This cut-off level we suggest for treatment is higher than that used by most primary care trusts. Rigid adherence to the relatively low BMI currently used across England and Wales is not in the best interest of the patient, creating unrealistic targets and worsening the often intense emotional and psychological difficulties that infertile couples already face.

We emphasise that it is the view of the society that continued inequality of access to treatment in the NHS is not acceptable to sub-fertile couples. Commissioners should work towards implementation of the NICE guidelines in full and in a consistent fashion throughout the country. The current situation continues to be a “postcode lottery”.

MARK HAMILTON
Chair, British Fertility Society

Sir, If something is medically possible and brings some benefit we should be able to provide the treatment. But we cannot meet every need free of charge on the NHS. We constantly hear of effective treatments that are restricted on the NHS because of budget constraints.

Inability to conceive is a personal tragedy but is not one that society should be leaping in to solve. There is a myth that we are somehow “entitled” or have a “right” to be a parent. This is not the case. Single women and lesbians certainly do not have a “right” to be a parent and society should not be allocating scarce resources to assist them to conceive free of charge. If we can afford to provide some infertility treatment then it should go to those who are best able to benefit. If that excludes obese women on sound medical grounds, so be it.

KEVIN MILLER
Penshurst, Kent

Sir, If the parent(s) are unable to afford to pay for the IVF, they are clearly unable to financially support the child. IVF is a lifestyle matter and not necessarily a question of healthcare.

BRIAN VALLANCE
Lefkimmi, Greece

Sir, While sympathetic to the plight of barren women, I would prefer that my subscriptions be first directed to the management of actual health problems, costs and overheads, including staffing levels, feeding of the elderly, accident and emergency and the physical conditions of the body which are well known to all. Sterility is not a health problem, no one has to endure pain nor will die of it.

PETER F. PENNEY
Sittingbourne, Kent

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