Fertility Treatments vs. VSG surgery

[misslady 130]

Well I really need some feed back on this one. Do I begin fertilty treatments or have the surgery first? The problem is the age factor. My ob/gyn has told us because of issues with my husband and my age we would need fertility treatments to have a higher chance of concieving. However, he is not willing to do treatments after 46 years of age and guess who turns 46 this year, ME! He is willing to try 3 cycles which will give me a weight gain of course. The road to surgery is just lacking insurance approval, waiting on me to tell them to submit. If I have the surgery I woudl have to wait a year before we could try and that puts me closer to 48.

I have fought thru months of mental and emotional stress, research, reading, praying all to get to a comfortable place about doing the surgery now this. And it's a major this! My ob/gyn has no issues with my weight or co-morbities because they are "controlled" with meds. I am confused as to which way to I go. Any comments are shared experiences would ne greatly appreciated. Thinking about the increased weight with treatments and pregnancy if that would be healthy enough to carry a baby. So many things whirling around in my mind.

[DrmBig4Evr 152]

Why can't you try both? Start the medicine now, gain weight, if you don't conceive then do this...if you do conceive do this after you have your baby.

[Kristina J. 581]

It sounds like your reality is that you CAN'T do both. If I'm not mistaken. If that is not an option and you really want children, it sounds like you may have to do the fertility treatments while you can and put off the VSG for a few years. It is in no way ideal, but one is limited by time and the other can be successful no matter when you do it. Best of luck!

[Kristina J. 581]

Also, I should add, I was younger, 26 and 28, but I delayed revision surgery and carried both my children with a BMI of 48+ and comorbidies. I wanted to start my family and decided that would come first. My pregnancies were not "easy" but they were healthy.

[Chris R 217]

I know they say that you shouldn't get pregnant for something like 2 years after weight loss surgery, because it's harder to get the nutrition that both you and the baby need. At age 46 and overweight, your pregnancy would be high-risk to begin with, I would think the nutrition issues might make it even more difficult.

At 5'8", I had my first child at age 30, and weighed 295 when I got pregnant. I developed gestational diabetes, but didn't have any other complications and carried 1 week past due date. I gained about 36 lbs with the pregnancy. My son was healthy and 8 lbs 12 oz. I had my second child at 37, after I had been diagnosed with type II diabetes. I weighed over 350 lbs when I got pregnant with her. They immediately put me on insulin, which I had to take 4 times a day, to keep my blood sugar under control during the pregnancy. I actually lost weight during the pregnancy. I had no difficulties until 3 1/2 weeks before the due date, when my amniotic Fluid suddenly dropped, so they decided to go ahead and deliver. Two attempts at induction failed, so I had a C-section, but my daughter was perfectly healthy and 6 lbs 9 oz.

I would have a serious talk with both your OB-GYN and your Gastroenterologist about this. I don't think I'd want to take both things on at once, and waiting to try for children at this point could mean too late.

[iggychic 1,405]

ART or IVF is very hard on your body and not something you can do while on a highly restrictive diet, not to mention while recovering from surgery. Getting your hormone levels straight alone would be impossible, making the ART a total waste of money.

At 46 your chances of success are not great...you likely know this, but if you are to be successful time is of the essence. Each year your chances go down exponentially. If you want to get pregnant you must do that first. You couldn't even take the meds necessary for ART or IVF after surgery. It's really a no brainer (ok for me cuz I've done both). You have no option but to do the ART first then when you are either successful or you chose to quit trying you can move to VSG.

in the mean time you can look to trying a six month weight loss period or diet. That you can do easily while also doing ART.

I wish you the best. I know that both are hard roads to travel.

[Evolving 973]

Well I really need some feed back on this one. Do I begin fertilty treatments or have the surgery first? The problem is the age factor. My ob/gyn has told us because of issues with my husband and my age we would need fertility treatments to have a higher chance of concieving. However' date=' he is not willing to do treatments after 46 years of age and guess who turns 46 this year, ME! He is willing to try 3 cycles which will give me a weight gain of course. The road to surgery is just lacking insurance approval, waiting on me to tell them to submit. If I have the surgery I woudl have to wait a year before we could try and that puts me closer to 48.

I have fought thru months of mental and emotional stress, research, reading, praying all o get to a comfortable place about doing the surgery now this. And it's a major this! My ob/gyn has no issues with my weight or co-morbities because they are "controlled" with meds. I am confused as to which way to I go. Any comments are shared experiences would ne greatly appreciated. Thinking about the increased weight with treatments and pregnancy if that would be healthy enough to carry a baby. So many things whirling around in my mind.[/quote']

Are there any doctors u CAN go to after --- ? I plan to do fertility tx after but I'm also 32 now--- do what u feel us right-- a healthy weight is a better chance of a healthy pregnancy I believe good luck!!!!

Sent from my iPhone using VST

[misslady 130]

Thank you all so much. Going to see my ob in a week for some more serious conversation.

