13 August 2007
ByAppeared in BioNews 420
A survey conducted by the Infertility Network UK (I N UK) and sponsored by the UK Department of Health (DH) has shown that the provision of IVF treatment in the UK does not meet government guidelines. The survey indicated that provision of NHS fertility treatment is patchy, with many PCTs not providing any IVF, and that there is a wide variation in the eligibility criteria employed by those that do.
UK guidelines, issued by the National Institute of Health and Clinical Excellence (NICE) in February 2004, stipulate that all eligible couples should be offered up to three free cycles of IVF if the woman is between 23 and 39 years old. A cycle of IVF, according to these guidelines, includes the freezing and re-implantation of eligible embryos. The survey showed that less than half of the fertility clinics in the UK are fulfilling this criterion; resulting in women having to undergo unnecessary ovarian stimulation and egg removal. Clare Brown, chief executive of I N UK, told the BBC: 'It is unacceptable that many PCTs are failing to include frozen embryo transfers as part of their IVF cycles. This is vitally important given the likely move towards single embryo transfer for appropriate patients'.
Whilst most of the clinics who responded to the survey had some provision for free IVF, the social eligibility criteria varied widely. This has apparently resulted in the bizarre situation that a 36 year old woman in Wiltshire was reportedly told she was too old for treatment, whilst a 28 year old woman in the Thames Valley was told she would have to wait until she is 36 before she is eligible for treatment.
NICE guidelines stipulate that priority should be given to couples who do not have children living with them; 40 per cent of respondents, however, disqualified couples with any children from previous relationships, regardless of whether the children lived with them or not.
In response to these findings the government has again committed to improving the availability and equality of access to IVF in the UK and to working with I N UK to develop best practice guidelines. Dawn Primarolo MP, who holds ministerial responsibility for fertility, said: 'We have initiated a project with Infertility Network UK to help the NHS in the development of good practice in the provision of fertility services, including involving patients in decision making'. The government has also committed to developing standard social eligibility criteria and implementing a national monitoring system of IVF provision.