While on a cost-cutting spree, the UK NHS has made many changes to the criteria for IVF funding over the last few years. The latest cutback means that NHS IVF funding may be refused if your husband is overweight.
Does the weight of the male partner significantly affect chances of IVF success and is this exclusion criterion fair?
Local CCG’s cut NHS IVF funding
The Clinical Commissioning Groups (CCGs) make NHS funding decisions at a local level. Given that their budgets are constantly shrinking, CCGs are cutting their services to account for this.
The axe has largely fallen on fertility treatments in the last few years, with some CCGs cutting down the number of cycles that they fund and others stopping IVF funding entirely.
They have reasoned that as fertility treatment is a non-urgent service, it is a viable area to save money. However, this decision gives little thought to the emotional and mental well-being of couples that are denied this potentially life changing treatment.
Local CCGs have introduced several criteria for couples to qualify for IVF funding, including:
- Being in a particular age range
- Being a non-smoker
- The woman being a healthy weight
- Neither partner having children from this, or a previous relationship
Effect of BMI on sperm quality
More recently, some CCGs are insisting that the male partner should be within a healthy weight range.
The Bath and North East Somerset CCG are one of the first to introduce this controversial new criterion. They have stated that males whose BMI falls over 30 will be refused treatment. Around one-fifth of the British male population would fall into this category.
The CCGs of West Cheshire and Devon have also introduced similar criteria based on the male’s BMI.
Access to IVF funding is already restricted based on the woman being within a healthy weight range. However, research shows that being overweight can significantly affect a woman’s chance of conceiving.
Besides affecting your chances of conceiving, obesity may also affect your response to fertility treatment. Weight loss in obese women has proven to improve the outcome of both spontaneous pregnancy and fertility treatment.
The NICE guidelines do state: “males with a BMI of 30 or over should be informed that they are likely to have reduced fertility.”
However, there is no conclusive evidence that shows that a male’s weight will affect his sperm quantity and quality. In fact, research suggests that, while a high male BMI can negatively affect the reproductive hormone levels, only an extremely high level of obesity may significantly affect a male’s chances of conceiving.
The measurement of BMI itself is also suggested to be a flawed representation of whether or not a person is overweight. This is because it does not take into account the composition of the body, for example, if a person is particularly muscular they may have a high BMI whilst having little body fat.
Therefore, the decision to withdraw the option of NHS IVF funding entirely from couples who fall into this category is a controversial one, which does not appear to be supported by any hard evidence.
NHS IVF postcode lottery
What is very difficult to understand is just how much the criteria for NHS IVF funding can vary depending on your location within the UK.
As mentioned before, Bath and North East Somerset, West Cheshire and Devon CCGs have all stated that NHS IVF funding will be refused for males with a BMI over 30. However, the East of England CCG only refuses funding for males with a BMI over 35.
In other areas of the UK, for example Bristol, overweight males are not refused treatment, but instead referred to weight loss groups prior to commencing their treatment.
This seems like a viable option to help overweight males become healthier, whilst still receiving the treatment they require. However, the issue with this is the extra cost to the NHS, when funds are dwindling.
Obviously shrinking funds mean that services need to be restricted within some areas of the NHS. However, the inconsistent funding of IVF between different areas of the UK provides an unfair system, which has been aptly dubbed the ‘IVF postcode lottery’.