Fatness and fertility

Elizabeth’s story

I have always been considered overweight as long as I can remember. My childhood pictures show me as gaining weight from around the age of 8, and I have never been smaller than a UK size 16 and a UK 22 at my largest.

My father’s mother was overweight as was his father, but my mother’s family are a healthy size and I grew up in a healthy and loving household. My mum did what she could to help me lose weight in a supportive way and I know she blamed herself for a long time for my unhealthy habits.

However, I think we have both come to realise that there are many factors to ‘ob*sity’ and having found exercise in the last 15 years, she sees that there are different measures of health.

My first memory of being really ashamed of my weight was when we were all weighed by the school nurse in secondary school and I remember the other girls telling each other their ‘number’ like it was the result of a test. I remember noticing that my number was the highest and knowing that it wasn’t a good thing.

Fast forward 20 years through countless diets and fads and although I have lost 40/50lbs more than once, I usually put it all back on within 6 months.

I was married in April 2019 (after losing 45lbs!) and we immediately started trying for a family. I was 35 when we got married so I was aware that my age might hinder us conceiving quickly but what I wasn’t prepared for was a denial of fertility referral due to my BMI.

I have always hated the idea of BMI: the idea that one’s health can be summed up with a simple equation seems unfair and simplistic. I understand that the NHS is stretched beyond belief however the subtext coming through from the NHS is clear: you’re too fat for motherhood. 

I was offered thyroid medication and had an ultrasound scan and several blood tests. Most came back normal but it was difficult to pinpoint ovulation. It seems I don’t ovulate each month. The Dr told me this, but then I felt like I’d been left high and dry because I was told that I til my BMI is under 30, I can’t be referred for any more help, tests or medication. 

My BMI is 37. I would have to lose around 4 stones to be referred and the pressure of that is too much to bear, especially when I already felt like a failure for not being able to conceive.

Photo by Christine Sandu

We decided to pay for some private testing and it was a breath of fresh air. They never mentioned my weight, and the tests have concluded that I have a low egg count. Nothing to do with my weight. I felt a huge sense of relief that I could stop blaming myself for our infertility. We have paid for medication to help me ovulate which so far has been unsuccessful. The next step will be IVF and with it brings a new worry. Even the private clinic advises your BMI to be under 35…

I don’t know how strict the clinic will be on this but it’s clear that my weight continues to be an issue, a factor, a defining part of my medical treatment and it is exhausting. I really hope we conceive soon but even then I know I will have to attend more appointments and have more intervention as it would be considered a geriatric and ob*se pregnancy.

I am so glad to have found some health professionals out there to give me some perspective and reassurance that my weight and BMI shouldn’t rule the medical care I receive. 

Elizabeth, Bristol

Weight stigma and fatphobia is particularly noticeable among fertility specialists. Elizabeth is by no means the first person to walk away from an appointment feeling like her inability to conceive was all her fault. Most NHS hospitals will deny any fertility treatment to women with a BMI above 30, even though it is not clear why these guidelines exist.