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Report recommends refusing IVF to women with unhealthy lifestyles

[BioNews, London]

'Fertility doctors should refuse treatment to women used to more than moderate drinking and who are not willing to minimise their alcohol consumption', according to a new report by the European Society for Human Reproduction and Embryology (ESHRE). The report, from ESHRE's Task Force on Ethics and Law, covers the effects of alcohol, smoking and obesity on pregnancy.

The advice from ESHRE is in line with the UK's National Institute of Health and Clinical Excellence (NICE), which advises that excessive alcohol consumption can reduce the effectiveness of IVF (in vitro fertilisation) treatment and increase the risk of harming a developing fetus.

Alcohol consumption is associated with lower pregnancy and higher miscarriage rates, the report states. Drinking during pregnancy also risks fetal alcohol syndrome (FAS), which can cause harm to the developing baby, including growth retardation, behavioural problems and facial deformities.

The report, published in this month's edition of the journal Human Reproduction, also says that 'treating women with severe or morbid obesity requires special justification' as they face significantly higher risks of serious pregnancy complications. The children of obese mothers have an increased risk of death during infancy, birth defects and long-term health problems. These increased risks to both mother and child led ESHRE to advise that 'reproduction after weight loss will not only lead to improved fertility, but also to improved reproductive outcomes'.

ESHRE acknowledges in the report that making these recommendations is a complex issue due to the sometimes conflicting interests of the patient, clinician and society, as well as the interests of the future child. It says it sought a balance by recommending that IVF should only be conditional on lifestyle changes if there was a risk of serious harm to the child, if the chances of a successful pregnancy were too low to justify the cost of the treatment, or if the risks of pregnancy to the mother were too great.

The report also says that doctors should support patients in achieving the necessary lifestyle changes. It calls for further research in this area, to assess the impact of lifestyle factors such as these on pregnancy.

Professor Allan Pacey, a spokesman for the British Fertility Society, says that the new guidelines on alcohol consumption are not necessary. He told the Daily Telegraph that clinics are already required to take into account the 'welfare of the child' so there is no need to create further blanket conditions on alcohol consumption.

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