IVF treatment to be denied to smokers

WOMEN could be told to give up smoking or lose weight to qualify for fertility treatment on the NHS, under new guidelines to be issued by the Department of Health.

Patients over the age of 40 are unlikely to be eligible for state-funded in vitro fertilisation, following a recommendation from the Royal College of Obstetricians and Gynaecologists that they have little chance of becoming pregnant.

Fertility clinics will also be told to be more realistic in their assessment of patients' chances of conceiving because ministers believe many people are being given false hope by unscrupulous doctors.

The Government will issue new national guidelines as part of wide-ranging changes to NHS fertility services. Tessa Jowell, the Health Minister, said the intention was to end the "geographical lottery" which has caused wide variation in availability around the country. "We need to make sure that the people getting treatment are people who have a reasonable chance of conception," she said.

The guidelines, to be drawn up by the new National Institute for Clinical Excellence, will be based on recommendations from the Royal College, to be presented to ministers shortly. Professor Alan Templeton, head of the Royal College review of fertility treatment, said the group of experts had concluded that women over 40 should be warned that "their chance of success is low". The Government is certain to take this on board when setting out its recommendations for the upper age limit of patients.

The Royal College will also emphasise the importance of giving "health advice" to patients to improve their chance of success. "Smoking, drinking and being overweight affect the outcome of treatment, so you may take the opportunity of saying to somebody `you do your bit and we will treat you'," said Professor Templeton.

Also, the foreword to the Royal College's recommendations will emphasise the importance of taking into account the future welfare of the child. Professor Templeton said doctors should "be satisfied that there's an established relationship there" before giving IVF on the NHS.

Ms Jowell stressed that the Government's guidelines would be based on "clinical evidence" rather than "nanny statism". But she agreed that a patient's lifestyle could affect the chance of getting pregnant from IVF. "In terms of fertility treatment all the clinical evidence is that smoking makes you less rather than more likely to conceive, drinking makes you less likely to conceive and being overweight means you will find it harder," she said.

Tough new guidelines will be issued to fertility clinics who are treating patients, either privately or on the NHS. Of the 23,000 couples who have IVF every year, 18,500 are treated in the private sector. In its report, the Royal College will advise ministers that clinics should face an annual audit to ensure that they are not giving patients an over-optimistic assessment of their chances of conceiving.

Ms Jowell said clinics could be struck off if they were found to be giving misleading advice.

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