Recommendations for HAES-literate REs or fertility doctors/practices?

[Anonymous]

In your shoes, I’d be looking at the overseas fertility clinics (Barbados, Guatemala). I assume their thinking is going to be more along the lines of if your money is green then we’ll help you. The clinics in big cities are more concerned with their stats than anything and they don’t need your money, they’ve got lines out the door.

I didn’t go through fertility treatment but had two babies with a BMI of 35+. Healthy pregnancies and babies, but get ready for a metric ton of fat shaming as you navigate pregnancy.

FWIW, I’m from the Midwest and have MANY friends who were 300+ Lbs and went through fertility treatment in their 20s/early 30s. Never had a problem finding docs to help them here in the Midwest. DC is a different beast.

[Anonymous]

Where did OP say she has 40 lbs to lose? I see one post where she says she has 15-20 lbs to lose. I think we can all agree that people who are 15 lbs overweight get pregnant easily everyday.

HAES does not say obesity is healthy. It says that body weight and BMI should not be the major players in medicine that they are currently. Yes, BMI often correlated with poor cholesterol, blood sugar, and blood pressure, but… we have ways to measure those 3 things independent of your weight! And plenty of people with high BMIs have perfect health metrics otherwise. Likewise, plenty of people with normal or low BMIs have poor health metrics.

I myself had a BMI of 29 before my most recent pregnancy. According to BMI, I had 30 lbs to lose. If you look at me, you can see I do not have 30 lbs of excess fat on my body. I got pregnant on the first try all 3 times. I’m guessing a fertility clinic might’ve turned me away.

[Anonymous]

Anonymous wrote:Where did OP say she has 40 lbs to lose? I see one post where she says she has 15-20 lbs to lose. I think we can all agree that people who are 15 lbs overweight get pregnant easily everyday.

HAES does not say obesity is healthy. It says that body weight and BMI should not be the major players in medicine that they are currently. Yes, BMI often correlated with poor cholesterol, blood sugar, and blood pressure, but… we have ways to measure those 3 things independent of your weight! And plenty of people with high BMIs have perfect health metrics otherwise. Likewise, plenty of people with normal or low BMIs have poor health metrics.

I myself had a BMI of 29 before my most recent pregnancy. According to BMI, I had 30 lbs to lose. If you look at me, you can see I do not have 30 lbs of excess fat on my body. I got pregnant on the first try all 3 times. I’m guessing a fertility clinic might’ve turned me away.

No clinic would have turned you away - this is ridiculous. Seriously.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Where did OP say she has 40 lbs to lose? I see one post where she says she has 15-20 lbs to lose. I think we can all agree that people who are 15 lbs overweight get pregnant easily everyday.

HAES does not say obesity is healthy. It says that body weight and BMI should not be the major players in medicine that they are currently. Yes, BMI often correlated with poor cholesterol, blood sugar, and blood pressure, but… we have ways to measure those 3 things independent of your weight! And plenty of people with high BMIs have perfect health metrics otherwise. Likewise, plenty of people with normal or low BMIs have poor health metrics.

I myself had a BMI of 29 before my most recent pregnancy. According to BMI, I had 30 lbs to lose. If you look at me, you can see I do not have 30 lbs of excess fat on my body. I got pregnant on the first try all 3 times. I’m guessing a fertility clinic might’ve turned me away.

No clinic would have turned you away - this is ridiculous. Seriously.

+1

No clinic is turning away women with a BMI in the overweight but not obese range. The vast majority of them won't even turn you away if you ARE obese. It's morbid obesity that is a problem for fertility clinics. No way OP is just someone with 15 lbs. to lose.

[Anonymous]

If a doctor pretends obesity doesn't affect fertility, they're not a good doctor. Fat cells affect your hormone levels. They will affect how much hormone your doctor prescribes for egg retrieval. If you want your doctor to treat you without taking your weight into consideration, they won't be able to treat you effectively.

It is also true that even small weight loss can affect your fertility. IVF is expensive and can be a real challenge mentally and physically. Do you really think a doctor recommending trying something that can help you get pregnant noninvasively is really a bad thing?

