# Obese Women. Age and IVF



## Yoda (Feb 24, 2005)

http://www.orange.co.uk/news/topstories/30740.htm?linkfrom=news_&link=box_left_pos_2_2_link_title&article=newstopitem

Who are they going to stop next  

I didnt get any NHS funding as I have 2 STEP children how wrong is that! The Scottish system is even worse! its all wrong  

YodaXX

This post contains an unconfirmed link/information and readers are reminded that FertilityFriends.co.UK or its owners are not responsible for the content of external internet sites


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## jem100 (Nov 8, 2005)

This makes me so angry but then the whole NHS PostCode makes me fume so I suppose theres no change there.  I'm 36 and my health authority have deemed that I'm too old to have funded IVF so we'll have to try and save the money ourselves which isn't easy when the general cost of living just seems to keep going up and up.  

Why can't the Government just do something about the whole lottery debate which would at least make the system the same over the whole country instead of some people getting funding and some not.  

Sorry, I just get so wound up about all this.


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## fingersarecrossed (Aug 8, 2006)

I've just posted on this subject elsewhere on the board.. basically I am one of these 'obese' women that have already been refused NHX tx because of my weight. This is bearing in mind that I was a skinny thing until I was diagnosed with PCOS and the weight has just crept on despite my eating less and more healthily than anyone I know in conjunction with exercise at least 4 times a week. I am a classic PCOS case with the weight gain, hirsutism, absent AF etc. My GP was fuming at the decision to refuse me NHS tx. Her exact words were " if you were a candidate for stomach stapling they wouldn't tell you to loose weight before they did it, the condition you have makes it difficult to lose weight and you wouldn't need the fertility tx if you didn't have this condition". It just makes me want to screaaaaaaaaaaaaaaaaaaaaaammm!! 

It is obviously the new fashion to blame everything on obesity, without thought of why you are like that in the first place. Fair enough, if I was sitting stuffing my face all day I could accept I was creating the problem and do something about it but when I am following a balanced diet and exercise plan and still nothing happens .........................


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## angel wings (Mar 25, 2006)

I have just seen the news about offering fertility to those who are obese or of a certain age, at the rate the NHS operates I will be falling into the latter catagory as I still haven't been offered an NHS go and all my tx has been private so far but if my next FET fails, then that is it for me.

 Who are people to say that women cannot have children, everyone's circumstances are different as fingerscrossed said, she has PCOS and weightgain can be associated with it.

This postcode lottery needs to be scrapped, I'm not deemed to be too old yet but the waiting list is so high by the time its my turn I will be.

Angel Wings
xxx


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## Catb33 (Aug 1, 2006)

This is such a lousy thing to be put out there, as if there wasn't enough pressure on people going through tx without having to worry about this as well. It's bad enough that post codes determine if and how much tx you can get funded (where I am it's only one cycle whereas the next county has 3) but for people like fingerscrossed who have done everything they can to stay healthy it's simply mean.

Cathie


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## Suzie (Jan 22, 2004)

funny that my comment hasnt been added!! to the comments board! they only put the ones that agree with the report!!!


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## joann7164 (Aug 18, 2006)

hi to all i think the whole nhs system is a load of crap excuse the language it just makes me so angry    because the system fails so many women i think every women large or small or weather you're 20 or 40 should be allowed treatment i was 17 when i had my son and i dont regret it for a second but because he lives with me (like hes gonna live anywhere else) ive been refused treatment even though my husband doesn't have children and its now 9 years since my son was born and the hardest thing ive ever had to do is answer his questions on why he can't have siblings like his friends (which hes so desperate for) we then resorted to do egg share but as you're only allowed so many goes on this scheme we are now left wondering how to raise the money for another go i think the people who make the decisions for the nhs will never understand and i bet none of them have found themselves in our situations otherwise they would'nt take there decisions so lightly good luck to all having treatment jo xxx


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## Minow (Aug 2, 2005)

Just to add my rant!
I'm 34 so not too old
I've never smoked
I'm not overweight or underweight
I exercise 6-7 times a week
I have a wonderful husband and we live in a lovely house
We could offer a child so much and yet we don't get funding.

