Obese and IVF

BananaPancakes02

So, I have my WTF appointment tomorrow.  I've really been struggling to figure out if I want to do injectables or just go straight to IVF.  I'm worried about multiples or being cancelled with injectables, IVF is just scary to think about a needle piercing my vagina to get to my ovaries.  But I really don't want to waste time on things that aren't going to work for me, and I am in huge need of my doctor's advice.

I follow people on Youtube who post about their IF treatments, and honestly, if they are overweight, I am especially interested in their updates.  There is one girl who is my size who just did an ET and it didn't work, and I was in tears watching her video.  She mentioned that her weight is what is keeping her from being successful.  So, I start googling ivf in obese women, and I click on an article that was just fucking awful.  It was about Canada covering IVF, and that there should be a weight limit to those who can undergo it, and all the comments, every single one, were about how fat people shouldn't have kids, are lazy, that nature is trying to tell them something if they can't get pregnant, and I just broke down crying.  I lost 50 lbs last year, but due to hell at work,depression outbreak, and then IF treatments, I have gained 40 of it back in the last year.  I am starting to worry my weight is going to keep me from being successful, and I only get 3 shots at IVF before my insurance cuts us off, and there is no way we could afford it OOP.

I'm 5'4", weigh 290 lbs.  I do not have insulin resistance, I have a job where I am constantly on my feet walking (I'm a nurse), and have no problem going to the gym and working out.  I am a pretty healthy obese person aside from my PCOS.  I'm just an emotional/stress eater, and I'm Southern, which I feel its just in my DNA to gravitate towards bad for you, but delicious food. lol.

So, basically, I'm wondering if I should just try injectables for maybe a cycle or two and see what happens, and then bench myself for a year to lose some serious weight before we attempt IVF?  The only time in my life my periods were regular was when I played soccer in high school, and I just don't want to go through treatments that are never going to work because of my weight.  The idea of giving up is probably just as devastating as injectables or IVF not working to think about to me.  But it has become obvious to me that I can not go through treatments AND lose weight at the same time, its just not possible.  I have to do one or the other.  I am waiting until we talk to the RE tomorrow, but I am starting to think our TTC journey is coming to a halt for a while.

ronniesgirl1981

Do you know if your clinic has a max BMI for IVF?  My clinic sets that max at 39. 

Here's the thing...after having an IVF converted to IUI (so essentially an IUI with injects), THAT WAS SO MUCH WORK FOR AN IUI.  I'd never voluntarily do an IUI with injects again.  If I am going through all that crap, I want the success rate of an IVF.  But that's just my opinion. 

I am going to go get a coffee and then I'm going to PM you. 

Ashlee8809

The place I'll be going to for fertility treatments has a max BMI for IVF. It scares the shit out of me. 

I don't have any specific advice regarding the IVF, but I would suggest not reading the comments! Comments are awful. They never fail to make me sad, angry, you name it.

Best of luck to you! {{Internet Hugs}} 

BananaPancakes02

I don't know if there is a max BMI at my RE, but he did put that as part of my TX plan to continue to lose weight, so I have a good feeling he's going to want me to lose weight before going forward.  I'm only 30, so I have time on my side for now.  This is so hard for me to say we aren't going to keep trying.  I refuse to go back on BCP, so I will have to figure out what plan I should have in place to keep me from going over 60 days each cycle.

lebradford

**loss mentioned**

So many hugs @bananapancakes02. I have been having some of the same thoughts about myself. I am in the "obese" category as well. Between the fact that we have already done 3 IUIs and the ectopic, it really doesn't make sense for us to keep doing IUIs. However, I am worried that my weight will lower our chances of success with IVF. It sucks to have something like that stand in your way. It is so hard to lose weight, and there is so much shame already associated with it, you know? 

My initial thoughts on your situation would be to try an injects + IUI cycle. That made a *huge* difference for me. It could also give your doctor a chance to see how your body reacts to injects before trying IVF, and you might feel like you gave everything a chance before moving on? 

I know @ronniesgirl1981 said that she thought an injects + IUI was too much work, but I have to disagree. For me, I had significantly fewer monitoring appointments and side-effects compared to Clomid, and literally the only thing that was harder was that I had to do an injection instead of take a pill.  Maybe you will find it to be more stressful than your oral med cycle, but maybe not. That's just something to think about. 

Whether you decide to do an injects + IUI in the meantime or not, you might be better of losing some weight before you do an IVF cycle. In some ways, at least at my clinic, there is a lot of waiting built into an IVF cycle anyways (taking BCPs, getting your cycle in sync with their group cycle dates), so you might not have to significantly delay your cycle to lose a little weight (obviously it depends how much you want to lose). Because of the treatment for my ectopic, the earliest I'll be able to cycle is November, so I think I will try to lose a little weight before I do IVF, but I am not necessarily going to delay my cycle any further just to lose weight. If that cycle is unsuccessful, then I guess I can always delay the next one an additional month or two to lose more weight if I feel like it is necessary. That might be a way to think about it too. 

