Call for IVF ban for obese, but young, smoking lesbians are OK
Very obese women should be denied IVF fertility treatment, experts say. The British Fertility Society is recommending women with a body mass index of 36 and over should not be allowed access to fertility treatment. Underweight women and those classed just as obese (BMI over 29) should be forced to address their weight before starting treatment, the society said. NHS guidelines say overweight women should be warned of the health risks, but do not impose any ban on treatment.
Being overweight can put both the health of the mother and child at risk through problems such as gestational diabetes and high blood pressure. In reality, many primary care trusts do not fund women who are obese. The BFS has published its recommendations in a bid to end the IVF "postcode lottery". It wants to standardise treatment so that clinics use the same criteria in relation to age and family status as well as weight.
"What we are saying is that they should be less stringent and more consistent with how they apply this. Obese women are less likely to get pregnant and more likely to encounter health problems. It makes sense to address obesity before seeking fertility treatment."
The BFS, which represents health fertility professionals, also recommended single women and same sex couples be given the same priority as heterosexual couples.
NHS guidelines say women aged 23 to 39 should be entitled to three cycles of IVF, although the government gave the health service a deadline of April last year to provide one cycle with a view to working towards three.
The society made its recommendations after surveying 64 fertility clinics in England and Wales.
It received responses from 37, showing one in 10 was not providing IVF treatment free on the NHS because they were not being given funding by the local PCTs. None of the clinics was providing three cycles, the poll, which will be published in the Human Fertility journal in September, said.
The poll also showed many of the PCTs which did provide IVF treatment were restricting access by taking social factors into account. These included barring people from treatment if one of the partners already had a child from a previous relationship or because the couple had paid for private treatment before going to the NHS.
And it also revealed a quarter of clinics were also restricting treatment according to age, with most only allowing women in their late 30s to have IVF. Dr Gillian Lockwood, who chairs the BFS's ethics committee, told the BBC that "unfairness" was the aspect of the NHS provision which people objected to most.
But Dr Lockwood said there were clinical factors which affected the success of IVF and, as well as weight concerns being over the age of 40 meant that "even very high-tech treatments like IVF are really very unsuccessful".
She added: "For £2,500, you have at least a 50% chance of producing a much wanted, beautiful healthy baby - the same cost as stripping varicose veins. I think the fourth richest country on earth should be able to afford effective fertility care for its citizens."
Clare Brown, chief executive of Infertility Network UK said: "From our own surveys and from the many, many calls we receive from patients, we know only too well that there are still unacceptable inequalities in the funding of treatment around the country and couples face huge difficulties in accessing services."
But Josephine Quintavalle, of the organisation Comment on Reproductive Ethics, told BBC Five Live limited NHS budgets needed to be focused on treatment for groups which would benefit the most.
"If it's a proven fact that it's very difficult to get pregnant when you're overweight, then the logical cure for that kind of infertility is to encourage the patient to lose weight."
Jo Webber, deputy director of policy at the NHS Confederation which represents over 90% of NHS organisations, said: "We recognise the distressing circumstances that couples with infertility problems find themselves in. However, primary care trusts receive a fixed allocation of money to deliver all the services for their local community and have to take difficult decisions on competing priorities."
The Department of Health said that, while it did not support bans being imposed, the current NHS guidelines were broadly in line with the recommendations on obesity.
A spokeswoman added: "Primary responsibility for implementing NICE guidelines, including the rate of implementation, rests with the NHS at local level and we have made it clear that we expect these guidelines to be followed."
She said the government was working with patient group Infertility Network UK to ensure PCTs listened to the views of patients.
http://news.bbc.co.uk/1/hi/health/5296200.stm
Dr John Reid made his infamous promise about the NHS funding three cycles of IVF a few months before Health Direct Blog got going. However we've found a copy of the origional promise on the Guardian's website. A summary is copied at the bottom of today's blog.
Health Direct did follow up on the promise a year later and found that: Feb 01, 2005 Labour Government pledge on IVF in tatters as units fail to cope with demand Thousands of couples desperate to become parents will not receive free fertility treatment, despite a government pledge to offer at minimum of one cycle on the National Health Service.
An investigation by revealled that fertility services in England and Wales are in crisis, with some NHS trusts refusing to supply any treatment for certain couples.
Health Direct questions the logic of more social engineering by the BFS when the Labour Government's delivery of NHS IVF services is of such muppetry proportions anyway.
Reid acts to end IVF postcode lottery- NHS to offer all infertile women under 40 one cycle of treatment Feb 25, 2004
All infertile couples where the woman is under 40 will be offered at least one full cycle of IVF treatment on the NHS from April next year, as the first stage towards making fertility services a more integral part of the state health system.
The health secretary, John Reid, has not, however, put a time scale on full implementation of recommendations from clinical watchdogs for three cycles to be offered.
That would cost an estimated £85m a year in England and Wales and Mr Reid says the transition cannot be made overnight. Priority will be given to couples who have no adopted or foster children.