I know a lesbian couple who
both smoke
rent a house
one of them is overweight
and they get funding

Logic please?!?!?!?!?!?!?!?

Perhaps it's coz I'm vaguely ginger?

lol
minow x


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## jem100 (Nov 8, 2005)

Thats very true Jo, you can bet the people who do make these kind of decisions can easily afford to raise the cash to have the treatement themselves if they need to.  

We need to have ICSI and at £3,000 plus for each attempt even a first go just seems out of our reach at the moment.


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## Yoda (Feb 24, 2005)

If we didnt raise our own cash we wouldnt have been able to have a baby - its crazy!!!  not everyone can raise this kind of money -it wasnt easy for us!

Think about some of the people who smoke take drugs,   bleed the nhs fund dry trying to mend themselves (yeah right) what do we get nothing having never asked for anything and paying NI for ever!!!     

I know - also people who have moved over to the UK.  When their life long citizens dont get it     Not saying these people shouldnt but it all needs looking @ big time!!


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## joann7164 (Aug 18, 2006)

To jem have you thought about egg share hun i have done it four times and had 1 fet they use icsi and all i had to pay for was donor sperm and some tests i know its not everyones thing and some people don't agree with it but i don't regret any of my goes as at least ive tried if you want any info let me know and i will gladly help love jo xxx


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## Yoda (Feb 24, 2005)

Minow said:


> Perhaps it's coz I'm vaguely ginger?
> 
> lol
> minow x


Class!! xoxo   if we didnt laugh we would cry


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## jem100 (Nov 8, 2005)

Hi Jo - I would love to do egg share, as you said it would be a lot cheaper for us and I'd love to help other infertile women but I'm too old, 35 is the cut off age and we didn't find out about my husband's infertility until a couple of months after my 35th birthday.  Seems stupid because everything is fine with me but its yet another NHS guideline/rule which is used against me.  

Thanks for the thought though.


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## Greeneyed (Apr 12, 2006)

I have been on the news webite - have your say section. All the most recommended comments are from the people saying NHS shouldn't pay for IVF at all and it's nature's way of telling you not to breed. How sad that so many people are so ignorant and cruel. 

My own comment which was 

"  As far as using the money to treat “real illnesses” instead. I have an incurable condition which causes pain most of the time. I have also discovered I am infertile. If I had the choice to cure one or the other it would be the infertility. I would take a life of pain if it meant I could have my own child. The human suffering caused by infertility is so great. If  IVF can relieve this suffering it is an excellent use of NHS resources. " 

It has not been posted, clearly not controversial enough or of great enough appeal to the masses. 

Bah!!!!


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## joann7164 (Aug 18, 2006)

Ah jem im so sorry but whatever you do dont give up there will be hope out there somewhere i know at times it does't seem it but just try and stay positive and hopefully one day you will get that precious little baby loads of love jo xxxx[br]: 30/08/06, 13:02If i went on that bloody news website they definatly wouldn't print what ive got to say because it would involve a lot of bleeps at all those small minded people who don't agree with ivf i don't beilieve in all that whats meant to be crap i beliieve you choose youre own fate otherwise why would people go to college to learn skills if its meant to be those jobs you train for would just fall in youre lap yeah right to every one reading this dont ever give up on youre dreams you chase them especially one as important as becoming parents sorry to babble on really mad      jo xxx


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## McMarylou (May 19, 2005)

Sorry, this probably isn't a very well-argued post, and, please take it in the SLIGHTLY tongue in cheek way in which it's intended - it's really just me venting my spleen (ooh, painful) so that I can get it out of my system and get on with some work.

