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Does high BMI hinder my chances?

Dear Professor Winston,

I have a BMI of 40 and have been diagnosed with unexplained secondary infertility. I had a traumatic first birth which ended up in an emergency C section under general anaesthetic. I feel that something hasn’t been right since then and have asked for laparoscopy and they won’t entertain me because of my BMI. I feel that this will help find the cause but it’s so frustrating. I’m 37 and my husband is 40 so time is running out? Can I have a laparoscopy without going through NHS regional fertility or any form of treatment with high BMI, even privately as I feel time is running out?

Thanks so much

R.

Dear R,

Yes, I am afraid to be brutally frank, but time is indeed running out.  You are unlikely to get pregnant at this weight, any infertility treatment is much more likely to fail, many investigations such as laparoscopy which you mention are made more dangerous, any pregnancy that you do achieve – unlikely though that is – is likely to be complicated and there is a risk to you and more importantly really, to your baby of a serious mishap.

I have put this into bald English, not because I am unsympathetic, but because your future hopes are in your own hands. I am truly sorry to put this so crudely – but from my clear experience, it is possible to get your body mass to normal levels.

Best wishes

Robert Winston