ABSTRACT
Introduction Denial of fertility treatment because of problems with a couple’s health (usually the woman’s) or because of unhealthy habits such as smoking is a contentious issue. The debate concerns the reduced success of fertility treatments in couples with health problems and the increased risks during pregnancy and to the subsequent health of the newborn child. Whilst the welfare of the child is of paramount importance, it is often argued by those seeking fertility treatment that fertile women with health problems similar to their own are neither forbidden from conceiving nor advised to terminate their pregnancy when they do conceive. Why should we therefore be selective in our choice of who we treat? The two main reasons given are:
1. limitations on resources that encourage selection of those who are likely to become pregnant quickly;
2. the fact that we are not very effective at preconception health screening and counseling for couples who have health problems but who do not have subfertility.
