The great IVF postcode lottery: Should access to fertility treatment be dependent on where you live?

Though it’s not a choice everyone will make, becoming a parent is a life long dream for many.

But for the 3.5 million people who are affected by infertility, it’s a dream could be slipping further out of reach.

That’s because for the one in six couples struggling to conceive access to IVF treatment, which for many is the only hope of becoming a parent, is being limited in some parts of England, creating an IVF postcode lottery.

What are couples entitled to?

The National Institute for Health and Care Excellence (Nice) guidelines, which advise CCGs (Clinical Commissioning Groups) on best practice, recommends that IVF should be offered to women under the age of 43 who have been trying to get pregnant through regular unprotected sex for two years, or who have had 12 cycles of artificial insemination.

NICE fertility guidelines also says women under 40 should be offered 3 full cycles of IVF.

The problem is the final decision about who can access NHS-funded IVF in England is made by CCGs, and their criteria may be tighter than those recommended by Nice.

Campaign group Fertility Fairness said England’s CCGs are rationing access to NHS fertility services by setting their own access criteria, including male body mass index (BMI) and age.

But Fertility Fairness said this “penalises women who take longer to find a partner”.

And couples seeking fertility treatment are being denied access for other reasons too.

Fertility Fairness said its 2018 audit of England’s 195 CCGs reveals that more than a quarter (27%) now use a man’s BMI to determine whether a couple can be referred for IVF on the NHS.

While fourteen CCGs (8%) stipulate men must be aged below 55 in order to have NHS fertility treatment.

Data obtained under the Freedom of Information Act by Fertility Fairness also reveals that almost half of the areas have cut IVF for women over 39 and 12 deny treatment to women aged over 34.

Seven CCGs have stopped offering IVF on the NHS completely. Meaning couples who live in different parts of the UK receive different access to IVF treatments.

The criteria also differs as some CCGs might stipulate that women must not already have children, must not smoke or must be within a specific BMI range.

Other CCGs may only offer one full cycle with other CCGs withdrawing all IVF treatment due to tight budgets.

And campaign groups are describing the criteria stipulations as a form of social rationing.

What the experts say?

Commenting on the UK’s IVF postcode lottery Aileen Feeney, chief executive of leading patient charity Fertility Network, told Yahoo UK: “Fertility Network believes it is cruel and unacceptable that 83% of England’s clinical commissioning groups (CCG’s) ignore the National Institute for Health and Care Excellence (NICE) fertility treatment guidelines.

“NICE recommends three free cycles of IVF should be offered to women under 40 if they have not conceived after two years. In reality, millions have restricted access to fair treatment based purely on their postcode and their CCG’s individual criteria.”

Aileen says this has devastating consequences on those who are trying to conceive through fertility treatment.

“Fertility Network’s 2016 study found 50% of people with fertility problems felt sad, frustrated and worried nearly all the time. A distressing 42% of respondents said they experienced suicidal feelings,” she continues.

And with IVF funding repeatedly being slashed all over England couples have no choice but to pay for treatment out of their own pockets.

In the UK a full cycle can cost between £4,500 and £10,000, with some London clinics charging £15,000 or more.

And couples are increasingly turning to extreme methods in order to afford their parenting dream from remortgaging their houses, to putting it on credit. Others simply move to another postcode or get treatment abroad.

That means a third of people struggling to conceive have put themselves in financial jeopardy in a bid to have a baby.

Fair Fertility

But Fertility Network and other campaign groups are trying to change this to ensure that the NHS and CGGs follow the recommended guidelines of three free cycles of IVF.

In September last year, they launched a campaign called Scream4IVF, asking people to sign a petition, forcing a debate in parliament on fertility funding.

“We campaigned and asked people to help us #Scream4IVF: to sign a petition to help force a debate at Westminster about fair access to NHS IVF,” Aileen says of the campaign.

“The response was overwhelming: the petition reached its goal of 100,000 signatures in three months and gathered support from MPs including Steve McCabe, Paula Sherriff and the leader of the Liberal Democrats Vince Cable.”

Earlier this week, on January 14th, the Fertility Network presented the petition to Prime Minster Theresa May at 10 Downing Street, another step to help the 3.5 million people in the UK suffering from infertility.

Back in November we spoke to Nicola Salmon, a fertility coach, who believes women should be provided the same fertility support and treatment options, no matter their weight.

Equally Nicola also believes the access women have to treatment should not depend on where they live in the UK.

“It’s completely unethical that whether you get treatment for a medical condition is based, not on your need, but on where you live,” she told Yahoo UK.

“Access to medical treatment should be the same for everyone, no matter where in the UK you are.”

“Infertility is one of the most stressful events a person can go through. To increase the level of stress with the uncertainty of how and when they may be able to access treatment is inhuman. We need to make things as easy as possible for these people to start their families, not add to the stress and worry that they are going through,” she continues.

“I want to see the NICE recommendation of three IVF cycles available to everyone in the UK if they need them. Being able to start a family is one of our fundamental rights and denying people the treatment they need is denying them this fundamental right.”

Last year we revealed that women over 34 are being automatically refused IVF treatment on the NHS in 12 areas of England.

BBC’s Victoria Derbyshire programme found that despite NICE guidelines saying treatment should be offered to women until age 42, around 80% of areas are failing to do this.

To join Fertility Network’s #Scream4IVF campaign, visit https://www.scream4ivf.org

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