# BMI question



## hle

I have been told by my gynaecologist that they have now completed their tests and due to my husbands sperm count being low our next stage is IVF. The consultant said I need to call her when my bmi is 35 and she will refer me for IVF. I questioned her on this, thinking it needs to be a max of 30 and she said it was fine. Does this mean there is discretion for NHS funded treatment or does it mean it gets me a referrAl, but once there I will be told to bring my bmi down again to under 30? I did have a bmi of 47.5 and it's now 42.5, however just to get it to under 35 I need to lose another 3.5 stone, So the prospect.of being told.my the IVF people I need to lose even more weight will be soul destroying! Does anypne know how it works? X


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## DollyBlueBags

Hiya,

My BMI is 38 and I was referred by my GP to the fertility clinic, and they saw us. The BMI limit for treatment if you are a private patient and self funding is 35 but if you are staying as NHS patient then BMI has to be 30 for treatment. 

Thats at my clinic anyway xx


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## smarla

Hi there

My GP referred me straight away even though my BMI was over 39, but the fertility specialist confirmed I'd need to be under 30 for NHS treatment.  The limits are set by your CCG, so you should be able to find it online, with the full NHS criteria.  Each area can be slightly different as a friend had to be 29.0 or lower.

As mrs peach said, privately the limit is usually 35, but it could be lower as each clinic sets their own limit.

Well done on losing so much weight so far, that's brilliant work!  xx


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## hle

thank you everyeveryone. The gp referred me right away as we had been trying so long and gynaecology said they will refer me on to the fertility clinic when I get to 35.

Will the ccg relate to my drs surgery, the hospital where I've been referred from I.e gynaecology or where I work be having treatment as that's two or three separate ccgS and want to make.sure I get the right one.

Are they pretty strict with the bmi on the NHS? I hoped there might be some discretion. I undoubtedly nerd to lose a significant amount of weight. However to reach a bmi of under 30 I would need to lose another six stone and I think I would be too thin!!!


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## smarla

I'm pretty sure the CCG is literally your postcode, where you live, regardless of where your GP or treatment is.  Your GP should be able to confirm though.

Unfortunately they are very strict.  My specialist said if they find out you weren't 30 or under when referred they'd stop treatment and send you the bill!!  Not sure how serious he was...

Now that I've been approved for funding the nurse said it was really important not to go back over 30 as they can weigh you at any stage.

Sorry that I can't give you any better news


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## smarla

Whoops, hit send too soon, silly phone!!

There is a weight loss board here which is really useful and supportive.  I've tried a lot of different diet and exercise plans so always happy to chat about what worked for me.  xx


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## Lilly83

Hello

Yes to confirm your CCG is the one your gp surgery is under, my NHS clinic refuses ladies until they under 30 but like said do check with the CCG just incase yours is different but 30 tends to be the norm 

Good luck 

L x


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## DollyBlueBags

Hiya sorry but yes they are very strict. I had an appointment canceled by the fertility clinic because I was over 35 still, they decided to weigh me at the pre op! 

I know it's awful and it's another load dumped on your shoulders but if your an NHS patient you must be 30 or under. One of my closest friends has been on the fertility departments books for over 3 years now, she just can't loose the weight. We're at the same clinic and they point blank refuse to test anything until she's the right bmi x


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## Poppy41London

Hi there, I don't qualify for NHS treatment due to being over 40 and living in London but I wondered if any of you know if there are any clinics that will treat you privately with a BMI higher than 35? I am aiming to get under that but age also being an issue it's a dilemma because it takes time. If anybody knows of clinics that are a bit more lenient on the BMI front providing the woman is healthy and reasonably fit, I would really appreciate knowing which ones they might be. Thanks!


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## staceysm

Poppy,

It really depends on the clinic.  My BMI was 37 and the private clinic were happy to treat me, but when I was scanned, it was really hard to get to one of my ovaries, so they refused to continue until my BMI was under 35.

I can't recommend slimming world enough.  You can lose a stone in about 3 weeks.

X


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## Poppy41London

Hi Stacey, thanks for that info. When I was scanned I was told it was hard to reach one of my ovaries too but they said under sedation it would be possible but she didn't want to hurt me during the scan.

