Women with obese partners are denied IVF

Fertility Fairness report criticises postcode lottery and ‘arbitrary’ criteria for restricting treatment

MEN seeking IVF with their partners are being told to lose weight as part of the increasing backdoor rationing of fertility treatments by NHS bosses, campaigners have said.

A report by Fertility Fairness reveals that local commissioners are imposing “arbitrary” criteria such as male body mass index (BMI), as well as age, as a means of restricting access to IVF.

This is despite the criteria forming no part of the National Institute of Health and Clinical Excellence (Nice) rules, which determine who is entitled to IVF.

The charity used an audit of England’s 195 clinical commissioning groups (CCGS), the bodies which hold the purse strings for local spending, and found that more than a quarter now use a man’s BMI – their weight in kilograms divided by their height in metres squared – to determine whether a couple can be referred for the treatment. Meanwhile, nearly one in ten now stipulate that men must be aged below 55 in order to have IVF on the NHS.

In addition, a quarter of CCGS insist a woman’s Anti-mullerian hormone (AMH) level and/or antral follicle count (AFC) is at a specific level. The level of AMH in the blood helps doctors estimate the number of follicles inside the ovaries and the corresponding size of a woman’s egg count, which is related to her chance of successful IVF. Nice recommends Government funding for three full IVF cycles, but funding varies across the country and access is often described as a postcode lottery.

It means six out of 10 IVF cycles in the UK are funded by patients themselves, says the Royal College of Obstetricians and Gynaecologists.

Sarah Norcross, the co-chairman of Fertility Fairness, said: “It is shocking to see CCGS introducing their own ‘access to IVF’ criteria, as well as reducing the number of IVF cycles they offer. It is not the CCG’S job to decide the criteria for accessing NHS fertility services. Nice has accessed the evidence in its guideline and developed access criteria for NHS patients and they do not include male BMI, male age, a woman’s AMH level or whether or not a couple has a child from a previous relationship. What criteria will CCGS introduce next – star signs and shoe size? ”

Nice recommends that IVF should be offered to women under the age of 43 who have been trying to get pregnant through regular unprotected sex for two years, or who have had 12 cycles of artificial insemination.

But the final decision about who can have Nhs-funded IVF in England is made by CCGS, and their criteria may be stricter than those recommended by Nice.

An increasing volume of scientific research in recent years has highlighted the importance of lifestyle on male sperm quality and the chances of successful conception.

Last year a study published in the journal Andologia found that being obese was associated with lower volume of semen, sperm count, concentration and motility, as well as greater sperm defects.