Publisher Health

A woman who has been trying to have a baby for more than two years said she was told to “lose weight and come back” by a fertility clinic.

Rachel Rowlands said she was not given any help or support about how best to get her body mass index (BMI) down to the appropriate range.

The 33-year-old of Nelson, Caerphilly county, said it left her “devastated”.

The Welsh government said all clinicians should support families with fertility issues.

Ms Rowlands said she was upset at the lack of support offered to address how her long-term health problems were preventing her losing the weight she knew she needed to in order to access fertility treatment.

The university lecturer, who is a clothes size 16-18, has endometriosis and a chronic pelvic pain condition, and was referred to a fertility service.

She understood the need to lose weight, but after being told her BMI was 36, was upset at the way she was spoken to.

Ms Rowlands recalled how she walked into the room with the doctor and, before she had sat down, was told “you need to lose weight, you’re overweight, you’re quite overweight, and the first thing you need to do is go away and lose weight, and then come back to us”.

NICE guidelines say women should be informed that female BMI should ideally be 19-30 before commencing assisted reproduction, as being outside that range reduces the likelihood of success.

Consultant obstetrician and gynaecologist Dr Sean Watermeyer said if women with a BMI of more than 30 do get pregnant there is an increased risk of miscarriage, stillbirth and congenital abnormalities.

Campaigners have said patients should be shown how to get help because “desperate women take desperate measures”.

Ms Rowlands said: “I had no offer of any professional support or advice whatsoever.

“I do understand how to lose weight, but weight issues are multifactorial, and it’s not just about going away and eating less food, or doing more exercise, there are a lot of things that can impact somebody’s weight, and those need to be addressed as well.”

She has since been diagnosed with an eating disorder.

“I want doctors and nurses to really think about how they address weight management issues with people who are struggling with fertility, and just approach it in a kinder way.”

Dee Montague-Coast at the Fair Treatment for the Women of Wales charity, said Ms Rowlands’ experience was “not rare”.

“There’s often a lot of assumption why someone is in a bigger body, from what we see with our members often they’re living with really complex, chronic health conditions that can really impact their energy levels, their ability to exercise, and their ability to eat well.

“Desperate women will take desperate measures – they will crash diet, go into exercise overdrive, and this can be catastrophic for their health, so what we need is person-centred care.”

The charity suggested signposting patients to services such as mental health support, a nutritionist or exercise referral schemes.

Cwm Taf Morgannwg University health board, which did not treat Ms Rowlands, is launching a weight management service for its patients in the new year.

Dr Watermeyer said he was “excited” to be able to refer into it.

“We’ve a doctor who’s there to advise, who’s got experience in this and may also prescribe, we’ve got a psychologist because it’s behavioural patterns that we need to sometimes change within these patients who need to lose BMI.”

He added that there were also physiotherapists and dieticians to further support patients.

The Welsh government said it believed in an equal Wales, where anyone who wanted to have a family could access the clinical support they need to achieve that goal.

“All clinicians should support families with fertility issues, and may refer them into specialist services where appropriate,” it added.