I have been losing weight on a special nutritionist protocol of 1000 calories a day in addition to the gym 6 days a week. It's just that it takes time and I am 41 so it's the issue of age vs weight. I pretty much tried every approach to get weight off before this but I have borderline thyroid issues and my body seems only willing to let go of weight when my calories are very reduced and I am doing loads of exercise. Effectively it's like I am doing one of those shake diets because I burn 500 calories each day at the gym so I am only taking in 500 calories per day after you subtract the exercise, but at least I am getting fitter as well at the same time. I will just press on for now and hopefully get to the desired weight later this year.


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## Calluna

Hi Poppy,

Do you know what your actual numbers are from thyroid tests? Or has your GP just said it's borderline? Your TSH needs to be under 2.5 (ideally around 1) for trying to conceive (and TSH doesn't always tell the full story) but most GP's think a TSH up to 5 or even 10 is ok. If you don't know the numbers it would be worth asking your GP for them and maybe getting retested. If it turns out you actually have a more significant thyroid issue, treating it might make losing weight a lot easier and remove a possible barrier to getting/staying pregnant.

Good luck and well done on sticking to that diet and exercise regime - sounds tough! xx


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## Poppy41London

Hi Calluna
Yes I have my thyroid results, the GP was useless on every front (!) but my fertility nutritionist suggested I get the full thyroid profile testing done privately which I did and she went over the results with me and advised what to do. My TSH is currently 2.3 which is down a bit from last year fortunately but some of the other numbers are also borderline and with a family history of thyroid issues and loads of the symptoms I know it's an issue for me and she believes so too. I am now taking natural thyroid tablets (the ones made from animal organs - yuck!) and it seems to be helping a bit but I have had to increase to the highest dose to keep feeling improvement in my energy etc. GP flat out refused me medication as said no issue whatsoever. But then they also said vitamin D has no bearing on fertility and did my hormone tests on the wrong days too - but they are the best in my area so just have to accept that v little help can come from GP.

I also was diagnosed with PCOS in my 20's which obviously contributes to difficulty losing weight and I used to have a lot of cysts on my ovaries but they're all gone now so the consultant at Hammersmith said I don't have PCOS. I did query this and said I thought it doesn't go away and that you can have the syndrome without the cysts but he just said no you don't have it. Great if I don't but I suspect I do. Always had normal cycles though which is at least good. The problem is I have found when you are overweight most medical professionals just don't believe you when you tell them what you eat and how much you exercise. I am willing to do whatever it takes to lose weight but it would be nice to get to the underlying reason why it's so difficult but  I am resigned to that not happening and just working with what's in my control. 

I am throwing loads of supplements at this too and i am happy to continue on 1000 calories a day if it continues to get me results. I just wish it were quicker but hey ho got to work with the situation.


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## Calluna

Hi Poppy,

Sorry I haven't replied sooner - I couldn't remember which bit of the forum this was posted on! 

After lots of scans showing I had normal ovaries I had one scan where the doctor told me my ovaries were polycystic and I had 46 antral follicles (it had always been about 18-20 before). That was when my thyroid was at its worst. Now I'm being treated for the thyroid (although it still isn't quite right) and my ovaries are back to normal. I did some research and there are several recent studies showing that an underactive thyroid (even at a level they would consider sub-clinical) can cause an acceleration of follicle recruitment in the ovaries, causing them to become polycystic, but that treatment with thyroxine can restore a normal rate of follicle recruitment so that the ovaries are no longer polycystic. I've yet to find a doctor who's familiar with this research though. My consultant says you either have polycystic ovaries or you don't and that it doesn't go away (even though he scanned me and said I don't have it and I have a previous scan report which says I do!). I've seen other ladies on here who have been told they do have it on one occasion and they don't have it on another occasion, who also have thyroid issues, so I think it's actually quite common for it to come and go depending on how well the thyroid is functioning. 

I'm seeing another doctor now who is investigating possible underlying issues that might be affecting my thyroid (adrenals etc) so I'm hoping to improve my thyroid treatment. Is it armour thyroid you're taking?

Sounds like you're doing everything you can to sort out the thyroid and get the weight off. Hope the diet goes well. It's amazing how disciplined we can be when we really want something! xx


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## Poppy41London

Hi Calluna

Sorry for the delay in replying to you and thanks for taking the time to respond to me on the thyroid issue. It sounds great you have found a doctor who is willing to investigate your adrenals and sees the link between adrenals and thyroid as there is a lot written about that when you start researching it. Is that on the NHS or private? I hope whatever they find out helps. All of this is such a minefield and you get so much conflicting advice or opinions it can be quite confusing and that's before even beginning the fertility process!  

Anyway, I hope that things will work out for both of us! Keep me posted. Xx


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