If you haven’t read my recent pregnancy announcement post, you may want to start there first… but long story short, my husband and I are overjoyed that we are expecting twins! I had referenced our fertility journey briefly and since sharing our news and mentioning our fertility struggle again, I’ve since received countless emails and DMs requesting the specifics or asking questions, so I wanted to prioritize sharing our story with you.
Over on my Instagram, I asked what specific questions you have and I’ll try my best to answer them all here. If you do have any additional questions after reading the post, please feel free to post a comment below. I’ll be monitoring the comments closely and will reply and/or update the post accordingly. I’d love to have the discussions here vs. my DMs or email if possible so that everyone can benefit from the conversation.
Disclosure: I know that most of you reading this post already know that I’m not a medical doctor, doula, birth professional, etc. but I want to be clear that I am in no way an expert on fertility, pregnancy, birth or parenthood. Like you, I’m a person trying to figure it all out as I go. I’m here to share my experiences in hopes of helping others in the same or similar situations feel less alone, but I highly encourage you to seek care from medical providers you trust through this journey.
Know that I have mulled over whether or not to speak about our fertility journey at all publicly… and for months I was SURE that I wasn’t capable of this level of vulnerability. It’s an emotionally raw subject, and while I was in the midst of it… I wasn’t capable of opening up and discussing it because it hurt too much. Now that we are on the other side of it, I want to share our experiences in hopes that you’ll find hope in your own journey or get some of your questions answered.
Question: How long did you try to conceive naturally?
We started trying in the Fall of 2017 and we had our successful IUI in June 2019. We had been under the care of the fertility specialist for a couple months prior to the IUI so there was around a year and a half of trying on our own.
While a year and a half felt like a lifetime, I know that so many people struggle for much longer than we did. We were really fortunate that once we finally found a great doctor, things went quickly and smoothly.
Our doctor was extremely realistic with us and let us know that we should prepare for several attempts at IUI and potentially IVF to conceive. I went into our first IUI hopeful but not exactly optimistic… we were thrilled that our first attempt worked and know that we were fortunate to have it happen so quickly.
Question: What fertility treatments and/or medications did you use?
We had one IUI and prior to the IUI, I took Metformin for a couple of months to help with PCOS and then Letrozole and a trigger shot just before the procedure.
Question: Were you treated poorly due to your weight or did you face any kind of size discrimination?
Prepare yourself. This is the longest response of the post.
The short answer to this is yes. I’m not quick to use the throw out the term discrimination because I know it’s a heavy word… but I believe fully that I was not treated the way thin patients would have been treated in my situation, and I believe it was detrimental to our progress as we tried to conceive, wasting precious time and leading to a medical emergency that could have likely been prevented with better care.
I’ll step back a bit… Even prior to officially beginning the trying to conceive process, I was on a multi-year mission to get to the bottom of a feminine health issue that I long believed to be PCOS. When I was a young teenager, I remember being told by my physician that I had a hormonal imbalance that could make pregnancy difficult one day. I don’t remember the term PCOS being used, but my doctor did recommend birth control to me to help at the time. I didn’t really pursue any additional information about the diagnosis for years because, as a teenager, becoming a mom was not on my radar.
Years later, as things started to get more serious in my relationship with Kevin and I knew engagement and marriage were in the near future, I began to feel haunted by the diagnosis I couldn’t quite remember from the past. I began a mission to get to the bottom of it and over the course of several years, I saw five different doctors asking about PCOS, hormonal imbalance, etc.
Sadly, I wasn’t taken seriously and was told that I was fine but just needed to lose a significant amount of weight and THEN try to conceive naturally for a year before further testing would be made available to me. (So much for being proactive.)
Finally, when we decided to start trying to conceive I made an appointment with an OBGYN who refused to even refer me for hormonal testing until we tried to conceive for a year. She also recommended that I lose 100 lbs. She bluntly told me that unless I did so, she would never do anything to support me conceiving but that if I “managed to figure it out” on my own she’d be so kind as to provide my GYN care during pregnancy.
I left her office in tears that day and my biggest regret of the entire experience is that I didn’t immediately go find a different OB/GYN.
I listened to her about trying on our own for a year, and once the year was up and after another terrible experience with a different OB/GYN in the same office, I went on a mission to find size-friendly care providers…doing that made all of the difference for us.
I hate even talking about the horrible experiences I’ve faced with the medical community during this process because I don’t want to discourage anyone from trying to find great care providers. They DO exist, but you have to be persistent in finding them. I do also want to remind you that you and EVERY SINGLE PERSON ON THIS PLANET deserve adequate health care and to be treated with kindness and respect regardless of your size or health. If you are in a situation where you are not receiving adequate care, please DO NOT continue to see that doctor. There are SO many options out there… keep going until you find someone who will listen to your concerns and help you.
I started with finding a great primary care physician and started asking for referrals to other specialists I needed. I was still in the midst of trying to find a helpful OB/GYN when I had a medical emergency with severe pain and mid-cycle bleeding that essentially forced the terrible previous OB/GYN office to refer me to a reproductive endocrinologist (AKA a fertility specialist). I actually considered myself LUCKY to have that emergency because I finally got the care (and the diagnosis) I needed. I was right… I did have PCOS. Not to mention, the same RE who helped with the diagnosis after the emergency immediately began working with me to resolve my issues and begin a fertility plan.
Question: What has been your experience actually being plus size and pregnant? I’ve never seen someone my size pregnant, and I’d love to know what it’s like.
I actually feel a little guilty even sharing my response to this. While the journey to GET pregnant was a difficult one, my pregnancy has been really easy so far. I had zero nausea or morning sickness. I’ve been pretty exhausted, but I’ve just been allowing myself to get extra sleep at night guilt-free. The only real symptom I faced in the first trimester was food aversions. I hated EVERYTHING. But, I was able to make it work.
