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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.

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
8 March 2010 - by Maren Urner 
The UK supermarket chain Asda is to become the first to sell IVF drugs without profit, saving patients up to £820 per treatment cycle. The move is part of the retailer's bid to become the most competitive pharmacy in the UK....
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....
1 September 2009 - by Antony Starza-Allen 
Leading fertility and adoption experts have called upon the Canadian government to fund three cycles of IVF for women under 42 in the state of Ontario. The Ontario Expert Panel on Fertility and Adoption, which released its report last week, recommended the province should fund IVF as well as including proposals to reform the adoption system....
10 August 2009 - by Ailsa Stevens 
More than eight out of 10 PCTs are still failing to offer the full three cycles of IVFtreatment as recommended by the National Institute for Health and Clinical Excellence (NICE), according to a report published by Tory MP Grant Shapps this week. The report revealed further inconsistencies in the criteria PCTs were using to decide who should get NHS-funded IVF, resulting in some mothers being both too old and too young to access treatment, depending on where they lived....
1 June 2009 - by Sally Cheshire CBE 
Around one in six couples in the UK seek specialist treatment for fertility problems, and infertility can have a profoundly distressing and devastating impact. British patients have traditionally faced considerable inequality of access to NHS treatment, resulting in many having to resort to privately-funded treatment, and there continue to be...
26 August 2008 - by Dr Charlotte Maden 
The NHS has been advised to offer more fertility treatment cycles to infertile couples by a government advisory committee, in a bid to abolish the IVF postcode lottery that exists in the UK. The National Institute for Health and Clinical Excellence (NICE) recommends providing couples in which...
14 July 2008 - by Clare Lewis-Jones MBE 
Louise Brown, the world's first IVF baby, will be 30 years old on 25 July 2008. Here Clare Brown, who was among those to speak at a reception organised by the All Party Parliamentary Group on Infertility to mark next week's National Infertility Day 2008, reflects on three decades of...
2 July 2007 - by Dr Francoise Shenfield 
Lord Winston's critique of the funding of fertility treatment in the UK sparked controversy and press headlines earlier this month. As I wrote in a recent letter to the Guardian newspaper (1), whilst I welcome Professor Winston's comments on the cost of IVF in the UK, he fails to address...
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