Australia - do not publicly fund assisted reproduction services for couples who are smokers or obese...

October 27, 2009 - Fertility Society of Australia’s 28th Annual Scientific Meeting - Perth, October 25-28, 2009.

Couples who smoke, or are overweight, should be denied taxpayer-funded access to fertility treatments until they take steps to improve their health, a visiting expert says.

Professor Nicholas Macklon, Head of Obstetrics and Gynaecology at Southampton University in England says Australia should follow the example of New Zealand and other countries, which do not publicly fund assisted reproduction services for couples who are smokers or obese. "I suggest that Australia should consider this model and patients should not expect to undertake infertility treatment unless they are prepared to give themselves the best chance of conceiving and having a healthy baby. We know, for example, that both male and female obesity is a factor in infertility and that smoking reduces IVF (in vitro fertilization) success rates by half."

Prof Macklon spoke at the Fertility Society of Australia's annual meeting, a three-day event which got under way in Perth on Monday. He is considered a leader in the specialty of periconceptional medicine - an emerging field focused on the health factors that impact on fertility. Prof Macklon said there was overwhelming evidence of the effects of poor diet, smoking and lack of exercise on reproductive health. And that infertile couples seeking assisted reproduction should prepare for pregnancy by making lifestyle changes that give them the best chance to conceive.

"Leading a healthy lifestyle to achieve fertility fitness should be considered as much a part of assisted reproduction as high technology interventions such as IVF," he said.

Prof Macklon also said the objective of infertility treatment should not solely be to help a couple have a healthy baby "but to ensure that the child becomes a healthy adult". "If a couple is fit and healthy, the chances of pregnancy are increased and the life-time health of the child will be greater," he said.

One in six Australian couples experience infertility - defined as the failure to conceive after a year of unprotected intercourse or the inability to carry pregnancies to a live birth. An estimated 10,000 children will be born as a result of assisted reproductive technology in Australia this year.

Dr Andrea Braverman, a renowned US specialist on the psychosocial aspects of fertility treatment, is also attending the conference. She said for some people, the news they were unable to conceive was equal to being "diagnosed with cancer". Braverman: The potential fall-out was not only personal, as it often had a corrosive effect on relationships. "For men it can cause feelings of sexual inadequacy, loss of potency and power (while) women can feel incompetent, useless and defective." "Sex as an expression of love can become an expression of failure month after month."

Dr Braverman said the medical or lifestyle factors contributing to fertility problems were shared equally by men and women. Making the decision to seek help could also feel like their problem was being "taken from the bedroom and into a cast of thousands". "For some there are happy endings, but not all," Dr Braverman also said.

Reference: Call to ban smokers from funded IVF, DANNY ROSE, BrisbaneTimes.com.au, 10/26/2009.