The advice to PCTs in itself hasn't made me particularly angry,  but certainly some of the comments on the BBC website have - here we are again, selfish, obsessive, infertile people who want the NHS to pay for costly treatment for a non-life-threatening condition simply in order to support our "life-style choice" (yes, that phrase has appeared again) to have a child, when nature's saying we shouldn't.  

I'm overweight and it's not caused by any physical or medical condition - but, believe it or not, I actually get slightly (ok, VERY) depressed sometimes after 9 years of trying to conceive naturally and with tx - and, when I'm depressed, as I don't smoke and I don't drink to excess and I don't take drugs or gamble, I comfort eat. It's stupid, self-destructive behaviour, which dulls the pain for a couple of minutes and then makes me feel even worse - but it's my way of coping with a great deal of emotional pain.

Of course I know that not losing weight is damaging my chances of conceiving and reducing the success rate of IVF (which is low anyway given that I'm 41 - it took 7 years from me first approaching my GP to having my first unsuccessful cycle of IVF - I was only 32 when I first started seeking treatment - and it was all complicated by misdiagnosis by a doctor who's now been struck off).  

Of course, I know I should pull myself together and get off my fat backside and exercise more and stop stuffing my face - and during the past 9 years I have, on several occasions, lost up to 3 1/2 stone - and then I have another BFN and I get miserable (silly me!) and I slowly put it back on again - but, hey, you know what, I'm a human being and sometimes we've got faults and weaknesses - and I've managed to put on a brave face in public for years about the misery that infertility causes so, sometimes, behind closed doors I deal with it by using food.  

Off to buy a couple of cream buns to stuff into my mouth ... cos I'm miserable.


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## fingersarecrossed (Aug 8, 2006)

Minow -     - faintly ginger ... maybe you ought to dye your hair or wear a wig at your next visit!!  I know what you mean though, I'm 33, married and ttc for 11 years, no other health problems except the PCOS and it's effect of me being overweight (which incidentally causes me no blood pressure or any other probs), no children or stepchildren, a wonderful DH and a nice house and plenty of love to give. The only thing I want in my life that isn't already in it is my own child..

Logic doesn't come into it, I'm afraid. At the end of the day it's all about saving money, so sod trampling over the feelings of the thousands of childless couples in this country, besides if they stop us having kids then it's less pressure on the system.. what they don't realise is that we'll stop at nothing to acheive our dreams. We get the big slap in the face, pick ourselves up and move on.. time and time again...

Greeneyed - hear hear, where do these people get off saying it's natures way? So it's nature's way to allow paedophiles and rapists to conceive children is it? Dear God, some people...    

Jem - good luck with the ICSI..

Yoda - don't get me started on paying NI and getting nothing back!!


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## Shi (Mar 15, 2005)

Hi everyone

I haven't been on FF for almost a year as that is the last time I had a negative result of my second IVF.  I understand how you are all feeling cos I have PCOS and weight gain etc etc and a relative who is a consultant told me IVF didn't work cos I was fat.  This didn't help me much to be honest, just like Marylou said all it made me do was want to comfort eat! 

Anyway to cut a long story short, I took time out to try to sort myself out (to be honest, this was enforced as I almost had a nervous breakdown over the whole thing) but I have been attending therapy and the therapist after hearing my story on the first session, told me that first things first, I had to deal with my body.  I had also looked into adoption and been told that I was too overweight for that too and I was extremely angry and frustrated.  However, I did listen to her for some reason as she recommended I read Dr Atkins New Diet Revolution.  She loaned me a copy and I went home that night and read the first 6 chapters.  Over the next month I had to read it over and over again to understand but from the moment I read it I knew it was written for me. 

I am not usually someone who recommends things (cos I usually hate the things people recommend) but I have been following a low carbohydrate diet now for 6 months and I have lost 4 stone.  But more than that, I feel like I am more stable like my emotions are under control.  So much so, that we have decided to have another IVF try in January.  I vowed never to do it again, but here I am back in the saddle so to speak! 