Now that I’m further along (22 weeks as I write this), I’m starting to feel some physical pain. After I’ve been sitting for a while, it’s uncomfortable when I stand up and walk. It’s also getting a bit harder to bend over which makes parts of daily life a challenge. I’m really grateful for my heating pad and a very helpful hubby! Haha.
Every pregnancy is so different… I find it best to avoid comparison as much as possible. I will say, though, that it seems as though my pregnancy has been even easier than most of my thin friends, at least so far. I’m sure I’ll have updates to this response once I’m further along, especially given that I’m having twins.
Question: Is your pregnancy considered high-risk? If so, is it due to your size, the fact that you’re having twins or both?
My pregnancy is considered high risk but as a natural worrier… I like the extra medical attention and getting to see babies on ultrasound every two weeks instead of every four weeks.
It’s considered high risk for both factors… my BMI and the fact that I’m having twins. Interestingly enough, I don’t even remember my doctor SAYING that I was high risk because of my BMI but I saw it included in his letter to the high risk/maternal-fetal medicine doctor (MFM) once my care was transferred to them.
The fertility doctor and my current high-risk OB have handled any weight discussions with such care and compassion, and it honestly doesn’t even really come up in discussion.
My understanding is that every twin pregnancy is considered high risk, and the focus of my care has really surrounded that, not my size.
Question: What is your pregnancy protocol from your doctor?
My protocol is pretty much like any other pregnant person’s protocol. Watch caffeine intake, don’t eat deli meat, drink lots of water, try to stay active, etc.
I take prenatal vitamins, folic acid, and vitamin D every day. We also recently added in a daily aspirin to prevent high blood pressure/ pre-eclampsia although my blood pressure has been perfect so far (thankfully)!
I see the high-risk OB every four weeks currently and get ultrasounds and cervix checks every two weeks. Soon, after 24 weeks – I believe, those visits and ultrasounds will become more frequent.
I did also have earlier testing for both gestational diabetes and preeclampsia than usual due to my high-risk status. Again, I was happy to be proactive and was fortunate that I didn’t have either issue.
Question: I’m pregnant too and really scared to gain weight. Any advice?
My advice is to spend as little time focusing on weight as possible during pregnancy and focus on eating and drinking the things that will keep you and your baby healthy. I honestly have lost weight so far in the pregnancy due to my food aversions in the first trimester so it’s not necessarily true that you’ll gain a lot of weight just because you were plus size before getting pregnant.
PS- I know me admitting that I’ve lost weight during pregnancy will spark more questions from some… my doctor is fine with it as my babies are on target and growing really well. I’ve started gaining back a bit of what I lost and all is well.
I think the most important thing is to work with your doctor and try to stay within the recommended ranges for weight gain if you can. If you need nutrition support or any other support during pregnancy, don’t hesitate to ask for referrals.
Question: Do you have PCOS? I know it’s common for plus size women and it’s what I’m battling.
I do. I didn’t know for sure that I had it until I was under the care of my fertility specialist but had suspected it for years.
It’s extremely common in plus size women (and in thin women too for that matter). I highly encourage anyone reading this look into PCOS and educate yourself on the topic. Knowing what you’re dealing with is a HUGE step in the right direction.
Question: Do you have any issues with the ultrasounds due to your size?
Not at all. This is one of the fears I had initially too. I didn’t know if the beds would work or if there was too much fat on my stomach to see the babies, etc. That has NEVER been an issue for me.
There have been times when the ultrasound techs haven’t been able to get certain images they needed but they’ve always attributed that to wiggly babies and/or their positions. They’ve never said anything about my size causing any problems even if it maybe has been the case. Because I get such frequent ultrasounds, they just always get any images they miss the next time.
Question: How do you handle “when are you having a baby” questions when you’re struggling?
Honestly, I would always say something like, “When God sees fit” or something like that… then I’d usually go home and cry.
People have good intentions, but those questions can cut deeply when you’re in the middle of the pain.
I personally wasn’t emotionally able to explain the situation to people so I avoided the topic and closed it down. I’m not sure if that was the healthiest way to handle it but that’s what I did.
Question: Did your fertility specialist require you to lose weight before working with you?
My fertility specialist did ask that I lose 15 pounds once I began taking metformin for my PCOS prior to starting fertility treatment. He explained it in a really helpful way (I wish I could remember the details) but it was something about how even a small weight loss would support the changes to my hormones and insulin levels and support the work the medication was doing in my body. When every other doctor had recommended weight loss surgery, significant weight loss, or even refused to help me altogether, I felt 15 pounds was fair and achievable so I worked hard and did it.
Question: Were the shots you had to take painful or difficult?
Because we did an IUI, not IVF, I only had to do one shot. My hubby is not a fan of needles so I didn’t want to put him through giving me the shot. I did it myself. I didn’t find it painful at all and was honestly excited to do it (I’m weird). I wasn’t exactly excited about the needle, but I felt strong and brave and was dedicated to the outcome so it didn’t phase me.
Question: What is your biggest piece of advice to someone starting the journey?
Don’t allow ANYONE, especially not the physicians entrusted to your care, discourage you from finding answers to the issues you face. You are your biggest advocate and no one cares more about your outcome than you and your partner.
Also, seek support in whatever ways you need it. For me, I relied almost exclusively on my husband for support, because I struggled to even discuss the topic with anyone else but I think extra support from family, friends, or even a counselor or therapist would be VERY helpful for both you and your partner during this time.
Have more questions? Comment below
I THINK this post covers most of the frequently asked questions I’ve gotten about fertility, but if I didn’t answer your question… leave a comment below so I can answer. I’ll be updating the post as new questions come through.