# Lifestyle 'should hit' IVF access



## Charlies-Mum (May 25, 2005)

Almost half of fertility experts say access to IVF should be conditional - and smokers or the obese could be denied treatment, a survey shows.

http://news.bbc.co.uk/1/hi/health/7523172.stm

Have to admit that I kind of agree with this.... It may make me unpopular but as a nation we are unhealthy, and if we don't make efforts to help ourselves why should the be made to pay?

I'm no skinny minny, and lost weight (a bit but not enough  ) before going down the (private) IVF route. I don't have a medical condition that causes my weight (and I know and accept that not all weight issues are due to a liking of chocolate such as mine!  ), but feel that we need to take responsibility for our own actions a bit more.


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## twiglets (Feb 13, 2008)

Of course we should be healthy. I don`t disagree with that. I think they are now mainly looking at cutting fundings even more. If being 'unhealthy' is the main reason, then they should be doing the opposite side of the coin too, that is to INCREASE funding for many of us who are 'healthy'. Especially for those who have given up smoking/drinking and lost weight for tx. We need to be rewarded too instead of being punished. I think this may even be an incentive for people, if they had done this.


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## Junnie (May 17, 2008)

well i agree with the smoking. I mean we dont give liver transplants to alcholics..

However the Overweight thing.. Hrm Well as long as it wasnt from a medical condition (thyroids sever PCOS) i think that saying you should be a certain weight is ok.

BUT saying that do i htink we should go by the BMI charts... No i dont. So there needs to be a look into the weight thing...

Smoking, drugs, Drinking sure i say you do these things you shouldnt have free IVF.


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## KatieKat (Aug 1, 2007)

I agree with the smoking and heavy drinking. Being obese is harder to measure, just going on BMI would be unfair as it can vary a lot and fit people can have a high BMI but have relatively low body fat.

I don't think doctors put enough emphasis on the partners behaviour and I just wanted to share my experience - my dh used to smoke and smoked (despite nagging and being sent outside) through our first two treatments. The doctor at our first clinic (private treatment at an NHS hospital so the same cycle / doctors as an NHS one) mentioned only very briefly to him at the first appointment that it would be a good idea if he gave up. 

We had a consultation at Zita West before our third treatment and they were really blunt with him about the effect it would have on our chances, especially given my old eggs. He gave up before our third treatment (he used hypnotherapy) and also stopped drinking about a month before egg collection - our fertilisation rate was 100% and we made 4 blastocysts,got a BFP, sadly we miscarried but we still have two blastcysts in the freezer and will try again soon. 
Previous fertilisation rates were 40% (egg collection on a Tuesday after he'd been on the beer and ciggies at the weekend) and if I remember correctly 70/80%. The embryo quality was ok on the first two cycles it was much better on the third (double the number of grade ones) - some of this might be a change in clinic but I don't think it all is!
This morning on radio 4 a consultant (I think from Guys) said that one research paper said that smoking in either partner was the equivalent to adding 10 years to the age of the eggs, I asked dh if he would have given up smoking before our first cycle if the doctor had put it to him in that way....he said yes (and I believe him ..still remember the look on his face at Zita West).

I just really believe that it is about being clear with both partners about the factors that affect their chances...not just the woman's age and as part of the initial investigations providing proper support to help with lifestyle issues.


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## Han72 (Feb 15, 2007)

Hi

fair enough if someone drinks like a fish and smokes 60 a day then it would be ridiculous to offer them free IVF as they clearly aren't capable of taking care of themselves, never mind a child. Obesity? Well I don't think it's right to look at someone and say "well you're too fat so it's a no". If the person's weight isn't causing any health issues then it shouldn't be a factor so I agree it's wrong to just look at BMI and go by that.

On the other hand, I can't believe that the "professionals" are still coming out with rubbish like this:

_"Dr Allan Pacey, secretary of the British Fertility Society, said: "It's expected that people will be magicians and can reverse the ageing process.

"I think many people in the profession find it frustrating.

"IVF should be a last resort, and starting to try five years earlier might make things better." _

Wow I bet he had to get up early to work that one out. 5 years earlier than what, exactly? 5 years before I know there's likely to be a problem with my fertility? What am I? Psychic?! Oh no, I see! He means just 5 years earlier than the date I did start trying. Hmm let's see, I started in 2004. I wanted to start earlier but DH wasn't ready. What should I have done, come off contraceptives and trapped him when he wasn't ready? And where was I in 1999 anyway? Just started my first permanent job in London, still stymied with student debt and a brand new mortgage and I'd only just met DH. So maybe I should have just [email protected] him the very first night and hoped to God that 
1. I got pregnant;
2. he wouldn't do a runner and;
3. I wouldn't end up being made redundant by my new employers having got pregnant during my trial period.