So basically I know we can all shout about how life isn't fair and everyone else gets it easy, and I was (and still am sometimes) one of them, but for anyone who has posted here who has PCOS I couldn't recommend enough buying that book.  Things changed for me once I understood my body and life is becoming good again.  By the way I also bought a book called the Vegetarian Low Carbohydrate Diet which I have incorporated as well.  I know Doctors are very negative about Low Carbohydrate Diets, but after 8 years no doctor has ever been able to help me with all my symtoms, like tiredness, depression, cravings, moodiness, spots, etc etc, and since the 3rd day of this diet, things changed.  It is dramatic try it.

Anyhow, I just want to pass this information on to you all.  I know life is hard, but it is harder when we are trying to fight off all the symptoms which come from PCOS as well as deal with the traumatic journey through IVF.  

I hope this helps some of you at least.

Shi


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## McMarylou (May 19, 2005)

Thanks for this, Shi - and congratulations on your weight loss - that's terrific.  I'm also glad to read that you've found low-carb diets help - they're the way I've managed to shift up to 3 1/2 stone - and, the same as you, I always feel so much better when I cut out carbs - fewer mood-swings, much more energy, no mid-afternoon blood sugar dips. Then when I start eating carbs again I feel lethargic, bloated again ... SO STOP EATING CARBS THEN, STUPID WOMAN!!!!   

I did actually decide to start again today (the comment about heading off for cream buns was tongue-in-cheek) - and your success story has spurred me on to stick with it.  I'll keep you posted about how I'm doing.

Thanks for your words of support and good luck with your IVF!


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## Catb33 (Aug 1, 2006)

The more I read about this story the more angry I'm getting. When I started tx my cons said my size wasn't an issue though if you'd have put my weight and height into one of those charts it would have put me a stone overweight. Unfortunately since then the weight has crept on, similar to McMarylou in that I've turned to food when I was down. 

I joined weightwatchers a few weeks ago to get things back under control and they, and other diet clubs I've looked at, seem to think I need to lose 3 stone to be a normal weight for my height. If I do that I'll be told off for being a stick insect, whereas if I lose half that I'll be a size 12 verging on a 10. These measures, which are also used by the NHS for determining who is obese or not, are v general and don't take account of different people and how their bodies carry weight. Why can't the NHS look at the individual rather than proscribing treatment for people that it might actually benefit?

Good luck to those of you also trying to lose weight.    It's tough but hopefully will be worth it. congrats to those who have already managed it.

Cathie x


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## jem100 (Nov 8, 2005)

Thanks Jo, theres no way I'll give up until I'm too old to conceive I'll keep fighting the unfairness of it all and saving every spare penny we've got in the hope that one day we'll get our chance and catch lucky.

I'm not going to go on that BBC website, it'll upset me too much. Why on earth do people find it so difficult to understand how much infertility takes over all our lives, I'm sure like me everyone on this thread had planned their life to include children and the idea that someone thinks it is a life choice just makes my blood boil.

Good luck to everyone.

Jem xx[br]: 30/08/06, 14:14Oh, I forgot I just wanted to congratulate you Shi on your weight loss. I know how difficult it is. I don't have PCOS but I am slightly overweight (need to loose about another stone).

As a few others have said, food is my comfort too and its sometimes very difficult to keep to a diet when your feeling so depressed about infertillity. I've recently started swimming to try amd speed up the weight loss and found that it really comforts and relaxes me when I've had a bad day.


