Show notes
Content note: This episode discusses weight loss, weight-based medical discrimination, and fertility challenges. Please take care of yourself as you listen.
This week’s episode is one that made me both furious and hopeful in equal measure. I sat down with Zoe, who spent years being told to lose weight before she’d be taken seriously about her fertility. After losing nearly four stone and still getting nowhere with UK fertility services, she went to Greece for testing and discovered extensive uterine scarring that would’ve prevented pregnancy entirely, regardless of her weight.
If you’ve ever been dismissed by doctors who only see your body size, or if you’re stuck in “unexplained infertility” territory, this episode is for you. Zoe’s story shows why proper investigation matters and what becomes possible when you get the care you actually deserve.
In this episode, we cover:
- Why “unexplained infertility” often means “we haven’t investigated properly” and what testing might be missing
- How Zoe discovered extensive uterine scarring that was completely treatable but would never have been found in the UK system
- The reality of accessing fertility care abroad and why Greece became the answer when UK services kept saying “lose weight first”
- What a hysteroscopy revealed in 10 minutes that years of UK appointments had missed
- Why weight loss couldn’t have solved the actual problem and what that means for anyone being told their size is the issue
Useful Links:
Download: Fat Person’s Guide to Getting Pregnant
Book a Fat Positive Fertility Roadmap Call
Email me a question for a future episode
Emma Haslam’s work helping UK folks access fertility care abroad
The Full Story
Zoe’s fertility journey began the way so many do: with hope, then growing concern, then eventual frustration when nothing seemed to be happening. She’d come off the pill in 2017, and like many of us, assumed pregnancy would just happen naturally. Years passed. Life happened. But no pregnancy.
When she finally went to her GP in 2023—six years after coming off contraception—the response was depressingly familiar: lose weight, and then we’ll see you.
The Weight Loss That Changed Nothing
Here’s what’s important to understand about Zoe’s story: she did lose weight. Nearly four stone of it. Not because she believed it would solve her fertility issues, but because she knew she needed to prove it wouldn’t. She needed to show that weight wasn’t the barrier everyone assumed it was.
Even after that significant weight loss, her BMI was still around 36.5, not low enough to qualify for NHS fertility treatment, which requires a BMI under 30 in most areas. In Lancashire, where Zoe lives, she would’ve needed to lose a total of 10 stone to access NHS support. That’s not just a steep requirement, it’s an impossible timeline when you’re already in your late 30s and facing age-related fertility decline.
“Me losing weight was never about me not being bigger,” Zoe explained. “It was always about giving myself the best opportunity to be taken seriously by a medical professional.”
Finding Another Path
This is where Emma Haslam comes into Zoe’s story. Emma specialises in helping UK folks access fertility care abroad, and Zoe knew her through work. When Zoe reached out, Emma’s response was clear: Greece. In Greece, Emma explained, the focus is on family, not on arbitrary BMI cutoffs or weight-based assumptions.
Zoe and her husband Ben flew to Greece in November 2025 for initial testing. The plan was to gather information, understand their options, maybe start thinking about IVF. Within 10 minutes of her first appointment, everything changed.
The Discovery That Changed Everything
During a pelvic exam, the doctor struggled to pass a catheter through Zoe’s cervix for an aquascan. She and her colleague started speaking rapidly in Greek. Zoe and Ben looked at each other, wondering what was happening.
“Ten minutes before, she’d said ‘I don’t think you need IVF,’” Zoe recalled. “Then suddenly it was ‘I think you’re going to need IVF’ and ‘come back tomorrow for a hysteroscopy.’”
A hysteroscopy is a procedure where a camera is inserted into the uterus to see what’s actually going on inside. It requires general anaesthetic and isn’t routinely offered in the UK unless you’ve had multiple miscarriages or specific symptoms. Zoe had neither, she’d never even had a positive pregnancy test.
