The UK's National Health Service (NHS) must improve access to IVF (in vitro fertilisation), according to a new policy briefing on infertility provision in England from the Royal College of Nursing (RCN). Only 30 per cent of Primary Care Trusts (PCTs) in England fund three full cycles of IVF treatment, according to a March 2009 Department of Health survey quoted in the RCN briefing .

This figure is an improvement from 2007, the briefing says. However, it still fails to meet National Institute for Health and Clinical Excellence (NICE) guidelines issued in 2004 that say all PCTs should offer three full cycles. Many PCTs have also adopted strict non-clinical criteria for funding IVF treatment, according to the briefing. IVF can be restricted to non-smoking women registered with a local GP for a minimum three years who are over or under 35.

The RCN recommends that all PCTs offer three full cycles vith a view to improving patient safety and reducing costs. Only 25 per cent of IVF in England is NHS-funded, but the NHS must provide antenatal care to privately-funded IVF patients.

Multiple pregnancies are the biggest health risk of IVF, the briefing says, but couples paying privately for IVF treatment may see multiple embryo transfer as more cost-effective. Three full IVF cycles may make single embryo transfer more acceptable to couples for whom it's recommended. Privately-funded patients going abroad for fertility treatment are also likely to receive multiple embryos, the RCN warns.

The policy briefing also recommends that fertility nurses provide concise and accurate information to commissioners of fertility services, and psychological support to prospective parents. 'We know progress has been made by PCTs to implement the NICE guidelines on fertility provision', says Dr Peter Carter, RCN Chief Executive and General Secretary. 'However,' he added, 'there are still staggering variations in the access criteria PCTs use in assessing who gets IVF as well as the availability of three full treatment cycles. We call upon all PCTs to work with nurses to take the necessary steps to ensure that the NICE guidelines are fully implemented and to end this unfair treatment for many couples'.