Anonymous wrote:Not familiar with the term HAES, but I was successful at SGF at age 39, and above-average BMI (27-28). I was not told that I needed to lose weight before starting IVF. Perhaps it varies doctor to doctor (I worked with Dr Moon). Who did you see, OP?

HAES= Health At Any Size. It's for people who don't believe obesity is unhealthy. Make of that what you will.

A BMI of 27 or 28 puts you in the overweight but not obese category. That is not a problem for any fertility clinic, and of course no one is going to tell you to lose weight. My friend who was told she needed to lose weight in order to have IVF had a BMI over 40. OP is talking about being obese, not just a little chubby.

Not familiar with the term HAES, but I was successful at SGF at age 39, and above-average BMI (27-28). I was not told that I needed to lose weight before starting IVF. Perhaps it varies doctor to doctor (I worked with Dr Moon). Who did you see, OP?

Anonymous wrote:You need to go to Manhattan. Please if you are AMA don’t waste your time at SG

Curious about this, why not SGF?

You need to go to Manhattan. Please if you are AMA don’t waste your time at SG

Anonymous wrote:OP, DCUM's BMI- and CICO-obsessed women will not listen to any science that challenges their rigid world view. Other people have tried and failed in other threads. I caution you against engaging on the current scientific research and just focus on your original question. These posters can't understand and actually don't want to understand.

OP here - very well put, thank you + your advice is being heeded.

To all considering responding (thank you), please focus on the scope of my original question: Recommendations for HAES-literate REs or fertility doctors/practices in the DC area.

To those who have already typed hurtful, unhelpful, or discriminatory things: these comments and views say much more about you than me or others.

Recognizing that these topics are very layered and nuanced for many (myself included), and that all deserve the right to be heard - and the right to respectful and comprehensive health care (including fertility and infertility).

Much gratitude to all who have offered helpful info thus far, and wishing the best to anyone else who is also hanging out on an infertility-based sub forum on a Sunday morning 🙏 💕

OP, DCUM's BMI- and CICO-obsessed women will not listen to any science that challenges their rigid world view. Other people have tried and failed in other threads. I caution you against engaging on the current scientific research and just focus on your original question. These posters can't understand and actually don't want to understand.

Anonymous wrote:

Anonymous wrote:Definitely work on losing weight, just the act itself can help your fertility.

Exactly. It's not a "crap metric" OP. I understand the importance of finding a doctor that is sensitive and respectful about it, but the reason that they may address weight is that it does affect fertility.

OP again - to each their own regarding the current info and studies out there, but the jury really does seem to be out on if BMI is really a solid indicator of health.

Harvard Health Publishing, June 2020: How useful is the body mass index (BMI)? https://www.health.harvard.edu/blog/how-useful-is-...dy-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.“

Great podcast episode from Maintenance Phase (excellent podcast as a whole, too) on BMI, too: https://podcasts.apple.com/us/podcast/maintenance-phase/id1535408667?i=1000530850955

Anonymous wrote:Definitely work on losing weight, just the act itself can help your fertility.

Not helpful when age and/or time need to be taken into consideration, which OP indicates it is. Healthy and sustained weight loss takes time.

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

Anonymous wrote:Definitely work on losing weight, just the act itself can help your fertility.

Exactly. It's not a "crap metric" OP. I understand the importance of finding a doctor that is sensitive and respectful about it, but the reason that they may address weight is that it does affect fertility.

Definitely work on losing weight, just the act itself can help your fertility.

Anonymous wrote:Dr. Sacks at Columbia Fertility (cfa) - no bmi/fat shaming issues. Very sensitive about health and size. I found out about CFA and size issues here and had a tremendously positive experience.

OP here - many thanks for the recommendation! My online research has found some great reviews of Dr. Sacks and Columbia Fertility. I’ve submitted a request to schedule a new patient consult + hope he is taking new patients! I really like what I’ve read about Columbia Fertility too. My husband and I look forward to comparing the two (and possibility three - looking at Dominion Fertility as well) consults.

Many thanks again! Wishing you well

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

Dr. Sacks at Columbia Fertility (cfa) - no bmi/fat shaming issues. Very sensitive about health and size. I found out about CFA and size issues here and had a tremendously positive experience.

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!