[Anonymous]

Anonymous wrote:Hello all! Might anyone have recommendations for Health At Every Size (HAES)-knowledgeable/literate REs and/or fertility specialists/doctors/practices in the DC area?

My husband and I are just starting to explore IUI and IVF, and recently had a consultation at Shady Grove Fertility. Overall it was a helpful consultation, though I did feel subtly fat-shamed by the doctor for my higher weight (BMI above 30; I thought BMI was now widely recognized as a crap metric, but they brought it up), even though the doctor did note our extremely healthy habits, eating, and overall “fantastic” health and hormonal metrics. I am AMA, too, with is an additional consideration.

Might anyone have recommendations for a HAES-literate RE or fertility specialist/doctor/practice? We are not writing off SGF, as we hear they are excellent at what they do, and would definitely consider another doctor there. But overall, I don’t want to be made to feel less than because of my weight (pandemic stress 15/20 lbs or not), or to experience any additional fertility fat shaming, when this entire process is hard enough as it is for all who go through it.

Many many thanks for any recommendations (or those to steer clear of) and sending positive vibes to all!

Hi all, OP here -I wanted to share a brief update, in case the info and perspective may be helpful to others. This past week, my husband and I had a virtual new patient consult with Dr Preston Sacks of Columbia Fertility Associates. Dr. Sacks was recommended early on in this thread (thank you!) + discovered through my research. We had a really positive and affirming experience speaking with him.

Right at the start of the appointment, he took a few minutes to get to know us as people (ie: chatting about sports when he noticed my husband’s football team sweatshirt). It’s little things like this that which, for me, really humanize the rather depersonalizing (IMO) experience of US health care in general right now - and I say that as the daughter of a doctor.

Dr Sacks clearly explained where we currently were, based on his review of our information/labs/diagnostics, and had recommended paths for short, medium, and long term. He allowed plently of time and patience for questions, and has a caring and sympathetic demeanor.

Dr Sacks is clearly a very knowledgeable and experienced doctor - I was so impressed with how he’d reviewed and analyzed the morass of labs and reports we sent his way! For me, though, one of the biggest things was that he made us feel like actual people - not just data points to be plotted on a chart. Conversely, our consultation with a doctor from Shady Grove was so impersonal that it made me feel like little more than a data point.

I thanked Dr Sacks for being HAES literate, and for supporting that everyone who chooses or needs fertility services deserves such, alongside compassionate care.

My husband and I are choosing to work with Dr Sacks and CFA (alongside OB/GYN care at Capital Women’s Care K Street, where I’ve been for years) instead of staying with Shady Grove after our initial consult. Shady Grove has been diligent about having a patient care coordinator and financial services follow up regularly since our early October virtual consult, but not once has the doctor we met with or anyone medical-related followed up with us. SGF has been a good fit for several friends, and the practice is clearly very good at their strengths, but it’s not the best fit or path for us at this time.

We are feeling so much more hopeful about where we are, and in what direction we are headed. Thank you to all who have provided helpful insight and suggestions, too.

Good vibes to all + wishing all who celebrate a happy, healthy, and safe upcoming Thanksgiving!

[Anonymous]

I was very happy with Dr. Humm at GW. I agree that BMI is rubbish but prior to pregnancy mine was rated "overweight" not "obese" no word was ever said. My understanding is that she is swapping to SG at the beginning of the year, so if it makes sense to stay there financially, you could try her.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Hello all! Might anyone have recommendations for Health At Every Size (HAES)-knowledgeable/literate REs and/or fertility specialists/doctors/practices in the DC area?

My husband and I are just starting to explore IUI and IVF, and recently had a consultation at Shady Grove Fertility. Overall it was a helpful consultation, though I did feel subtly fat-shamed by the doctor for my higher weight (BMI above 30; I thought BMI was now widely recognized as a crap metric, but they brought it up), even though the doctor did note our extremely healthy habits, eating, and overall “fantastic” health and hormonal metrics. I am AMA, too, with is an additional consideration.

