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Postcode lottery rages on as IVF funding lacks continuity

12 January 2009
Appeared in BioNews 490

Only one in five PCTs in England is providing the recommended number of NHS-funded IVF cycles, it was revealed at a fertility conference in Edinburgh last week.

The results of a survey conducted by a team at St Bartholomew's Hospital in London show that four years since the National Institute of Health and Clinical Excellence (NICE) made the recommendation that women should receive three cycles of IVF on the NHS, that guidance is not being followed and in the case of one unnamed trust - no IVF is being funded at all.

Although the NICE guidelines were devised as guidance for PCTs rather than as a legal minimum, the researchers at St Bartholomew's have called for a common national funding policy to address the disparity in IVF provision around the country.

Facing limited resources, trusts impose restrictions on who is eligible for treatment. Criteria such as weight, age, being a non-smoker and not having any children from previous relationships all contribute to the decision. The survey, conducted between July and September 2008, revealed that half of trusts will not fund treatment for smokers, and some trusts will only fund treatment if women are over 35 years old when natural fertility is thought to decline.

NICE's guidance suggested three funded cycles of IVF for infertile women, each cycle including one fresh embryo transfer and if that failed, as many frozen embryo transfers as possible with available embryos. The research team at St Bartholomew's, led by Parimalam Ramanathan discovered that none of the 148 trusts in England provides this. Of the 29 trusts providing three fresh cycles, 15 do not fund any frozen cycles, 14 are funding only one frozen cycle and only two trusts fund two frozen cycles. Tony Rutherford of the Assisted Conception Unit in Leeds said that if the NICE guidance was implemented in full, everyone would have 'a realistic chance of a successful singleton pregnancy'.

Rutherford also pointed out that the initiative to promote single embryo transfer in an effort to cut the number of multiple births resulting from IVF is being held back by a lack of funding. 'If more cycles were funded on the NHS then one embryo could be transferred to the womb at a time', he said. Multiple births are one of the biggest risks in IVF when more than one embryo is transferred into the womb during one cycle. Clare Lewis-Jones of the National Infertility Awareness Campaign said that 'with the move to single embryo transfer, it is even more important to end this totally unacceptable situation and allow patients access to the treatment promised to them by the government.'

In response. a Department of Health spokesman insisted that the number of PCTs providing three cycles of IVF continues to increase.

Fertility treatment on the NHS is still a postcode lottery: research
The Daily Telegraph |  7 January 2009
21 March 2011 - by Ayesha Ahmad 
A recent survey has found that two thirds of women would consider moving to another area of the UK to access IVF on the NHS....
21 December 2009 - by Dr Vivienne Raper 
The NHS must improve access to IVF, according to a new policy briefing from the Royal College of Nursing (RCN)...
23 November 2009 - by Ailsa Stevens 
The Lister Fertility Clinic in London is offering free fertility treatment to 21 couples to mark its 21st birthday and the opening of their newly expanded clinic. Mr Sam Abdalla, Medical Director of the clinic, said that the gesture was part of the clinic's 'duty to make treatment more accessible' and an ongoing commitment to offer a number of free cycles each year as part of the clinic's 'community programme.'...
29 October 2009 - by Ben Jones 
The Labour party is urging the Scottish parliament to take action to standardise IVF provision across Scotland, after Labour MSP Jackie Baillie discovered wide disparities in provision between the 11 Scottish NHS boards. Ms Baillie contacted all of the boards after having been approached by a constituent who was upset about the length of IVF waiting lists where they lived....
26 May 2009 - by Sarah Pritchard 
Two separate online petitions are calling for a change to the way IVF services are provided under the UK's National Health Service (NHS). Janine Macallister, 27, of Newport, Shropshire and Richard Mackenzie, 29, from Whitney, Oxfordshire have each started a petition calling for their local Primary Care...
30 June 2008 - by Dr Jess Buxton 
Only nine out of 151 primary care trusts (PCTs) in England are funding the recommended three cycles of IVF for infertile couples, according to the UK Department of Health. The latest figures reveal that despite guidance issued over four years ago, four trusts are still offering...
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