Having a healthy body mass index will improve your fertility health and if you need IVF treatment your BMI must be between 19-30. When Jenny and Ben from Norfolk were told they needed to lose weight for IVF they took up exercise and healthy eating – and found the benefits ‘amazing’.
Started trying at 20
“I came off my contraceptive implant after we got engaged when I was 20, and we thought we would see how things went,” says Jenny. “I have always had really regular periods, every 28 days on the dot.
“When we hadn’t got pregnant after three years of trying we thought ‘something is wrong here’. I went to see my GP, who organised a few tests, and after that we got a referral to the subfertility clinic at the James Pagett Hospital.
“I had various scans and tests which found that I had cysts on my ovaries, and Ben’s sperm test at the time revealed low morphology. The hospital put me on clomid but I still didn’t get pregnant.
Getting fertility fit for IVF
“We were told our next option would be IVF but we had to both lose some weight before we could be referred for NHS-funded IVF. I think my BMI needed to be under 28 and I was just over so we started Slimming World and I managed to get it down to 26; Ben’s BMI was about 38 and he had to get it under 35 so it was only a little bit of weight we needed to lose. It took us about six or seven months to get it down.
“I bought the ‘Pinch of nom cookbook’ and Slimming World cookbooks and we had treats, but I cooked from fresh every day and we didn’t restrict ourselves, so if we wanted a takeaway we had it but then obviously we had to be good the next day!
“This was all in 2017; we had a lot going on – I changed jobs to work in a children’s nursery, we got married, and we were trying to get fertility fit for IVF. The wedding was a welcome distraction and it was nice that I lost weight for that too. I did the ‘Couch to 5k’ which really helped with my mental health and I would go off every morning by myself for a run.
“We also started taking loads of vitamins, Ben went on zinc and vitamin D and we had acupuncture.
Freeze all provides break in treatment
“In 2018 we went to an open evening at Bourn Hall Norwich and then I had to have a smear test before we could start treatment. When treatment started in early 2019 I produced a lot of eggs – 26. Initially we had thought that we would need ICSI treatment but Ben’s sperm sample at Bourn Hall was better than before so the eggs were fertilised using IVF. After day five we had seven embryos. They all had to be frozen, though, because I had OHSS and had to have a break in my treatment.
“It was disappointing but I was just glad that we had our embryos and that they had been frozen and were okay. We had had a ‘freeze-all’, which meant that we were entitled to three NHS-funded frozen embryo transfers.
“In September 2019 we went back to Bourn Hall for a frozen embryo transfer, which unfortunately failed. We were due to go back in February 2020 for a further FET but then Covid happened and everything was delayed. We eventually went back to Bourn Hall in September 2020 for a second frozen embryo transfer and a slightly changed protocol, but that didn’t work either.
“For our third frozen embryo transfer in February 2021 Bourn Hall changed my protocol completely, put me on a different drug and transferred two embryos instead of one.
The longest wait
“I woke up on the day of the pregnancy test at 4:30am and I went to the toilet and did the test. When it was positive I just didn’t believe it at first! I woke Ben up and told him; his face was a picture, he was half asleep and was like ‘OMG really?!’ And I said ‘yeah!’
“I contacted Bourn Hall and they wanted me to test again in another seven days – and that was still positive so they booked me in for a scan at seven weeks.
“At the scan the fertility nurse told me that initially I had conceived twins but that one had stopped growing at around five weeks. The other embryo had carried on growing and I saw the heartbeat.
“It was really strange. I was happy because we had got the one baby but sad that we had lost one too. Obviously going through the other cycles of IVF I had known the chances and the statistics and things so I was sad but happy at the same time, which was a really odd feeling. I was by myself as well, as Covid restrictions were still in place and they weren’t letting partners in.”
Parents after ten years
“Felix was born in November 2021 and we couldn’t believe that after ten years we had finally become parents. None of my friends have got children yet but they all know about our struggles. Initially, I started a blog about it and was very open, but then after the second attempt failed I decided to keep our last frozen cycle a bit more private and we just told family.
“I haven’t run since getting pregnant but I plan on doing it once Felix is weaned in a few months. I can’t wait, actually, because I do really enjoy it and as we live by the sea I run along the beach, which is really nice. IVF is really tricky to go through but by getting fertility fit with the healthy eating and exercising was amazing; I felt like I was taking control.”
BMI and fertility – know the score
Kathryn Rayner, Lead Nurse at Bourn Hall Norwich
Being overweight is known to have an impact on male and female fertility – and to maximise the chance of natural conception and a healthy pregnancy it is recommended by the National Institute for Health and Care Excellence (NICE) that couples have a BMI of 19-30.
BMI (body mass index) is a measure which uses your height and weight to work out if your weight is healthy.
Kathryn Rayner, Lead Nurse at Bourn Hall Norwich, has seen an increase in people arriving at Bourn Hall for NHS diagnostic testing whose BMIs are too high.
“I’ve met a number of people who have told me that they have put weight on over the pandemic and we do sometimes meet resistance from patients who won’t accept that they have a problem weight-wise or they ‘don’t agree’ with measuring BMI,” she says.
“We are limited to what we can do treatment-wise if a woman has a high BMI because even if she could be treated with Ovulation Induction she still needs to have a BMI of 35 or less. If she has a BMI higher than that the OI drugs would not be as effective.
“For couples who need IVF the woman’s BMI has got to be 30 or less for NHS funded treatment and so we do give quite a bit of lifestyle advice to couples coming to us for diagnostic testing, and we also put them in touch with nutritionist Angela Attwood who offers a free 30-minute consultation.”
Where obese women have irregular or no periods losing weight can stimulate ovulation.
“If you have an increased weight then your hormone levels will fluctuate and therefore you may not ovulate as frequently,” says Kathryn. “We have had patients come to us who once they have lost a bit of weight start having regular periods and get pregnant naturally. And for those who don’t get pregnant naturally the chances of them getting pregnant with IVF is increased because the drugs will be more effective because their weight is lower.
“We give the same lifestyle advice to men, even though an IVF referral might not be so dependent on their BMI, because sperm production can be adversely affected by carrying excess body fat.”
To calculate your BMI go to nhs.uk.