Might anyone have recommendations for a HAES-literate RE or fertility specialist/doctor/practice? We are not writing off SGF, as we hear they are excellent at what they do, and would definitely consider another doctor there. But overall, I don’t want to be made to feel less than because of my weight (pandemic stress 15/20 lbs or not), or to experience any additional fertility fat shaming, when this entire process is hard enough as it is for all who go through it.

Many many thanks for any recommendations (or those to steer clear of) and sending positive vibes to all!

Hi all, OP here -I wanted to share a brief update, in case the info and perspective may be helpful to others. This past week, my husband and I had a virtual new patient consult with Dr Preston Sacks of Columbia Fertility Associates. Dr. Sacks was recommended early on in this thread (thank you!) + discovered through my research. We had a really positive and affirming experience speaking with him.

Right at the start of the appointment, he took a few minutes to get to know us as people (ie: chatting about sports when he noticed my husband’s football team sweatshirt). It’s little things like this that which, for me, really humanize the rather depersonalizing (IMO) experience of US health care in general right now - and I say that as the daughter of a doctor.

Dr Sacks clearly explained where we currently were, based on his review of our information/labs/diagnostics, and had recommended paths for short, medium, and long term. He allowed plently of time and patience for questions, and has a caring and sympathetic demeanor.

Dr Sacks is clearly a very knowledgeable and experienced doctor - I was so impressed with how he’d reviewed and analyzed the morass of labs and reports we sent his way! For me, though, one of the biggest things was that he made us feel like actual people - not just data points to be plotted on a chart. Conversely, our consultation with a doctor from Shady Grove was so impersonal that it made me feel like little more than a data point.

I thanked Dr Sacks for being HAES literate, and for supporting that everyone who chooses or needs fertility services deserves such, alongside compassionate care.

My husband and I are choosing to work with Dr Sacks and CFA (alongside OB/GYN care at Capital Women’s Care K Street, where I’ve been for years) instead of staying with Shady Grove after our initial consult. Shady Grove has been diligent about having a patient care coordinator and financial services follow up regularly since our early October virtual consult, but not once has the doctor we met with or anyone medical-related followed up with us. SGF has been a good fit for several friends, and the practice is clearly very good at their strengths, but it’s not the best fit or path for us at this time.

We are feeling so much more hopeful about where we are, and in what direction we are headed. Thank you to all who have provided helpful insight and suggestions, too.

Good vibes to all + wishing all who celebrate a happy, healthy, and safe upcoming Thanksgiving!

OP, I’m curious what substantive advice this other practice had for you. Did you just give better with the doctor or were they actually willing to do something different?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Hello all! Might anyone have recommendations for Health At Every Size (HAES)-knowledgeable/literate REs and/or fertility specialists/doctors/practices in the DC area?

My husband and I are just starting to explore IUI and IVF, and recently had a consultation at Shady Grove Fertility. Overall it was a helpful consultation, though I did feel subtly fat-shamed by the doctor for my higher weight (BMI above 30; I thought BMI was now widely recognized as a crap metric, but they brought it up), even though the doctor did note our extremely healthy habits, eating, and overall “fantastic” health and hormonal metrics. I am AMA, too, with is an additional consideration.

Might anyone have recommendations for a HAES-literate RE or fertility specialist/doctor/practice? We are not writing off SGF, as we hear they are excellent at what they do, and would definitely consider another doctor there. But overall, I don’t want to be made to feel less than because of my weight (pandemic stress 15/20 lbs or not), or to experience any additional fertility fat shaming, when this entire process is hard enough as it is for all who go through it.

Many many thanks for any recommendations (or those to steer clear of) and sending positive vibes to all!

Hi all, OP here -I wanted to share a brief update, in case the info and perspective may be helpful to others. This past week, my husband and I had a virtual new patient consult with Dr Preston Sacks of Columbia Fertility Associates. Dr. Sacks was recommended early on in this thread (thank you!) + discovered through my research. We had a really positive and affirming experience speaking with him.

Right at the start of the appointment, he took a few minutes to get to know us as people (ie: chatting about sports when he noticed my husband’s football team sweatshirt). It’s little things like this that which, for me, really humanize the rather depersonalizing (IMO) experience of US health care in general right now - and I say that as the daughter of a doctor.

