Nearly half of fertility experts believe fertility treatment should be denied to people with unhealthy lifestyles, such as smokers or the obese, a survey has found.
More than 45% of the international experts polled, most of which work in the UK, disagreed that fertility treatment should be offered to everyone unconditionally.Just under 29% agreed that "access to in-vitro fertilisation (IVF) should be offered to all regardless of lifestyle", according to the British Fertility Society (BFS) poll.
Obesity and smoking have been linked to fertility problems, so doctors say it is fair to ask patients to change their habits before they are given care. Although most IVF experts work in the private sector, more than 70% of those surveyed thought fertility treatment should be paid for by the NHS.
Dr Allan Pacey, senior lecturer in andrology at the University of Sheffield and secretary of the BFS, said: "For me, the fact that so many experts now believe that IVF should be made freely available to patients through the NHS should be a wake-up call to government and those who decide how NHS money is spent.
"These bodies have scandalously failed to move anywhere near the recommended National Institute of health and Clinical Excellence (Nice) guidelines of three rounds of IVF per patient."The survey also found that almost half of the doctors, nurses and scientists polled thought that new fertility treatments were being offered to patients without sufficient proof that they work.
Almost all those questioned wanted to see more clinical trials to test the effectiveness of novel (IVF) techniques. The survey of 186 fertility experts was carried out to mark the 30th birthday of the first IVF baby, Louise Brown. Louise was born at Oldham and District General Hospital in Greater Manchester on July 25 1978, ushering in a fertility revolution, which continues to this day.
IVF is now a major industry with clinics competing fiercely to provide the best birth rates. A total of 46.2% of participants in the survey agreed that new procedures were being introduced "far too quickly" before they had been adequately tested. Some 85% of those polled thought more clinical trials should be conducted to assess the effectiveness of new treatments. Almost two thirds of the experts predicted infertility rates rising in Europe over the next 30 years.
The government's recent decision to remove the right to anonymity from sperm donors remained unpopular with the experts. Almost 60% either agreed or strongly agreed that donors should not have to have their identities revealed. Dr Mark Hamilton, chairman of the BFS, said the poll's findings did not represent the official policy of the society, or, he believed, the views of the majority of its members.
"There shouldn't be a ban on access to treatment for those with unhealthy lifestyles." He said. "But they should get access to advice and support on how to improve their health, such as information about smoking cessation and weight loss clinics."
However, Hamilton said that IVF should be delayed for women with a body mass index (BMI) in excess of 35 until they have reduced their weight to a less risky level.
"If you have a BMI of 35 you are very, very overweight," he said. "That kind of weight undermines the safety and effectiveness of treatment and is associated with serious obstetric complications."
More than half of the 295 women who died while pregnant or giving birth in the UK between 2003 and 2005 were either overweight or obese, according to an investigation carried out under the auspices of the medical Royal Colleges together with the National Patient Safety Agency. More than 15% of those women were extremely obese.