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Scottish fertility experts call for IVF ban for obese women

Dr. Kirsty Horsey

Progress Educational Trust

17 December 2005

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[BioNews, London]

A public consultation, taking place as part of the Scottish Executive review of NHS-funded fertility treatment in Scotland, closed this week. The consultation set out to examine clinical criteria for treatment, such as age limits; social criteria such as whether couples have no other children in the home; and other issues such as potential impact on waiting lists that may result from widening access to treatment. Despite guidelines for national criteria for Scottish NHS-funded infertility treatment laid out by the Expert Group on Infertility Services in Scotland (EAGISS) in 1999, service provision amongst NHS Boards has remained inconsistent.

This week an advisory group comprised of the heads of Scotland's IVF units, leading clinicians and patient representatives submitted a report to a cross-party parliamentary group recommending a ban on NHS-funded IVF for clinically obese women. Currently, individual health boards are able to select patients for treatment according to their own policies, with Glasgow Royal Infirmary the only one of Scotland's four publicly-funded fertility clinics to already ban IVF for obese women. Fertility centres in Aberdeen and Dundee do provide treatment to obese patients, but they are required to join a weight loss programme. If ministers were to accept their recommendations it would be the first time Scotland has implemented a blanket government policy limiting health care according to patient weight.

Although the view was not unanimously held, the recommendation will suggest that women with a body mass index (BMI) of 36 and over will automatically be denied treatment. A BMI measuring over 30 marks clinical obesity, with 40 and over indicating morbid obesity. Chairman of the advisory group Dr Mark Hamilton, a consultant obstetrician at Aberdeen Royal Infirmary and an inspector for the Human Fertilisation and Embryology Authority, was reported as saying that IVF is less likely to be successful in obese women and that 'there are also safety issues for the baby and mother. Politicians are a bit nervous about using weight as a barrier to accessing treatment but we have to be pragmatic and sensible about it, acknowledge that it is an issue in society and take on board that treatment might be hazardous'.

Hamilton added: 'There needs to be a consistent approach to the funding of fertility services throughout Scotland and not only the age of the woman, the number of cycles that couples should receive but also health-based criteria like weight and smoking and so on. We are not trying to use weight as a barrier to treatment - saying that we don't like the overweight - it is a case of safe and appropriate treatment'.



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© Copyright Progress Educational Trust

Reproduced with permission from BioNews, an email and online sources of news, information and comment on assisted reproduction and genetics.

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Date Added: 17 December 2005   Date Updated: 17 December 2005
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Kirsti Sweeten   13 August 2006

This blanket ban would be really unfair. I'm currently on the IVF waiting list at the Glasgow Royal, with a BMI of 32-33. I was a competetive swimmer for many years and work out at my local gym 4-5 times a week. I don't smoke, eat well and financially secure and married. All the hospital care about is my BMI, they don't look at the composition of my weight. As a result of this i struggle to reduce my BMI, all the while my fertility reduces as the months and years go by. However as I have been advised twice now by the hospital, if i wish to pay for my treatment they don't care how fat i am. Tell me where the justice is in that?


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