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Saturday 22nd October 2016

IVF refusal for obese women

31st August 2006

08032006_embryo.jpgAn influential group of IVF specialists have said that women who are obese should not get NHS fertility treatment unless they lose weight, and the most seriously overweight should not be treated free at all.

The British Fertility Society has recommended that free IVF should be limited to women of healthy weight because obesity reduces success rates and adds to the risks of pregnancy. Approximately 27,000 women receive IVF in Britain each year and around a quarter of treatments are provided by the NHS.

Currently primary care trusts offer women at least one free cycle of IVF treatment, but the Government provides no detailed guidelines on who should qualify or any extra funds, meaning that trusts impose a range of restrictions. 

The British Fertility Society proposes that couples with children from previous relationships would qualify and those who have had a child together would be eligible if local funds permit. There would be no discrimination against single women and lesbians. Treatment would be refused to men and women who had previously been sterilised, severely obese women and women aged over 40; women would not be accepted on to a waiting list within six months of their 40th birthdays. Smokers would not be excluded from treatment, but would be given advice on quitting and its implications for fertility.

The Society recommends that women with a body mass index (BMI) of 30 or more should be accepted by NHS fertility clinics only on the condition of dieting and exercise. They also recommend restrictions on very underweight women, with a BMI below 19. At the average female height of 5ft 4in, a BMI of 19 equates to weighing 8 stone. A BMI of 29 equates to 12st 2lb and a BMI of 36 is 15st 1lb.

Richard Kennedy who led the working party said that limiting access to IVF for obese women was a matter of effectiveness and safety, not discrimination; obesity leads to poor prognosis and risks to their health, particularly if an anaesthetic is required during childbirth.

The society‚Äôs proposals, which will be sent to all primary care trusts responsible for funding NHS fertility treatment, are part of the first attempt to draw up national eligibility criteria.  The Health Minister responsible for fertility treatment, Caroline Flint, said that although the Government is not planning to impose national eligibility criteria, it would study the proposals with a view to advising trusts on best practice.

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