Fertility Network UK
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New here! PCOS & BMI for Clomid question

Hey everyone, very new here and not 100% sure how this works but have a question.. I have PCOS, we have an appointment with our consultant next week and hopefully (keeping everything crossed) will finally leave with a clomid prescription. I have a bmi of 35.5, am doing all I can to get it lower but my question is does anyone know if there is a bmi restriction/max limit before you can be prescribed clomid on the nhs? Thanks :)

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Hello 😁 I am currently in the same situation. Went to consultant last year and bmi was 36.9 and was told has to be below 30 before any intervention can happen. So frustrating! Was back again just after Xmas and bmi is 31.8 but gotta keep going until 29.9 then I can commence treatment. I'm in Scotland and I k know that's nhs Scotland guidelines x

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Heya ☺️, firstly HUGE WELL DONE on the weight loss! You’re so close 👍🏻. Secondly, thank you for a bit of clearance. Feeling a bit frustrated, we’ve been seeing the specialist for 2 years now, even though had the PCOS diagnosis at the start have had to undergo several pelvic ultrasound, and prodded countless times with needles! Hubby’s sperm all great, blood results all fine, progesterone test good, had the tube check x-ray in December and will get proper results next week but was told all looked ok. This next app is to discuss treatment routes. Thing is, we’ve had a lot of appointments with the specialists but aside from saying ‘try to lose some weight’ there hasn’t been a goal to have to work towards and I think I’m finding it hard to keep motivated when we don’t have a date or goal to work towards if that makes sense? Anyway I’m waffling so apologies but I hope you get to start treatment soon 🤞🏻X

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I feel your frustration! We are the same all bloods fine, semen tests fine, progesterone levels great, tube test clear so deemed as unexplained and I am the same all.i rally have been told is lose some weight. It is so frustrating i understand they need a cut off but I am a size 12/14 and feel such a big emphasis is placed on these numbers on the scales. I believe once my bmi is 30 we will commence iui but I don't feel very hopeful as my periods are so spotty and clotty I really believe its something to do with that but consultant disregards that so fingers crossed. I hope you get some more information and a plan when u go next. We have looked into private ivf for the future and their bmi cut off is 35 but obviously comes with a price tag x

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I know, private is so expensive! We looked at going abroad to have it done and I buy the ‘ferility road’ magazine which follows a few abroad IVF stories so it’s an option but if we can get it free would obviously rather go down that route. I agree about too much emphasis being on those numbers. When we last went back the dr said he wanted to weigh me and I said I was dreading it as I knew I’d gone up and he said ‘we have your last bmi logged as 34 and I can tell by looking at you that you’ve definitely lost weight and are under that’ - got weighed and sure enough had gone up to 35.4! He didn’t really know what to say! I’m a dress size 16 but wear a size 14 for everyday and work so I don’t feel I’m that bad but obviously I am! I’ll push for an answer this week and let you know how I get on ☺️🤞🏻 x

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I had a bmi of 32. And my nhs refused .

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Thanks for this, can I ask If they gave you a minimum bmi to reach?

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Hi, I was 31 and they told me it needed to go 30 or below. I am now 27. They say 25 is best, but apparently best chance of success is 26-27. I think 30 is standard across NHS. If you go private they don't really bother so much with weight.

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Hey, thanks so much for this, had helped massively!! Time to get super focused then! Well done for getting down to 27! 👍🏻☺️. I’m going to ask our consultant what goal he wants me to get to and just try to push myself to that point. Having a child should be the best motivation but I keep slipping :( x

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Sorry forgot to say, these weights are for fertility treatment but I think clomid falls within this, if it's all on NHS? I did clomid for 3 months but went through private on this as NHS were incredibly slow and we were getting frustrated. Did 1st icsi on NHS though and I had to get below 30. What are you using to lose weight, I found slimming world great, lost all the weight and kept if off. Now I use Nutracheck to maintain. It's also excellent xx

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were heading down the nhs route, have felt a little frustrated with how long it’s taken to get to this point BUT we’re so lucky it’s free & I know the nhs have a huge demand & not enough resources so keep myself in check :). I know regardless of what treatment route we go down I’ll benefit greatly from getting my weight & bmi down to the recommended range so need to stick with it. To start with they put me on orlistat which helped me lose around a stone but it’s not a long term fix so I stopped taking it. The only thing that seems to work for me & that I’ve seen results with has been a diet of no gluten, no dairy (no cow dairy), high protein, low GI, minimum carbs (only with 1 meal and a small amount) but i find it incredibly hard to stick to as I’m somewhat limited to things I can eat 😬. Each time I’ve stuck to this though I’ve lost a lot of weight, I just find maintaining hard. I’ve heard great things about slimming world but I don’t know anyone with PCOS who has used it so I’m a bit on the fence! Anything is worth a go though. Would you say slimming world is better than weight watchers? How was clomid for you? X