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## Minow (Aug 2, 2005)

food was my comfort too! Now it's exercise.
I really do feel for you ladies with pcos and other problems that lead to weight gain.
I'm not going to read that BBC website story and fingers are going i the ears and very loud singing every time it comes up on the news. It doesn't really help but we know we are right and there's no way we will ever change the ignorant!
Good luck to you all...us all (better include me in that)
lol
minow x


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## ♥ M J ♥ (Apr 17, 2004)

hi girls

just to let you know there is also another post going on about this

http://www.fertilityfriends.co.uk/forum/index.php?topic=66469.0

hugs

xxx


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## Mrs Jo (May 22, 2006)

Hi All,

Sorry to but in I just wanted to say that I totally agree with you all about this new rules on who and who cannot have treatment.

The end of the day it does not matter how thin or big or young or old you are if you are so wanting a child of your own you should be given the chance to.  The end of the day it is not like you think I want a child today I will pop in and have IVF there is alot you have to go through mentally and physically so if people like us cannot naturally have children and are prepared to go through the treatment to get our dream then we should be entitled to it.  The people who make these decisions probably have children and never need treatment to conceive.  I hope the law changes for the better sooner rather than latter for people.
xx


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## Ceri. (Sep 6, 2004)

I agree with everyones points here. IVF is hitting the headlines more and more lately, but it seems to create more debates than anything else, people with 2.4 kids dont have a clue, no-one does unless theyve been through it them selves. 

What'll it be next? Youre too ugly to have your own kids? It makes my blood boil, that the people who decide on who are and who aren't eligable to have tx, aren't bloody eligable themselves to decide. They have no idea whatsoever.

There are young kids out there getting pregnant, totally oblivious they could end up with a baby in 9 months, or because they DECIDE to have one as its a fashion accessory. Whats done about this? It's almost encouraged for the youngsters to have kids. We, the people who really yearn for a child are disuaded for any number of reasons. People have so much more to say about fertility tx. Basically because theyre bloody ignorant to it and need to be educated about the whole piggin thing. Yes documentaries are shown every now and then, but is the right information shown? Is it portrayed in a good light?

Could quite easily ramble on and on and on.


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## Becki (Aug 1, 2006)

Hi ya Ladies 

                   
Well this sums up a little bit of what i feel!!! i was out all day yesterday so did not get  a chance to read papaers or news! i got in bed last night put on the tv and this is what i read on the headlines! 
I was so angry and upset! i could not get to sleep till this morning! it really P******* Me off if you get my drift!

Im only 24 and going through IUI/IVF i have not had regular cycles since i was 12 and i was skinny back then! but it was not investigated till 3 years ago and i have PCOS, My weight has crept on over the years and i am finding it so hard to loose weight because of my condition! like many of you ladies out there!!! 
I am so disgusted i want to do something! im so on my soap box! these people need to hear from us! 
AAAAAAAAAAAAAAGGGGGGGGGGGGGGGHHHHHHHHHHHHH

Ok i am ok now! 
Sorry foir ranting ladies im sure you understand! 
Love to you alll and a lot of positive vibes!

Love 
BEcki


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## jem100 (Nov 8, 2005)

God yes, we all understand how you feel here, I'm still fuming today and like you had trouble sleeping last night because I was just so angry.  I'm so glad we have this site, I really think I'd go mad without it.  

I wish we could do something to make everyone listen.  I have been emailing and writing to my local MP but he did'nt even know I couldn't get treatment (because of my age and weight) until I told him and then he just fobbed me off and told me the government was looking into it.  PAHH, and a lot of good that has done.


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## Becki (Aug 1, 2006)

I admire your battle!

I had to fight so hard for 3 years 2 get to where i am! they said i was to young!!!! and of course overweight! but i fought and got to where i am 2day!

Dont give up on your dream!!

Love 
BEcki 

P.s Im thinking of writing a short letter well long letter to our government and saying what i think?

Of out now will chat later!


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## Dobby (Oct 23, 2005)

One of the Authors of the report was interviewed on the Jeremy Vine show on BBC Radio 2 yesterday. He made a very good point (if it is true!!) that the report they have published has nothing to do specifically with obesity. The report apparently says that there are guidelines published by NICE which recommend 6 cycles of IUI/3 cycles of IVF to be available for all couples meeting the nice guidance, but that this isn't what is being offered by all PCTs - some do but many don't as they either offer only one cycle, or apply there own criteria, and some of those criteria are very restrictive.