Dr Sacks clearly explained where we currently were, based on his review of our information/labs/diagnostics, and had recommended paths for short, medium, and long term. He allowed plently of time and patience for questions, and has a caring and sympathetic demeanor.

Dr Sacks is clearly a very knowledgeable and experienced doctor - I was so impressed with how he’d reviewed and analyzed the morass of labs and reports we sent his way! For me, though, one of the biggest things was that he made us feel like actual people - not just data points to be plotted on a chart. Conversely, our consultation with a doctor from Shady Grove was so impersonal that it made me feel like little more than a data point.

I thanked Dr Sacks for being HAES literate, and for supporting that everyone who chooses or needs fertility services deserves such, alongside compassionate care.

My husband and I are choosing to work with Dr Sacks and CFA (alongside OB/GYN care at Capital Women’s Care K Street, where I’ve been for years) instead of staying with Shady Grove after our initial consult. Shady Grove has been diligent about having a patient care coordinator and financial services follow up regularly since our early October virtual consult, but not once has the doctor we met with or anyone medical-related followed up with us. SGF has been a good fit for several friends, and the practice is clearly very good at their strengths, but it’s not the best fit or path for us at this time.

We are feeling so much more hopeful about where we are, and in what direction we are headed. Thank you to all who have provided helpful insight and suggestions, too.

Good vibes to all + wishing all who celebrate a happy, healthy, and safe upcoming Thanksgiving!

OP, I’m curious what substantive advice this other practice had for you. Did you just give better with the doctor or were they actually willing to do something different?

Give = jive

[Anonymous]

Anonymous wrote:

Anonymous wrote:Hello all! Might anyone have recommendations for Health At Every Size (HAES)-knowledgeable/literate REs and/or fertility specialists/doctors/practices in the DC area?

My husband and I are just starting to explore IUI and IVF, and recently had a consultation at Shady Grove Fertility. Overall it was a helpful consultation, though I did feel subtly fat-shamed by the doctor for my higher weight (BMI above 30; I thought BMI was now widely recognized as a crap metric, but they brought it up), even though the doctor did note our extremely healthy habits, eating, and overall “fantastic” health and hormonal metrics. I am AMA, too, with is an additional consideration.

Might anyone have recommendations for a HAES-literate RE or fertility specialist/doctor/practice? We are not writing off SGF, as we hear they are excellent at what they do, and would definitely consider another doctor there. But overall, I don’t want to be made to feel less than because of my weight (pandemic stress 15/20 lbs or not), or to experience any additional fertility fat shaming, when this entire process is hard enough as it is for all who go through it.

Many many thanks for any recommendations (or those to steer clear of) and sending positive vibes to all!

Hi all, OP here -I wanted to share a brief update, in case the info and perspective may be helpful to others. This past week, my husband and I had a virtual new patient consult with Dr Preston Sacks of Columbia Fertility Associates. Dr. Sacks was recommended early on in this thread (thank you!) + discovered through my research. We had a really positive and affirming experience speaking with him.

Right at the start of the appointment, he took a few minutes to get to know us as people (ie: chatting about sports when he noticed my husband’s football team sweatshirt). It’s little things like this that which, for me, really humanize the rather depersonalizing (IMO) experience of US health care in general right now - and I say that as the daughter of a doctor.

Dr Sacks clearly explained where we currently were, based on his review of our information/labs/diagnostics, and had recommended paths for short, medium, and long term. He allowed plently of time and patience for questions, and has a caring and sympathetic demeanor.

Dr Sacks is clearly a very knowledgeable and experienced doctor - I was so impressed with how he’d reviewed and analyzed the morass of labs and reports we sent his way! For me, though, one of the biggest things was that he made us feel like actual people - not just data points to be plotted on a chart. Conversely, our consultation with a doctor from Shady Grove was so impersonal that it made me feel like little more than a data point.

I thanked Dr Sacks for being HAES literate, and for supporting that everyone who chooses or needs fertility services deserves such, alongside compassionate care.