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Yeah I went to weight watchers and it didn't work for me. Much prefer the freedom of slimming world, you can eat so much and still lose weight. Clomid didn't work for us, but we have small issues for both me and my husband (he has poor morphology, I have possible blocked tube) so I don't think me ovulating was the issue. If you can be 100% on slimming world, I think you will lose weight which will help with your PCOS. I agree your diet is quite restricted, and you just need to ensure that when you do get pregnant you get all the right nutrients. Dairy affects oestrogen production, so could well be a good thing to cut out. Sometimes it's more about the willpower than the food! I do wish you well, I'm so glad I lost weight - I just feel like I have done everything I can to help our struggle 😊 x

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I think I’ll give slimming world ago, we’ve made so many lifestyle changes and I even changed jobs to reduce stress, I just need to sort my weight out! Did you do online slimming world or go to the group meetings? I really hope everything works out for you x

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Hey, I went to the meetings. I tried online but it didn't work. I needed the weekly motivation!

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I suppose as well the benefit of going to group sessions is you definitely want to see a loss on the scale rather than a gain! :) thanks so much x

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They asked for 30 or below. I actually got to 30.9 . But they still told me to wait. The stress, anger , time wasted, guilt all emtionals at that point made me put more weight .So I had to make my mind up to go private.

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Really? Even though you were only .9 off? I guess they have to be strict but after all the hard work you put in that must be quite a blow! I’d have put weight back on as well! I might re-look at the costs for private and see if we can stretch it. I’ll see what the outcome is of our app this week 🤞🏻 X

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Yea my part of London is very tough. The whole journey with them was a series of emtional blows. From the beginning I didn't like the way they treated me. They always made me feel like a number and it was all about numbers. But your really doing well so far . I hope you get the outcome you want . An all the best

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I’ve been through pretty much same procedure , BMI was 35 got it down to 32 and struggling now I’ve had clomid for 6 months on NHS and it made me ovulate but nothing happened for me ! So it was a waiting game to bring my BMI down but I feel it’s more about the money when it comes to NHS as she told me if I can’t reach my BMI by April then she will price the drugs for me !!! My doctor feels they are being harsh as I have an active healthy lifestyle and the same size 14 but they won’t approve it until I’m under 30 so we have made an appointment with private clinic which is this Thursday I’m looking forward to it !

But u can have the clomid in the NHS with ur BMI at 35 x

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Thanks so much for this, really helpful information. I guess my worry is I was told you can only use clomid for a certain period of time so I want to make sure I’m in the best place (physically and mentally) to make it stand the best chance of working but I worked it out last night and to lose the weight I need to lose it’s around 4 stone and I’ve never lost that much in one stint before. I’m worried about how long it will take but also the mental stress of needing to lose that much (when I do pig out it’s usually stress related!). Thing is if that’s the only option I have to make it work. Our app is Thursday as well :) huge good luck and fingers crossed for both of us 🤞🏻🤞🏻🤞🏻 X

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I’ve lost 3 stone but this last stone is not for leaving me been 9months at the same weight and joined the gym n everything so I’m opting to go private and biting the bullet lol

Yeah I was told 6months on the clomid I started on 50mg and they take ur blood to make sure it’s working and I was upped to 100mg and it definitely worked for me but still didn’t achieve a pregnancy so we will see what Thursday holds !! Good luck x

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Good luck to you too :) x

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I know it is frustrating and really so hard to lose weight but part of the reason they want the BMI lower with PCOS is that fat tissue also produces sex hormones which contributes to the imbalance in PCOS. Maybe invest the money you are considering for private into either slimming world or weight watchers and continue along the NHS route? I lost 10% of my body weight with weight watchers (over 6months) and keeping it off- I used online only as I could not get to the meetings but meetings(of any group)are proven to help with weight loss. The WW app has a little online community too which is helpful. I have had friends lose with slimming world too. Your previous diet attempts sound super restrictive and not maintainable for anyone!! Wishing you lots of luck. Losing weight is a slow journey so don’t get disheartened- it normally takes about 12 weeks before you notice the difference.

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I agree, the bmi guides are in place for a reason. A lot of NHS trusts now only give one go of ivf for free (and some give none) so really I think they are super restrictive because they really want it to work for people. I found my NHS cycle a lot better than my private cycle, unfortunately when you go private you can sometimes feel like another cash cow for them so don't assume you'll get different treatment because you're paying a ton of cash. I would suggest talking to your consultant and ask them to explain exactly why you need to lose weight, they should be able to give you stats as well. It might be the focus you need to come to a decision about which way to go xx

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Hey, so an update from the app today, got weighed and my bmi is 35.1. We’ve been prescribed metformin and clomid, literally so happy! I’m starting the metformin tomorrow and building up the dosage over the course of a couple of weeks and keeping to the healthy eating then we’ve agreed with he consultant that we’ll start taking the clomid in March when my new cycle starts that month 🤞🏻X

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