He said that the only point in the report which discussed obesity specifically actually recommended that MORE people should be able to have treatment - that the current recommended cut off limit of a BMI of 30 was considered to be too restrictive by the British Fertility Society, and they thought a BMI of under 35 was a more reasonable limit. In addition to this, they recommended that people who were above this limit, rather than just being told to 'go away' as at present, are offered positive support and help to get them to a reasonable limit.

I wonder how much of of what has been reported in the press/tv/radio yesterday and today is journalism 'Spin' - after all the BMI limits have been around for many years which restrict fertility treatment to those with a BMI of less than 30, but the headlines/news reports yesterday all seemed to say something along the lines of researchers are suggesting that treatment should be withheld from obese women... well treatment is ALREADY withheld, so saying someone is suggesting this doesn't make sense.

I think I will try to get a copy of the official report, but I am very suspicious that what is being portrayed in the media, may not actually be representative of the report's recommendations at all.

By the way, I AM obese, but my private clinic have NEVER mentioned my weight as an issue - other than to say that if I take the time to lose it, at my age of 40 this would have had more of a detrimental effect on my fertility than just going ahead at my high BMI (which by the way hasn't seen the underside of BMI 35 for many years). And my second ICSI worked, with two embryos implanting.

Dobby[br]: 31/08/06, 16:12I have had a search around for the actual report.. but can only find a summary from the British Fertility Council which says.....

http://www.britishfertilitysociety.org.uk/news/documents/SocialCriteriaAndNICEImplementation30Aug06.doc

29 Aug 2006

Survey of NHS fertility treatment across England shows inequalities; fertility doctors set out social criteria access to treatment

Unequal access to fertility treatment, poor planning to meet Government targets, and no clear criteria for who should receive NHS-funded fertility treatment; these are the findings of a survey by British fertility doctors to be published in the journal Human Fertility in September. In response, the British Fertility Society - the organisation representing professionals working with assisted conception - has issued a series of recommendations on social criteria for access to NHS-funded fertility treatment.

The BFS surveyed fertility clinics in England to establish how Primary Care Trusts are implementing the NICE guidance on fertility. Two years after publication of the NICE guidance, the survey results show a wide disparity of access to treatment, with little planning on how to implement the guidance in full.

They also show PCTs apply a wide variation of social criteria to determine who should qualify for fertility treatment, and the BFS is setting out a recommendations on criteria such as previous children, obesity, smoking, single-sex parenthood etc, to help PCTs decide who should receive NHS-funded fertility treatment.

The survey found that:
·	Number of cycles has increased, but there are still 'black holes'. Despite the NICE recommendations, 16% of clinics report decreased support for fertility treatment. 
·	Only one cycle is offered in vast majority of cases. Only 9% of respondents reported 2 cycles of treatment being provided.
·	There is little indication of PCTs making any long-term plans to implement the NICE guidance, and no reassurance that the full guidance will be implemented (in contrast to Scotland)
·	There is a wide disparity on the social criteria used for acceptance onto an NHS-funded programme, especially as regards existence of previous children, high BMI, smoking, etc. For example, half of the clinics said that their PCT wouldn't fund treatment if either partner had had a child previously.

The British Fertility Society has written to every Primary Care Trust in England and Local Health Board in Wales asking them to meet government fertility targets, and setting out recommended criteria for NHS funding of fertility treatment.