My husband and I are choosing to work with Dr Sacks and CFA (alongside OB/GYN care at Capital Women’s Care K Street, where I’ve been for years) instead of staying with Shady Grove after our initial consult. Shady Grove has been diligent about having a patient care coordinator and financial services follow up regularly since our early October virtual consult, but not once has the doctor we met with or anyone medical-related followed up with us. SGF has been a good fit for several friends, and the practice is clearly very good at their strengths, but it’s not the best fit or path for us at this time.

We are feeling so much more hopeful about where we are, and in what direction we are headed. Thank you to all who have provided helpful insight and suggestions, too.

Good vibes to all + wishing all who celebrate a happy, healthy, and safe upcoming Thanksgiving!

Thank you for the update and best of luck to you!!

[Anonymous]

Anonymous wrote:

Anonymous wrote:I mean, observational studies do show a BMI cut point around 27 (you said above 30 but not your actual BMI) and a fertility benefit of losing even 5% of bodyweight. It might not be the most prognostic factor but it is the easiest one to modify

OP again - agreed, yes, such can often be modified through things like lifestyle changes. Or not, if that is the size and BMI that your body naturally is.

Also if time is a factor - which in my case it is because I am AMA - taking ‘a few months to lose some weight’ may not be an option. In fact, my doctors and even SGF specifically recommend NOT doing this, rather, encourage me to keep focusing on the healthy habits such as balanced eating and regular exercise. I would love if taking the time needed to healthily lose weight was an option, and had very much been working on this prior to TTC. Nor am I interested in quickly and unhealthily losing weight.

With my specific case, though (which is all I can speak to), my health and hormonal metrics indicate that I am extremely healthy. Given that, I was not presented any data, studies, or analysis on why my weight or BMI might be the issue, as such issues frequently present as hormonal imbalances, which I do not have. The Dr’s response when I asked that question: “we don’t know why, then, but it may be.” Not a great answer, and fell into the realm of fertility fat shaming for me.

Info below may be helpful + offer different perspectives:

Harvard Health Publishing, June 2020: How useful is the body mass index (BMI)? https://www.health.harvard.edu/blog/how-useful-is-the-body-mass-index-bmi-201603309339
From article above: “Research suggests that BMI alone frequently misclassifies metabolic health, which is linked to how much fat a person has and how it is distributed. And, BMI may be particularly unreliable during pregnancy, for athletes, and the elderly.“

NYTimes, June 2019: When You’re Told You’re Too Fat to Get Pregnant
https://www.nytimes.com/2019/06/18/magazine/fertility-weight-obesity-ivf.html

No one is naturally obese. They've just become accustomed to a level of calories and activity (or lack thereof) that maintains that weight.

[Anonymous]

Anonymous wrote:Where did OP say she has 40 lbs to lose? I see one post where she says she has 15-20 lbs to lose. I think we can all agree that people who are 15 lbs overweight get pregnant easily everyday.

HAES does not say obesity is healthy. It says that body weight and BMI should not be the major players in medicine that they are currently. Yes, BMI often correlated with poor cholesterol, blood sugar, and blood pressure, but… we have ways to measure those 3 things independent of your weight! And plenty of people with high BMIs have perfect health metrics otherwise. Likewise, plenty of people with normal or low BMIs have poor health metrics.

I myself had a BMI of 29 before my most recent pregnancy. According to BMI, I had 30 lbs to lose. If you look at me, you can see I do not have 30 lbs of excess fat on my body. I got pregnant on the first try all 3 times. I’m guessing a fertility clinic might’ve turned me away.

She said her BMI is over 30. There's no way she only has 20 pounds to lose to get to a healthy weight unless she's a midget.

[Anonymous]

Good luck OP!

[Anonymous]

Some midwives do IUIs, I don’t know if this person does, but she is very knowledgeable about HAES and pregnancy. I am a midwife in the area and have attended education sessions from her on it. https://gwdocs.com/profile/katie-depalma

[Anonymous]

I don’t have recommendations, but I just wanted to chime in and say I’m sorry this happened to you! You shouldn’t have to put up with that. Hoping everything works out for you!