight or not is more complex than just to say you need to get down to a certain weight.  It would have taken me a fair while to lose weight enough to reach the ideal weight, and at the age of 40, the time that would have taken would have meant that my overall fertility decreased significantly - as well as the fact that I am stressed enough over treatment without needing to worry about anything else.  So for me (excuses, excuses) I actually feel I have a better chance just going ahead at my current weight, than I would if I took the time out to lose it!!

In addition - I used to be a midwife, and saw many women who were larger ladies who had had IVF successfully, as well as those who conceived naturally of course, and they seemed to have just as happy healthy pregnancies as the skinny beans!

Best wishes to you... but don't get stressed over your weight.  Try ringing around a few more clinics and see what they say.

Dobby.


----------



## Angel4 (Nov 25, 2004)

Hi Dobby

Thanks for your message - this is very interesting and thanks for taking the time to write in detail.

I called my consultant's secretary today and asked her to ask him my question re the weight loss issue and NHS -v- Private.  Without even asking him she knew the answer in that whether I go private or NHS with him then the requirements are the same.  He feels very strongly about women with PCOS and getting pregnant (i.e. problems associated with pregnancy if you have PCOS (diabetes, HBP etc)).

I know for my health sake that I need to be a reasonable weight whether I fall pregnant or not but this has been going on for 8 years now.  I feel I have wasted so much time over the years.  I am now 36.  I fell pregnant naturally last year but m/c'd at 20 weeks which was devastating.

I am being more positive (well trying) and have decided to really have a look at the whole picture.

Thanks for your feedback - it helps me understand a bit more.  I am going to send you a PM.


----------

