NHS Fertility Care Is ‘A Lottery’

Access to IVF on the NHS is a lottery, with different areas adopting different rules, an MP says. Grant Shapps MP obtained data under the Freedom of Information Act showing inequitable IVF provision across England’s Primary Care Trusts (PCTs).

Guidelines say all eligible women aged 23-39 should get one free cycle of IVF. But some areas have introduced restrictions such as age limits, with some saying a woman over 35 is too old, with others saying that is too young.

Other PCTs, like North Staffordshire, are so cash-strapped they have put a freeze on all forms of fertility treatment. In Birmingham East and North, the PCTs ask that both partners are non-smokers.

And Gloucestershire PCT asks that couples are together for three years before seeking treatment, while Kensington and Chelsea PCT identify a relationship length of just one year. Mr Shapps received responses from three-quarters of England’s PCTs. Half of the 114 PCTs offered couples free IVF even if either partner already had a child. National Institute for Health and Clinical Excellence (NICE) guidance says childless couples should be the priority.

Mr Shapps, whose own three children were conceived through IVF, said that PCTs were, to some extent, “playing God” – deciding who had the right to a child and who did not, based largely on the state of the PCTs’ annual budgets and deficits.

He explained: “Couples are effectively being told that they cannot have a baby while their friends on the other side of the street, who might have a similar set of circumstances, are able to obtain three cycles of IVF provided for them by the NHS.”

Health Minister Caroline Flint said: “We recognise that infertility causes pain and distress – one in seven couples experience problems. So it is important that infertile couples have access to IVF, regardless of where they live.

Ms Flint said NICE guidelines were one of many factors that PCTs had to take into account when deciding on which local services to provide. She added the government was funding work by charity Infertility Network UK to identifying the areas where IVF provision is lacking.

Dr Mike Dixon, chairman of the NHS Alliance which represents PCTs, said: “For the individual, it might seem an unfair system. But looking at it nationally, I think it’s better that there should be local determination of provision. When money is short you have to look at what is the crucial priority, such as a life-saving operation or drug.”

However Infertility Network UK said: “We urge the government to consult with all those involved, including patient representatives and clinicians, with a view to implementing the full NICE guideline and to setting centrally agreed criteria to overcome these inequalities once and for all.”

Fertility experts have also urged the government to consider making it policy that women undergoing routine IVF in the UK should only have one embryo implanted, rather than two, to reduce the rate of multiple births.

They say this would save the NHS millions of pounds that could then be spent on more treatments, including extra IVF cycles.

A new study in The Lancet shows a milder form of IVF that uses low dose fertility drugs and grows one embryo gives equally good results and is safer and less gruelling for patients than conventional IVF.