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Lancashire CCGs cut IVF services from two cycles to one

5 November 2018
Appeared in BioNews 974

Access to NHS IVF services in Lancashire and South Cumbria will be reduced to one cycle, the eight Clinical Commissioning Group (CCGs) in the region have announced. Seven of the CCGs previously permitted two cycles.

While the number of cycles provided has been cut, the definition of a cycle has also been changed. The new definition allows for all embryos created from eggs collected during a session of ovarian stimulation to be used, 'however many that may be, until a live birth is achieved', the CCGs said. Previously, a cycle only included using two to three embryos, varying between CCGs. 

'It is possible for one treatment unit to give patients access to more embryo transfers than two previous cycles might have [done],' Elaine Johnstone, chair of the commissioning policy group, told Fleetwood Weekly News. 'It will be dependent on how many individual embryos they are able to create and how many it takes before they achieve pregnancy.'

The age limit for women to receive IVF in the region will also be updated to 42 across all eight CCGs, an increase from 39 for all but Blackpool and Morecambe Bay, which already had a cap at 42 years. The minimum age will also be reduced to 18 years across the region. 

Couples with a biological or adopted child from a previous relationship will now not be eligible for treatment throughout Lancashire and South Cumbria. Two of the CCGs – Fylde and Wyre and Morecambe Bay – did not previously have this restriction. 

The group said that changes are an attempt to equalise the provision of IVF services across Lancashire and South Cumbria. They are also an effort to expand access to IVF services to same-sex couples, single women and the trans community, according to the CCGs. 

'Until now each CCG area of Lancashire and South Cumbria had different access criteria for assisted conception services,' said Andy Curran, executive medical director for the Healthier Lancashire and South Cumbria partnership, which includes NHS, local authority and community organisations. 'We expect the increased access to wider patient groups in the new policy will be funded within the existing budget.'

A spokeswoman for the charity Fertility Network UK said that the changes were 'very disappointing'. 

'That's not the way to ration NHS medical service. Infertility is defined as a disease, you have a medical condition affecting your reproductive organs. You are as entitled to treatment as anybody else,' the spokeswoman told BioNews. 

The National Institute for Health and Care Excellence (NICE) recommends that women under the age of 40 should be able to access three full cycles. 

Sarah Norcross, co-chair of the campaigning organisation Fertility Fairness, called the move a 'backward step'. 

'While I am pleased that the CCGs have come up with a decision which will improve equity of access to patients and they are all going to use the definition of a cycle as defined by NICE, they are falling far short of what NICE recommends,' said Norcross, who is also director of the Progress Educational Trust, which publishes BioNews. 

'Not all women will need all three [NICE-recommended] cycles and so the cost of providing a fully NICE compliant service may cost less than the CCGs think. Fertility Fairness urge the CCGs to commit to increase the number of full cycles they provide in the near future. To make this decision during Fertility Awareness week seems a particularly callous act.'

SOURCES & REFERENCES
Fertility treatment to be standardised across Lancashire
Fleetwood Weekly News |  5 November 2018
'Heartbreak' as IVF cuts loom for East Lancashire
Lancashire Telegraph |  31 October 2018
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