Yeah! Sounds like a great plan! Does this guy get paid for this [email protected]?

So basically we get blamed for trying to sort ourselves out financially or, God forbid, waiting for the right man and then waiting for him to decide he's ready before starting a family, and then we're told we've left it too late as if we did it on purpose! And he says he's frustrated?! What an @ss! I'm glad he's not my doctor!


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## Caz (Jul 21, 2002)

Nix... 

Oh but I agree  I started trying to conceive at 25. I understand what he is getting at, yes, there is a trend to leave it until later and sort out your career / finances to get pg but you know a lot of people don't marry or start ttc late by choice; that's just the way life happens and, perhaps we have to accept that it is going to mean more people need help but I don't think you can say no tx becuase you should have got your finger out earlier. That would be harsh. 

The smoking thing is another issue. Smoking, well, yes actually I do think both parties should be encouraged to give up smoking before they have treatment but then that's easy for me, a non smoker, to say that. My DH smokes and I've seen first hand how hard it is for him to try to give up.

As for weight - so long as it's assessed sensibly and deemed that it will help their chances of natural conception... i.e. what's the point of worry about a patient being slightly overweight if their tubes are blocked and they'll need IVF anyway? 
So long as the patient is given help with weight loss and not just told to clear off and lose xxx before they will be eligible for treatment. I've seen that happen a few times here on FF and it's dreadful. How can a medical professional tell someone they need to lose weight (or, for that matter quit smoking etc.) without at least offering to provide them proper support to do so? I know doctors can refer to dieticians. They should do so more often! 

Above all else I don't think the system should actively discriminate against anyone for lifestyle reasons if it wouldn't for any other type of medical need (i.e. back problems, cancer treatment etc.) As long as they are healthy in all respects and it's not actively contributing to their fertilitty issues then why shouldn't they get treatment. 

C~x


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## Guest (Jul 31, 2008)

I just want to agree with Caz and Nix. I started ttc at 28, a few months after DH and me got married. This never helped me at all. Only now, 11 years later (!) I am told that there may be genetic issues   so who was leaving it too late?! Maybe the medical profession, not us ... 
I think there is a culture of blame surrounding IF, which you don't get with other medical conditions. Same about obesity, surely very often IF is associated with hormonal inbalance, and this would cause overweight. But women are just being penalised for what they maybe can't change.
Sorry, rambling on ...
Rivka x


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## NuttyJo (Jun 29, 2007)

_"IVF should be a last resort, and starting to try five years earlier might make things better."_

if i had followed this guys advice i would have been 15  - another stat to add to the teenage mums list if it had have worked 

totally agree though that if you smoke then you shouldnt be allowed nhs ivf tx. totally disagree with the BMI though as some people can still be healthy with a higher BMI than some who have a lowish one.

i do think that the postcode lottery should be abolished and everyone should have the same amount of goes on the nhs


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## sallywags (Jun 27, 2005)

rivka said:


> I think there is a culture of blame surrounding IF, which you don't get with other medical conditions. Same about obesity, surely very often IF is associated with hormonal inbalance, and this would cause overweight. But women are just being penalised for what they maybe can't change.


Devils advocate slightly... it is rare for a medical condition to affect weight (except PCOS, i accept that some women with this do also struggle to control their weight - but not always), but it IS very common for someone who is VERY overweight (not just a bit overweight - which many of us are!! and i've suffered with my weight issues too) to have hormone imbalances and issues that affect fertility - I have to be honest my clinical knowledge here is limited, but i do know that there is a link between fat cells and oestrogen production.... (please don't shout at me for getting my facts right! just chucking in my 2penneth,....) I have heard of quite a lot of evidence that losing weight if you are VERY overweight can help you with conception.

I DO agree that smokers etc should be treated differently if they aren't prepared to help themselves - mainly because we are finding out more and more that smoking is possibly one of the worst things you can do to your body and can dramatically affect your chances of conception.

i also agree that other clinical procedures should be withheld for anyone who refuses to help improve their own health but still expect the NHS to fund treatment regardless of the damage that they continue to do to themselves.

I am also an ex smoker... and it is Bl00dy hard to give up. but I did do it, and i was a 20-a-dayer.

Have i ranted?

sorry if i have!!

xx

oh yes - and that idiot who suggested we should all start trying earlier needs a good .


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