Just Fat, Not Morbidly Obese

Yes, I did break down and email my RE about the whole being fat/poor response question. I couldn't help myself in the end. And, I did have to find out my progesterone results, right? My original email and his response are below for your reading pleasure. Notice how I ask him a question, then tell him what I think the answer is? LOL. I can't help myself. I have tried to just ask questions without editorial comments and adding what I think the answer is. I just can’t do that. I can’t. I feel compelled to tell him what I think is the correct answer and then he just has to confirm I was right or tell me the errors in my logic.

What a guy! My interpretation is that it was not a factor for me since I am not morbidly obese, just fat. I am sure that the weight didn’t help, but I do feel a bit better after reading his response. And, I had to laugh about my progesterone results being "more than adequate". Anything above 5 indicates ovulation; they want to see above 10 on a natural cycle and above 15 on a medicated cycle. He knows I know this, have long had it memorized, and can and do quote it often. However, it is all relative, since a 12 IS a decent progesterone level for me. Yes, that IS with 400 mg of vaginal suppository supplementation a day, but it is over 10 and close to the highest progesterone level I ever got (around 15) and that was when I was 10 -11 weeks pregnant with Max. I’m happy with my 12.

And, I did read the articles from my friend on BMI (Body Mass Index) affecting fertility. I was a bit afraid to read what they said, but decided to suck it up. They all talk about how success rates decline with a higher BMI and some of the other issues that I already know about, but I did not read any strong link, only a slight mention, about response to response rate. In fact, one article stated that the number of follicles, the number of eggs retrieved, and the number of fertilized eggs were about equal, it was the chemical and clinical success rates that were lower. Oddly enough, I was actually encouraged after reading the articles. Out of 6 complete cycles (excluding current cycle since results are currently unknown), I had 3 pregnancy’s and 1 child. This is a decent stat all things considered when you hear the odds of conception naturally for any one given cycle and that on average it takes about 6 months to conceive.

All and all. I’m feeling much better about things today. It is almost a whole day closer to Friday. And, I have dinner with Mom on Wednesday and my sister is going to come and stay on Thursday night so HOPEFULLY the rest of the week will go by relatively fast and I will have enough distractions to keep me from worrying too much. Yes, it is always in the back of my mind. I just wish I knew now.


-----Original Message-----
From: Debbie
Sent: Tuesday, August 08, 2006 11:22 AM
To: DR. N
Subject: P4 results in? And, poor responder question

Hi Dr. N - Just wondering if my progesterone results from Friday were in yet? Also, I was reading the transcripts from your live chat the other day and there was a question about being overweight being a contributing factor in poor response. I had never heard that before. Just that it could affect hormone levels, ovulation, make ET/ER a bit more difficult. I’m assuming that it has something to do with the absorption, which is why it is recommended to do IM shots instead of SubQ. What’s the theory? In an ideal situation, the stims get absorb into the blood stream triggering a response in the hypothalamus and in an overweight person it gets absorbed into the fat cells causing diminished response? How does this work for oral stims like clomid or letrozol? The same except it is being absorbed from the stomach instead? How likely do you think my being overweight has played in my dismal response to even high doses of stims? Just wondering from an academic standpoint since it is very unlikely, if not completely impossible, that I would be able to loose enough weight to make a difference even if there wasn’t a limited time associated with my remaining fertility. See, plenty of other things to worry about other than whether this cycle worked or not. And, no, I don’t have a clue or a prediction on the cycle outcome. I have been tired and sleeping great, but that is likely progesterone induced. And, I have been a bit crampy and felt like my uterus was spasming, which probably many would see as a good sign, but I have never had on any of my confirmed pregnancy only my 3rd cycle (the one after my myomectomy) which was a negative. So, anyone’s guess at this point. My guess would be a no go, but I have been wrong before and would be happy to be wrong on this again. Friday’s beta will tell the tale. Hope you are having a good week. Debbie

----- Response -----
From: Dr. N
Sent: Tuesday, August 08, 2006 2:03 PM
To: Debbie
Subject: RE: P4 results in? And, poor responder question

Exactly right about the overweight theory. But the studies looked at morbidly obese women ( over 300 lbs) For just overweight patients it does not matter. Your progesterone was 12.3. More than adequate.