The guidelines published yesterday by the National Institute for Clinical Excellence (Nice) will, when fully implemented, cause an extra 5,000 babies to be born a year, a huge increase on the 8,000 now conceived through IVF.
Being overweight can put both the health of the mother and child at risk through problems such as gestational diabetes and high blood pressure. In reality, many primary care trusts do not fund women who are obese. The BFS has published its recommendations in a bid to end the IVF "postcode lottery". It wants to standardise treatment so that clinics use the same criteria in relation to age and family status as well as weight.
"What we are saying is that they should be less stringent and more consistent with how they apply this. Obese women are less likely to get pregnant and more likely to encounter health problems. It makes sense to address obesity before seeking fertility treatment."
The BFS, which represents health fertility professionals, also recommended single women and same sex couples be given the same priority as heterosexual couples.
NHS guidelines say women aged 23 to 39 should be entitled to three cycles of IVF, although the government gave the health service a deadline of April last year to provide one cycle with a view to working towards three.
The society made its recommendations after surveying 64 fertility clinics in England and Wales.
It received responses from 37, showing one in 10 was not providing IVF treatment free on the NHS because they were not being given funding by the local PCTs. None of the clinics was providing three cycles, the poll, which will be published in the Human Fertility journal in September, said.
The poll also showed many of the PCTs which did provide IVF treatment were restricting access by taking social factors into account. These included barring people from treatment if one of the partners already had a child from a previous relationship or because the couple had paid for private treatment before going to the NHS.
And it also revealed a quarter of clinics were also restricting treatment according to age, with most only allowing women in their late 30s to have IVF. Dr Gillian Lockwood, who chairs the BFS's ethics committee, told the BBC that "unfairness" was the aspect of the NHS provision which people objected to most.
But Dr Lockwood said there were clinical factors which affected the success of IVF and, as well as weight concerns being over the age of 40 meant that "even very high-tech treatments like IVF are really very unsuccessful".
She added: "For £2,500, you have at least a 50% chance of producing a much wanted, beautiful healthy baby - the same cost as stripping varicose veins. I think the fourth richest country on earth should be able to afford effective fertility care for its citizens."
Clare Brown, chief executive of Infertility Network UK said: "From our own surveys and from the many, many calls we receive from patients, we know only too well that there are still unacceptable inequalities in the funding of treatment around the country and couples face huge difficulties in accessing services."
But Josephine Quintavalle, of the organisation Comment on Reproductive Ethics, told BBC Five Live limited NHS budgets needed to be focused on treatment for groups which would benefit the most.
"If it's a proven fact that it's very difficult to get pregnant when you're overweight, then the logical cure for that kind of infertility is to encourage the patient to lose weight."
Jo Webber, deputy director of policy at the NHS Confederation which represents over 90% of NHS organisations, said: "We recognise the distressing circumstances that couples with infertility problems find themselves in. However, primary care trusts receive a fixed allocation of money to deliver all the services for their local community and have to take difficult decisions on competing priorities."
The Department of Health said that, while it did not support bans being imposed, the current NHS guidelines were broadly in line with the recommendations on obesity.
A spokeswoman added: "Primary responsibility for implementing NICE guidelines, including the rate of implementation, rests with the NHS at local level and we have made it clear that we expect these guidelines to be followed."
She said the government was working with patient group Infertility Network UK to ensure PCTs listened to the views of patients.
http://news.bbc.co.uk/1/hi/health/5296200.stm
Dr John Reid made his infamous promise about the NHS funding three cycles of IVF a few months before Health Direct Blog got going. However we've found a copy of the origional promise on the Guardian's website. A summary is copied at the bottom of today's blog.
Health Direct did follow up on the promise a year later and found that: Feb 01, 2005 Labour Government pledge on IVF in tatters as units fail to cope with demand Thousands of couples desperate to become parents will not receive free fertility treatment, despite a government pledge to offer at minimum of one cycle on the National Health Service.
An investigation by revealled that fertility services in England and Wales are in crisis, with some NHS trusts refusing to supply any treatment for certain couples.
Health Direct questions the logic of more social engineering by the BFS when the Labour Government's delivery of NHS IVF services is of such muppetry proportions anyway.
Reid acts to end IVF postcode lottery- NHS to offer all infertile women under 40 one cycle of treatment Feb 25, 2004
All infertile couples where the woman is under 40 will be offered at least one full cycle of IVF treatment on the NHS from April next year, as the first stage towards making fertility services a more integral part of the state health system.
The health secretary, John Reid, has not, however, put a time scale on full implementation of recommendations from clinical watchdogs for three cycles to be offered.
That would cost an estimated £85m a year in England and Wales and Mr Reid says the transition cannot be made overnight. Priority will be given to couples who have no adopted or foster children.
The guidelines published yesterday by the National Institute for Clinical Excellence (Nice) will, when fully implemented, cause an extra 5,000 babies to be born a year, a huge increase on the 8,000 now conceived through IVF.
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