I'm sorry you're stuck making this decision. I know it is really hard to deal with. I feel the same way you do, where delaying cycles is hard. I hope after you talk to your doctor you come up with a plan you feel good about. I hope you'll keep us updated. 

tweetyknicks

lebradford said:

I know @ronniesgirl1981 said that she thought an injects + IUI was too much work, but I have to disagree. For me, I had significantly fewer monitoring appointments and side-effects compared to Clomid, and literally the only thing that was harder was that I had to do an injection instead of take a pill.  Maybe you will find it to be more stressful than your oral med cycle, but maybe not. That's just something to think about.  

I found this too. After the first shot, injects were no biggie and I definitely had fewer side effects.

BananaPancakes02

I just don't want to be on them long term anymore.  I was on them for over 10 years, and coming off of them was a pretty big mind fuck.  I also don't want to miss out on the possibility of my periods coming on their own as I lose weight.

ronniesgirl1981

FWIW, it's not that the injects cycle was a lot of work...I just found it to be a lot of work for just an IUI.  For me and for my response, the same amount of monitoring would be needed for an IVF cycle.  And that may not be true for you. 

But I do agree that side effect-wise, it's way better than clomid.  I didn't get the clomid rage, but I did get a yeast infection both cycles that I was on it. 

tweetyknicks

ronniesgirl1981 said:

FWIW, it's not that the injects cycle was a lot of work...I just found it to be a lot of work for just an IUI.  For me and for my response, the same amount of monitoring would be needed for an IVF cycle.  And that may not be true for you.  

Though I have not yet done an IVF round, I expect the monitoring will be the same since my reaction to the meds was extremely varied. I guess I find it less involved with respect to side effects. From the stories I've read on here, it sounds like IVF is much more emotionally and financially (duh), if not physically, taxing.

Obviously I've decided that IVF is more worth my time, money, and effort that IUI since I'm moving on after only two IUI cycles. I am glad I did two cycles of IUI to see how I respond to the injects. I hope that will be useful information for my new RE for IVF.

emmuffy

Ugh. I feel the need to apoligize on behalf of the Canadians on this board for the nasty comments you had to read in relation to potential government coverage for IVF services. That sucks.

Good luck to you if you are trying to lose weight, but FWIW, there are also lots of thinner gals out there who are struggling to conceive. Weight isn't everything and I hope you don't beat yourself up too much.

Hugs.

wishiwaspreggo

************Siggy Warning**************

 

 

I'll preface this by apologizing for being a dirty lurker and/or unwanted contributor but I wanted to chime in since I'm an expert on TTC while obese

Fat shamers suck, and they need to STFU.  Don't listen to them.  I'm large, like you.  I'm 295, 5'9, and I believe my BMI is 43.

I did one natural IUI, 3 Clomid, 1 Femara + Follistim, and 1 just Follistim.  The Follistim was my silver bullet

I gave my last cycle a LOT of thought.  I was pissed because I'd already tried 5 goddamned times and I the only positive pee sticks I ever had were from my HCG shots.  I thought my last cycle would be a bust and mentally prepared myself to move on to IVF.  The only reason I gave it a go was because our sperm bank gave us a free vial since I didn't get pregnant on my first 5 tries.  Lo and behold, here I am, 11 weeks pregnant and going strong.

I cannot say injects are 100% guaranteed - obviously it doesn't work for everyone, but it made a big difference for me.  It helped to be so closely monitored, with blood work and ultrasounds.  It was thanks to my last blood draw that I got my IUI in a day earlier - had we just gone off of ultrasounds I probably wouldn't have gotten pregnant.

In any case, I am pro-trying and IUI with injects.  Then at least you'll know how you respond to FSH (whether it's Follistim, Gonal-F, etc.) and then if you must move on to IVF then you'll have a better idea for what to expect.  Just my two cents.

Either way you decide, good luck!  And ladies, if you want me to buzz off please tell me and I'll stick to lurking.  I just thought maybe my story would provide a little hope.

The fun side of being obese and pregnant: fat-shaming OBs!  Yay! :P I go into each appointment wearing my emotional armor.  As long as my BP and sugars are good, then I'm not worrying about my weight.  Fuck it.

Ashlee8809

NariaDreaming said:

BananaPancakes02 said:

I just don't want to be on them long term anymore.  I was on them for over 10 years, and coming off of them was a pretty big mind fuck.  I also don't want to miss out on the possibility of my periods coming on their own as I lose weight.

Fair enough. Provera may be the way to go for you!

Those were my thoughts exactly. I want to have an idea of what's going on with my cycles, especially with the weight loss, in hopes of them getting better/more normal. Provera is a good solution for now.