The BFS makes eleven recommendations on social criteria for NHS treatment, including:

·	Waiting times for treatment should be the same as for any other medical condition
·	No woman should be commence NHS funded treatment after the age of 40
·	Women who are obese must initiate a weight reduction programme and those severely overweight (defined as having a BMI of 36 or more) should not receive treatment until their weight has reduced.
·	Single women and same sex couples should be treated the same way as heterosexual couples
·	If people have had children from a previous relationship, they should not be excluded from access to NHS treatment

The recommendations will be published in full in the September issue of the journal Human Fertility. A summary of the recommendations is attached. Infertility Network UK, the main fertility patient group, supports these recommendations.

Dr Mark Hamilton, Chair of the British Fertility Society, said:

Continued inequality of access to treatment is unacceptable in a state-funded health service and the source of considerable distress to a great number of people with fertility problems. We are presenting the recommendations to the PCT's and Local Health Boards with the intention that they provide a basis for consistent application of social as well as medical criteria for access to State funded fertility treatment in England and Wales. They are similar to core recommendations currently before the health minister in Scotland. As Health Minister Caroline Flint pointed out in a recent letter to PCTs, "the persistent inequality of provision is hard to bear, and hard to understand for those affected".

Lead author of the study, Mr Richard Kennedy (Coventry) said:

The results of this survey suggest that there is no sense of any long term planning for the provision of fertility services and provide no reassurance that full implementation of the NICE guidance will be achieved as was recommended by the Secretary of State for Health over 2 years ago. There is considerable disparity across England and Wales in the commissioning arrangements relating to a range of social criteria applied for acceptance into NHS fertility programmes. If we are to see an end to inequity of access across the United Kingdom there must be an explicit plan for the provision of three fresh cycles of IVF and consistency in the criteria used for NHS treatment. The criteria we propose, if adopted by all PCT's in England and Wales, would standardise access to treatment. We must use the findings of this survey to pursue the goal of full implementation of the NICE Guideline.

Not quite what was reported in the media then!!!!

Dobby


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## jem100 (Nov 8, 2005)

Oh let us know if you do manage to see the original report, I'd like to have a read too.  

I will have to pay privately for my treatment because of my age (I need to be under 35 to get treatment with my PCT) but my clinic still won't treat me until my BMI is under 30 and at the moment after strict dieting for the past six months and loosing almost 2 stone my BMI is still above their level at 33.  If my BMI really doesn't make a difference why would my private clinic still want me too weight?  

Humm...... Think I might have to look at going to a different clinic.  If you don't mind me asking which one did you go to Dooby


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## Dobby (Oct 23, 2005)

Ok, I admit I am on a roll here... but I have actually found the original report. It is posted at http://www.fertility.org.uk/news/documents/HumanFertilitypaper.pdf

This is what it says about funding for IVF patients regarding weight.

4. Female weight

Body mass index (BMI) in the woman has an effect on fertility and on the efficacy of
infertility treatment. The NICE Guideline has made explicit recommendations on the
management of anovulatory infertility when the female patient has a BMI > 29 and <
19 on the basis that reduction of weight in women with a BMI > 29 increases their
likelihood of a spontaneous conception and their response to ovarian stimulation. It
also recommends that patients are advised that a BMI outside this range is likely to
reduce the success of assisted reproduction procedures. NICE further recommends
that more research is needed to understand the effectiveness of assisted reproduction
in relation to BMI. Commissioners have extended this recommendation to include
BMI outside the 19 - 30 range as an exclusion criterion.

Whilst we agree with the NICE recommendations we question the inclusion of BMI
as a funding criteria. Several authors report no adverse effect of BMI on IVF
outcome (Lashen et al., 1999; Wittemar et al., 2000; Winter et al., 2002 ). A recent
large Norwegian study of 5019 treatments of IVF/ICSI also showed no statistically
significant correlation between BMI at either end of the range with IVF outcome
although they did demonstrate a significantly decreased response to ovarian
stimulation and increased usage of gonadotrophins (Fedorcsak et al., 2004).

