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The IVF postcode lottery: Don't promise what you can't deliver

9 August 2009
Appeared in BioNews 520
For anyone who has found it easy to conceive naturally, it's possibly hard to imagine how IVF can become all-encompassing in someone's life. The endless check-ups, scans, tests, periods of waiting and - finally - the day when you learn the result. It's a physically punishing process for the women and an emotionally exhausting process for both partners.

IVF became the only way we would be able to have children after I was treated for Hodgkin's Lymphoma 10 years ago for the best part of a year with fertility destroying chemotherapy. And whilst the cancer treatment was predictably punishing for me, I was struck by the anguish of the IVF process and in particular the impact of the failed cycle on my wife.

So by 2007, two years after the new guidance had come into place from the National Institute of Health and Clinical Excellence (NICE), I decided to carry out a study to find out whether what the Health Secretary had subsequently promised, which is that all women under 40 who have trouble conceiving should be offered three state-funded cycles of IVF on the NHS, was actually happening. In my report The Messy Business of Conception, I established that the criteria for IVF treatment was random to say the least. For example: a 40 year old woman might be considered too old to have IVF in one part of the country but too young in another!

Wind forward to today and I decided to find out whether the situation had changed. NICE guidance has certainly been firmed up with women now able to get three cycles of IVF treatment, but how was the NHS coping? My report, Putting All Your Eggs In One Basket, published on 6 August 2009, revealed the truth - which is that in eight out of 10 areas of the country you will not receive three IVF cycles. What this research makes clear is that the guidelines are being ignored in most places.

Of course, there are plenty of people who would say that IVF isn't a business that the NHS should be in anyway. After all, shouldn't our state-funded health service be about saving lives, not creating them? And - speaking as someone whose life was saved through NHS cancer treatment - I've got every sympathy with this argument and there's a perfectly legitimate debate to be had about the best role for the NHS. But this clean view of the world is challenged by dozens of other things that the NHS does and specifically by politicians, including the then Prime Minister Tony Blair, who boasted about the NHS providing three cycles of IVF.

The reality is that it would be wiser and even kinder for politicians to be responsible about what they claim the NHS will do, because the pain of having raised expectations for parents who are desperate to start a family, only to see those hopes crushed, is more cruel than having said nothing at all.

SOURCES & REFERENCES
All your eggs in one basket
a report by Grant Shapps MP |  6 August 2009
The messy business of conception
a report by Grant Shapps MP |  1 March 2007
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