Chasity08

Early last year I hit my 50 pound weight loss mark, which I lost over about an 8 month period. I was going to the gym 4-5 days a week, eating better, I'm not perfect by any means, but I was making a serious attempt and was doing well. Then I got my IUD out. I thought I had just hit a plateau (not really connecting that my weight loss stopped when my IUD came out) and after about 4 months of losing absolutely no weight, even with changing up my working out and trying different work out plans, I got diagnosed with PCOS and Endo. My blood sugars were out.of.control. I started taking metformin, and it wasn't working for me at all. I ended up stopping with the blood sugar meds because instead of helping they were actually making me have levels too low, and I kept getting dizzy and passed out at work. At the time I was just seeing an OB who really didn't understand my blood sugar issues because of my PCOS so I just stopped all medication.

Fast forward a year and a half later and I am now seeing an RE who is seriously looking in to options for my blood sugars, but more important (to me anyways) she said that she fully believes the reason I was unable to continue losing weight is BECAUSE of my blood sugars (and a thyroid issue I didn't know I had). BUT, even with that happening, my RE doesn't think that my weight should hinder me in getting pregnant. She said of course the healthier you are the better chance you have, but she feels that I am very healthy, my blood work (besides my blood sugars and thyroid) are darn near perfect, my uterus and ovaries are "beautiful" haha, and I respond well to the medications.

I am 5'5 235 pounds, if that helps at all, so I do have a higher BMI. I am still actively working out and trying to eat well, knowing that I will continue to be plateaued until I can get my blood sugars and thyroid figured out, but as long as my RE thinks I'm golden, then I just try not to worry about it.

That was ridiculously long, so I apologize, but I just wanted to let you know that my RE doesn't necessarily have a negative outlook on it, even though I'm considered obese.

Good luck!! 

ttuprincess

***SIGGY WARNING***

I hope it is okay if I respond to this.  I have debated all morning on whether to post or not. 

From what I can tell from your siggy, you and I have a relatively similar DX -- PCOS, ovulation issues, and DHs with normal SAs.  (sorry if I am misreading or misinterpreting) 

I can totally sympathize with the weight struggles.  And mean people can suck it.  I am so sorry you are dealing with it.  I struggled a lot with my weight during my treatment cycles.  I had decided to do one more treatment cycle before we moved onto adoption or living child free (we are OOP).  Before my last cycle I took a break and was determined to lose some weight.  I can say that, for me it was hugely beneficial in several ways.  (1)  I lost a lot of weight which I would like to think helped with my last cycle.  (2)  Losing weight helped me feel accomplished at something and good about myself.  For me, dealing with IF was really emotionally hard and I was getting beat down.  When I took a break and really focused on something else I started seeing positive changes in me  and I started feeling better about myself in a number of ways.  I know no one wants to take a break (I know I didn't), but I was really glad I did. 

I also did injects + TI and was really glad I did.  We had much better success with injects producing good eggs and my lining plumping like it should than we ever did with clomid.  I would say it is worth a try to do an injects cycle before moving to IVF.  I agree with the other ladies that I had less side effects and saw much more promising results from my monitoring appts than I did with clomid. 

In the end, I think you have to do what is right for you.  I remember when we decided to do TI instead of IUI people looked at us like we were crazy because IUI has higher success rates.  But we had to do what we were comfortable with at the time and for us that was TI.  I hope you are able to find a path that you and your H are comfortable with!  I am keeping everything crossed for you! 

iLoveMyPups

HUGS to all!! I am in the same boat as far as trying to lose weight to better my chances (currently not taking any IF drugs though). I'm looking at atleast 20lbs, even though I could lose more... I want to make my goal a little more realistic so I don't feel overwhelmed. 

BunnyBerry

I'm so sorry, that's really stressful. How much is a woman supposed to be able to deal with at once??

Just thinking about the options you mentioned...I might wait on the injectibles until after taking off time to get healthier, because I'd want them to have the best chance, but also because I think an injectible cycle can give really helpful info to the RE on how to put together an IVF protocol if needed, so I would want my injectible cycle right before IVF if needed.

That said, I would first ask my doctor for straight up numbers to know how much a weight loss would/wouldn't make a difference in my chances. I would not want to give up a year or so TTC just to improve my chances by 5%, for example. I would want to know, too, how much weight I'd need to lose in order to make a big difference in my chances.

I hope you get some great news at your WTF appointment! Good luck.

BananaPancakes02

So, just got home from my appointment.  It went really well.  He think it would be best for us to go straight to IVF due to my husbands samples being kind of up and down.  We would do IVF with ICSI.  He said that weight loss would be ideal, but if in 2 months, I haven't made any serious progress, he thinks we should go ahead.  We have awesome chances, 55% with one embryo transferred and 85% with 2 embryos transferred.  Where as with injectables/IUI we only have about 15-25% chance.  So, its pretty hard to ignore the huge difference in our chances between the two.

So, my goal is to lose 70 lbs.  If in 2 months, I haven't lost around 20 pounds, we'll go back and start our IVF cycle.  I'm giving myself 6-7 months to do this, because I know I can.  I really do appreciate all of the support you ladies have given me.  This board is truly a god send.  

Ashlee8809

@bananapancakes02 That's great news! You can do it!!

Hollowvic

Good Luck!!!