The Fertility Fairness group, which campaigns for equal access to infertility treatments on the NHS, has been reporting on the shocking disparities in criteria across the UK. Recently, an investigation on the programme Victoria Derbyshire also found concerning restrictions. This is sparking further discussion of what the limitations should be for IVF from the NHS.
What is IVF?
IVF stands for in vitro fertilization, which is a treatment for infertility. Some couples are not able to conceive naturally, often due to medical conditions and genetics. Infertility can lead to depression, social isolation, and the breakdown of relationships. Treatments like IVF can help couples to successfully start a family and the life they want to live. During IVF, eggs are taken from the body to fertilize them with sperm in a laboratory. Then they will transfer the embryo back into the body in the hope that it will continue developing. A similar treatment is ICSI (intracytoplasmic sperm injection), where they inject a single sperm directly into an egg to fertilize it and then transfer it to the womb. Infertility itself is a medical condition, so people with this condition deserve treatment from the NHS to improve their quality of life.
Who can get IVF on the NHS?
There is wider funding for medicines and surgical procedures that assist fertility. However, treatments which assist conception like IVF and ICSI are subject to regional access criteria. There are 209 Clinical Commissioning Groups (CCGs) in England which are led by GPs and responsible for providing fertility services. Generally, three full cycles of IVF should be made available on the NHS to patients who are infertile. This is according to guidelines from NICE, or the National Institute of Health and Clinical Excellence. They make recommendations for the provision of health services considering clinical and cost effectiveness. The problem is that many CCGs are apparently not following these guidelines. They are also setting their own access criteria instead. In Scotland and Wales, couples can get IVF until the age of 42. But in the UK, CCGs setting their own restrictions is resulting in a “postcode lottery” for IVF.
Who isn’t able to get IVF on the NHS right now?
Recent investigations by Fertility Fairness and Victoria Derbyshire are drawing attention to the unfair restrictions on access to IVF treatment in many regions of England. Some CCGs are denying IVF treatment to couples based on arbitrary ages. Fourteen of them won’t allow men over 55 years old to access the treatment on the NHS, and twelve of them won’t allow it for women over 34. This is especially unfair for women. It may take some women longer to find a partner or achieve financial stability before being ready to start a family. Over 40% of CCGs (85 of them) are failing to offer IVF services on the NHS to women above the age of 39. As well as age, CCGs are denying IVF to couples according to their BMI. This is affecting women with a BMI of 30 or above and men with a BMI of 35 or above. These denials aren’t fair because such criteria is not a part of national guidelines. The restrictions are mainly to reduce the cost of IVF services for the NHS, though the criteria are not proven to negatively affect the success of IVF procedures. Seven CCGs are no longer offering any IVF on the NHS.
How do we improve access to NHS fertility treatment?
There are several groups campaigning to improve access to NHS treatment for people in the UK who are infertile. These include the aforementioned group Fertility Fairness, and the Fertility Network UK. You can read more information about their research and campaigns on their respective websites. They will tell you what you can do to help if you would like to get involved in their campaigns. This usually involves writing letters to your local MP and local CCG. You can also attend public consultations if your local CCG is reviewing their IVF provision. These groups can provide support for anyone struggling with fertility problems.