Niki and Adam welcomed their son Louis on 25th December 2021 after seven years trying for a baby. Before the couple could be referred for NHS-funded IVF Niki needed to get her BMI down – the couples ‘weight loss for IVF’ marked the beginning of a new, healthier lifestyle.
“Having children is something that I have always wanted and there were nights when I would cry myself to sleep because it just wasn’t happening,” says Niki.
“It was really hard going on social media sometimes when friends had posted up photos of their pregnancy bumps and baby scans. I tried not to look but you notice these things a lot more when all you want is to be pregnant and it feels as though everyone else is moving on with their lives.”
As the couple live in Norfolk they were referred by their GP for NHS fertility testing at the Bourn Hall Norwich clinic, as Bourn Hall provides both Level 2 (testing and Ovulation Induction treatment) and Level 3 (assisted conception including IVF) in the county.
The diagnosis from the testing was ‘Unexplained infertility’ the reason given for around one third of couples seeking IVF treatment in the UK. It simply means that, following investigative tests, no direct cause can be identified. It might be caused by sub-fertility on both sides.
“I did find it frustrating that we didn’t have a cause for our infertility; it was baffling,” says Niki, aged 33. “Adam’s sperm count was fine, and my periods were regular. We obviously just needed a bit of a helping hand.”
Weight loss for IVF
The couple were told they would need IVF and may be eligible for NHS funding if they were able to reduce their BMI to below 30. Being overweight can be cause of infertility and it also makes treatment less effective. Getting fertility fit can improve your chances of success and is best for the health during pregnancy.
For Niki and Adam this led to a complete change of lifestyle. As well as counting her calories Niki embraced regular exercise.
“I did a lot of swimming and went to the gym, going on the treadmill and going to spin classes. I lost two stone,” she says.
During the couple’s IVF treatment at Bourn Hall Niki continued with her health drive and ensured that Adam was onboard with the new healthy lifestyle too.
Getting fertility fit as a couple
It is important that both partners have a healthier BMI as this can improve sperm quality.
Niki continued with her health drive and ensured that Adam was onboard with the new healthy lifestyle too. “I did everything I could to ensure that we were both as healthy as possible,” she says. “As well as exercising regularly, I took lots of vitamins and made ‘fertility smoothies’ with maca powder and pineapple cores in for myself and Adam. I also ate lots of eggs, avocados and salads.
“Adam had vitamin supplements and I lined them all up for him to make sure he took them!
“Like lots of people during the pandemic we took up walking when the gyms and swimming pools had to close. Walking wasn’t something we had really done before but love it now, we did lots of nice nature trails and walking on the beach. I also took up jogging.
“I basically did everything I could to get my body as ready as possible for IVF treatment and pregnancy. I felt healthier than I have ever felt in my life.”
Bit the bullet and tried again
Sadly, the couple’s first round of IVF treatment was unsuccessful, but their consultant gained information from this cycle to tailor treatment for the next round – changing the dose of medication and recommending a general anaesthetic to enable greater access to the ovaries for egg collection.
“I kept putting further treatment off until the beginning of the year of 2021, but then decided that I was just going to bite the bullet and go for a second round. I didn’t need so many tests this time, so it went really smoothly,” says Niki.
“Strangely enough my egg collection and transfer for our second round of IVF were at the Easter weekend. When I came round from the anaesthetic, I was told they had only collected three eggs. The girl in the bed next to mine had 17! I was devastated, I thought ‘it’s not going to work’ and cried all the way home.
“I got a call the next day to say two of the eggs had fertilized. One was transferred and then we had to wait two weeks to get the result. I was really scared of taking the pregnancy test in case the IVF hadn’t worked; when I found out I was pregnant it was amazing.”
“Louis was born on Christmas Day and we had the Eastern Daily Press come round to take pictures of him for the paper.
“Embryo transfer at Easter and born at Christmas – it was very bizarre how it worked out that way! He is truly a little miracle.”
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.