[clk 3,519]

In your case, I'd do ART now, unless your weight is a very serious consideration. I'm not sure of your specifics or stats.

At the very least, do the stim cycle/harvest and have him give his donation to the cause as well. I'm assuming IVF, of course.

DH and I did IVF w/ICSI in 2007 - I was obese but otherwise the doc had no serious concerns about my conceiving. We did have success (b/g twins!) and we froze five embryos as well.

I had my sleeve in 2010. In July of 2012 we did a frozen transfer of the embryos that made the thaw and I'm due in three weeks. In all absolute honesty I am going to state that in my case, at least, this pregnancy post VSG was HARDER than the twin pregnancy prior. I'm healthy, yes - and I didn't develop gestational diabetes this go round which was nice. But watching my diet and general physical discomfort were actually worse. I'm not saying that having babies while obese is the ideal - I'm just saying that for me, losing the weight didn't make pregnancy as easy or better like my docs told me it would!

I say do a cycle now. Do your sleeve post baby, once you're done weaning (assuming you plan to BF) and then focus on your body and you. I didn't conceive until two years post sleeve and it was still a challenge to build up to eating enough and eating properly. I cannot even imagine doing it sooner, though many women do.

Some types of ART are more likely to make you pack on pounds than others. I can say that I gained quite a bit with my full IVF cycle because the stims. No doubt, it was absolutely worth it to me. This go round I was really worried about weight gain and I admit that the hormones did have me gain ten pounds almost right out of the gate, but then I slowly put on the rest of my gain over the next seven months. I've had a perfectly normal weight gain this time and it's apparent that it's all baby. I have no doubt I'll be back at goal within months of delivery.

Best of luck to you!

~Cheri

Edited to add: Do yourself a favor and find an aggressive reproductive endocrinologist that's experienced with advanced maternal age. Don't waste your time on someone that hasn't dealt with your situation before - get onto some fertility message boards and put feelers out, because as iggy mentioned, your rates of success are lower (sorry to say) so you don't want to waste precious time. All the best!

[iggychic 1,405]

Cheri, great idea! OP, there is an IVF specialist in Denver who specializes in advanced maternal age. Their rates for over 45 are top in the nation. They use a form of viagra that increases the uterine wall lining (biggest issue for most of us). You don't need to live there, just fly there for a couple visits and they work with your local doc. But yes, do find a specialist that has proven success rates in the geriatric group . we have different issues than the kids do.

[misslady 130]

In your case, I'd do ART now, unless your weight is a very serious consideration. I'm not sure of your specifics or stats.

At the very least, do the stim cycle/harvest and have him give his donation to the cause as well. I'm assuming IVF, of course.

DH and I did IVF w/ICSI in 2007 - I was obese but otherwise the doc had no serious concerns about my conceiving. We did have success (b/g twins!) and we froze five embryos as well.

I had my sleeve in 2010. In July of 2012 we did a frozen transfer of the embryos that made the thaw and I'm due in three weeks. In all absolute honesty I am going to state that in my case, at least, this pregnancy post VSG was HARDER than the twin pregnancy prior. I'm healthy, yes - and I didn't develop gestational diabetes this go round which was nice. But watching my diet and general physical discomfort were actually worse. I'm not saying that having babies while obese is the ideal - I'm just saying that for me, losing the weight didn't make pregnancy as easy or better like my docs told me it would!

I say do a cycle now. Do your sleeve post baby, once you're done weaning (assuming you plan to BF) and then focus on your body and you. I didn't conceive until two years post sleeve and it was still a challenge to build up to eating enough and eating properly. I cannot even imagine doing it sooner, though many women do.

Some types of ART are more likely to make you pack on pounds than others. I can say that I gained quite a bit with my full IVF cycle because the stims. No doubt, it was absolutely worth it to me. This go round I was really worried about weight gain and I admit that the hormones did have me gain ten pounds almost right out of the gate, but then I slowly put on the rest of my gain over the next seven months. I've had a perfectly normal weight gain this time and it's apparent that it's all baby. I have no doubt I'll be back at goal within months of delivery.

Best of luck to you!

~Cheri

Edited to add: Do yourself a favor and find an aggressive reproductive endocrinologist that's experienced with advanced maternal age. Don't waste your time on someone that hasn't dealt with your situation before - get onto some fertility message boards and put feelers out, because as iggy mentioned, your rates of success are lower (sorry to say) so you don't want to waste precious time. All the best!

Thank you for the tips. I am 45 I'm 5'8' eigh 240lbs my co morbidare whats driving my desire for VSG more than even weight. I have sleep apnea, diabetes, hypertension, sore joints ....all those fluggy girl things lol but seriously he is a specialist and he does not know about my journey to WLS yet(he will next week). He has never mentioned my weight as an obstacle. My husband has the fertility issue but of course my age is considered. My reserve is decent for my age. He will use Menopur injectables and try intauterine insemination ( 3 attempts). We have no coverage for fertility treatment and can't afford the 15,000+ for IVF.