Furthermore, it should be recognised that this group of patients are particularly prone
to emotional and psychological difficulties, grappling with both body image and
infertility, and a refusal to treat on the grounds of weight will further compound these
problems. However, it must also be recognised that there is an increased likelihood of
obstetric problems in women with a high BMI including an increased incidence of
gestational diabetes, pregnancy induced hypertension, thrombo-embolism and postpartum
haemorrhage (Ricart et al., 2005; Kanagalingam, 2005; Balen et al., 2006).

We therefore accept the NICE guideline but in addition recommend that management
of patients with high BMI be pro-active, include dietary support, exercise programmes
and possible referral for psychosocial support. Funding of this support should be
included in the commissioning arrangements. Providing there is demonstrable
compliance with such programmes a BMI upper limit currently accepted by
anaesthetists as fitness for day case surgery seems more reasonable.

*We recommend that:
Women with a body mass index of < 19 and > 29 should be referred for advice from
a dietician, warned of the risks in pregnancy, if appropriate, provided with access to
exercise advice and offered psychosocial support. NHS funding of their treatment
should be deferred until they demonstrate response to these interventions. If the
menstrual cycle is regular and the FSH normal, assisted conception may be
provided if the BMI is < 36.*

Which is actually FAR FAR BETTER than my PCT who just insist on a BMI of 25 or less.

Dobs

Jem100

I had treatment at the South East Fertility Clinic in Tunbridge Wells, Kent - I think their website is www.sefc.co.uk 
They are fairly reasonable price wise also.

Dobby


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## *Kim* (May 5, 2002)

Hi Ladies

I have First magazine wants to do a story about ladies who have got pregnant despite their BMI so would you like to take a look?

http://www.fertilityfriends.co.uk/forum/index.php?topic=66633.0

love Kimx x x


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## skyred (Oct 5, 2005)

Hello Ladies,
Just wanted to say
         
It makes me so mad, 
There are so many examples of the madness, money waisting
George Best known for his drink problems, was he told no you cant have a liver transplant?!!!!!!!!!!!!!!!!!!!!!!!!,
Could they not see, did they not guess.      Call me a synic, but could it be his fame??

Northampton (my PCT) has put funding on hold again. And made the the process harder.
Thankfully I'm one of the lucky ones, my miracle is 9wks old. But had we not been so fortunate.............................
Ive known since I was little, things wouldn't be easy. Its hard enough knowing for so long without someone saying sorry no can do till your 31. and then only if bla bla bla twodle whatnot.
It may not be life threatening, but its all consuming. 

I wish everyone on this great journey LOVE & LIGHT.
Debs


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## jem100 (Nov 8, 2005)

Hi Dobby - I just wanted to thank you for finding the report, it does make me feel a little better reading the whole thing, as usual most of the upsetting part was due to media hype.  

It still makes me angry and sad to realise that there are so many bigotted and selfish people out there though.  I did'nt actually read the comments on the BBC website myself as I knew it would upset me too much but got the gist of it though peoples comments on here.  

My PCT are due to have a meeting to discuss my case and hopefully approve funding for at least the drugs for my treatment, I've sent them an email highlighting parts of the report which I think might help to back up my argument about how unfair my treatment has been.  I'm keeping everything crossed we'll have at least a bit of help from the PCT.  

Jem x

Jem xx


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## pawa (Mar 21, 2006)

Hi everyone

Just want to vent my frustration too!!    I find it very unfair that single sex couples, single parents, smokers etc are getting priority over heterosexual, stable, loving couples where the woman is overweight!! (thats us!).

I was reading the Sun yesterday (bit embarrassing to admit   ) but Mr Taranissi (from the ARGC) said that in his experience overweight women do not have less of a chance of conceiving. He also said that making a woman lose weight first can affect fertility more as a lot of women crash diet which is bad.  And by waiting a year or so for them to diet makes them older and he said this is more of a barrier to success than the weight. Someone should listen to him seeing as he has the best stats for IVF!! 

Who can I write to...? My MP or the British Fertility Council Its so annoying!!!

Pawa


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