Should Obese, Smoking and Alcohol Consuming Women Receive Assisted Reproduction Treatment?
January 21, 2010 1:31 PM Subscribe
The European Society of Human Reproduction and Embryology (ESHRE) has published a position statement on the impact of the life style factors
posted by VikingSword (63 comments total)
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obesity, smoking and alcohol consumption on natural and medically assisted reproduction. Rationing health care
is a complicated subject easily
has published five recommendations. While smoking and alcohol consumption can have a clearly negative impact on the fetus, so
can apparently obesity
. Is this part of a slippery slope or needed restraints on medical services
ESHRE Task Force on Ethics and Law:
1) In view of the risks for the future child, fertility doctors should refuse treatment to women used to more than moderate drinking and who are not willing or able to minimize their alcohol consumption.
2) Treating women with severe or morbid obesity required special justification. The available data suggested that weight loss would incur in a positive reproductive effect, although more data was needed to establish whether assisted reproduction should be made conditional upon prior life-style changes for obese and smoking females.
3) Assisted reproduction should only be conditional upon life style changes, if there was strong evidence that without behavioural modifications there was a risk of serious harm to the child or that the treatment became disproportional in terms of cost-effectiveness or obstetric risks.
4) When making assisted reproduction conditional upon life style modifications, fertility doctors should help patients to achieve the necessary results.
5) More data on obesity, smoking and alcohol consumption as well as other life style factors were necessary to assess reproductive effects. Fertility doctors should continue research in this area.
According to the group obesity negatively affected reproductive potential through interference with hormonal and metabolic mechanisms leading to lower ovulation frequency and reduced chances of conception. The risk of gestational diabetes increased from twofold in overweight women to eightfold for morbidly obese women. The infants of obese mothers were at risk of perinatal death, congenital abnormalities such as neural tube defects (80% increase) and cardiovascular anomalies (30% increase).