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Holding back the British IVF Revolution: A report into public IVF provision in the UK today

13 June 2011
By Gareth Johnson MP
MP for the Dartford constituency in Kent
Appeared in BioNews 611
IVF is one of Britain's greatest inventions. Professor Robert Edwards received the Nobel Prize for Medicine for his pioneering work developing this fertility treatment and - in the last week - it has been announced that he will be knighted in the Queen's Birthday Honours list. The result of Professor Edward's work was Louise Brown, the world's first so-called 'test tube' baby. Britain, more than any other country, should be championing the use of IVF treatment.

This is why, as Chairman of the All Party Parliamentary Group on Infertility, I have produced a report to provide a snapshot of IVF provision in the UK today. This report seeks to compare the practises of PCTs - or their equivalent in Scotland, Wales and Northern Ireland - against the guideline for IVF provision laid down by the National Institute for Health and Clinical Excellence (NICE). The information on which the report is based was collected through Freedom of Information (FoI) requests to Primary Care Trusts (PCTs) or their equivalent in March 2011. In total, 177 responded to the FoI requests and these data can be reviewed in the full report.

When I commenced work on this report, I had a hunch there would be a wide variation in IVF provision around the country - the so-called 'postcode lottery'. I do not claim to be a healthcare expert, but it seemed there was little consistency in IVF availability on the NHS. But I was not prepared for the numerous conditions and restrictions placed upon infertile couples, even in areas that offer IVF treatment. PCTs and their equivalents need to uphold the spirit of the NICE guideline, not only the letter, for IVF treatment on the NHS to be genuinely available to infertile couples.

The NICE guideline provides a good basis for deciding how IVF treatment should be offered to infertile couples. Many PCTS have used the guideline as the basis for their own policy and allow infertile couples up to three cycles of IVF treatment with certain restrictions. This is exactly how the guideline should be used. However, other PCTs have added their own stringent restrictions on who is eligible for treatment to the guideline. These restrictions have covered both partners' BMI (body mass index), whether they have children from previous relationships, and whether or not a partner smokes.

Perhaps the most disappointing finding of this report was the small number of PCTs providing three cycles of IVF, as recommended in the NICE guideline. Of the PCTs offering IVF to patients, 39 percent only offered one cycle of treatment. Twenty-six percent of PCTs offered two and a further 27 percent offered three cycles. Therefore, 73 percent of PCTs are offering less than the three cycles recommended by NICE. I believe PCTs should be striving to fulfil these important NICE recommendations to ensure the best possible IVF success rates.

There will always be limits on the amount of infertility treatment that can be given on the NHS. The NICE guideline achieves a fair balance between the needs of infertile couples and the limits that have to be placed on funding. It is therefore vital that PCTs adhere to it. It is also essential that IVF is recognised as a clinical need. All too often PCTs consider IVF to have the same priority as tattoo removal or other cosmetic procedures. However, as fertility problems affect one in seven couples in the UK - approximately 3.5 million people - I believe it is time that PCTs recognise the importance of treatments, such as IVF.

Thousands of couples who otherwise would have been unable to conceive are parents because of the IVF revolution. Thousands of children worldwide are alive today because of Professor Edward's work. That work should be celebrated and its provision across all parts of the NHS - in accordance with the NICE guideline - should be ensured. I look forward to reading the reviewed NICE guideline in 2012 and encourage all PCTs to strive towards meeting the criteria set out in it.

You can read the report in full on my website.

SOURCES & REFERENCES
Holding back the British IVF revolution?
Gareth Johnson, MP |  3 June 2011
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