The next day, under general anaesthetic, the doctor performed the hysteroscopy. What she found was extensive scarring throughout Zoe’s uterus, so much scarring that the endometrial lining wasn’t getting enough oxygen. The doctor was clear: “You never would have got pregnant naturally. IVF wouldn’t have worked either. Nothing would have worked because of this scarring.”
But here’s the crucial part: she removed all the scarring during that same procedure. In 40 minutes, she’d found the problem and fixed it.
What Causes Uterine Scarring?
Intrauterine scarring (also called Asherman’s syndrome) is typically caused by four things: a D&C procedure, miscarriage, previous uterine surgery, or infection. Zoe had never experienced the first three. That leaves infection as the likely cause, but she’d never had symptoms.
This is what “unexplained infertility” often looks like: there is an explanation, but it’s hidden. It requires investigation that goes beyond basic blood tests and ultrasounds. It requires doctors who are curious enough to keep looking.
The Weight Conversation That Never Happened
Throughout Zoe’s entire experience in Greece, the initial consultation, the testing, the hysteroscopy, the recovery appointments, weight came up exactly once: when they asked her what she weighed for the pre-surgery cardiogram. They didn’t weigh her themselves. They didn’t lecture her. They didn’t make her BMI part of the conversation about her fertility.
“At no point was weight even in the ether of what we were discussing,” Zoe said. “There was no conversation about what my size was, how much I weigh, why this wouldn’t work because of my weight or anything like that.”
This stands in stark contrast to her UK experience, where “lose weight” was the entire conversation. Where years passed with that being the only advice offered. Where her actual fertility issue, the scarring that would have prevented any pregnancy, at any weight, was never investigated.
The Bigger Picture
Zoe’s story matters because it exposes several critical gaps in UK fertility care:
Testing gaps: Procedures like hysteroscopy aren’t routinely offered unless you fit specific criteria. If you haven’t had miscarriages, if you don’t have extreme pain, you likely won’t get this investigation—even though it could reveal treatable issues.
Weight-based barriers: BMI requirements for NHS fertility treatment mean that many folks in bigger bodies never access proper investigation, let alone treatment. Even going private often involves BMI restrictions.
The cost of waiting: Zoe wishes she’d explored options abroad two years earlier. That’s two years of her reproductive timeline she can’t get back, time spent jumping through hoops that ultimately didn’t address her actual fertility barrier.
“Unexplained” doesn’t mean unexplainable: It often just means we haven’t looked hard enough. Zoe’s scarring had a cause. It had a treatment. But without the right investigation, it would have remained “unexplained” forever.
Where Things Stand Now
Zoe is three months post-surgery and trying to conceive naturally. The doctor who treated her was clear: “There’s no reason you can’t get pregnant now.” If natural conception doesn’t happen within a few months, Zoe and Ben will return to Greece for IVF, but this time with a uterine environment that can actually support a pregnancy.
The total cost for all her testing in Greece, including the hysteroscopy? £3,000. That included chromosomal testing, microbiome analysis, and the surgical procedure itself. For context, a single round of IVF in the UK typically costs £5,000-£8,000, and it wouldn’t have worked for Zoe without first addressing the scarring.
What This Means for You
If you’re reading this and thinking about your own fertility journey, here’s what I want you to take away:
You deserve curiosity from your healthcare providers. You deserve thorough investigation. And you deserve to know that “lose weight and come back” is not adequate fertility care, it’s a dismissal dressed up as medical advice.
If you’ve been told your infertility is “unexplained,” it might be worth exploring what testing you haven’t had yet. If UK services are gatekeeping care behind BMI requirements, there are options abroad where your body size won’t be the primary conversation.
Zoe’s story shows what becomes possible when you get actual investigation instead of assumptions. When doctors look at what’s happening inside your body rather than just looking at your body itself.
Ready to navigate your fertility journey with proper support? Learn more about working with me through my Fertility Roadmap calls, where we explore all your options, including what testing might be missing and how to access care that actually serves you.
