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Updated NICE guidance expands entitlements to IVF

25 February 2013
Appeared in BioNews 694

Women over the age of 40, same-sex couples, and people with disabilities have been addressed for the first time in the updated NICE (National Institute for Health and Clinical Excellence) guideline on fertility treatment.

'The good news is that, thanks to a number of medical advances over the years, many fertility problems can be treated effectively. It is because of these new advances that we have been able to update our guideline on fertility, ensuring that the right support, care and treatment is available to those who will benefit the most', said Sir Andrew Dillon, Chief Executive of NICE.

In the clinical guideline, NICE recommends women aged between 40 and 42 should be offered one cycle of IVF if they have not conceived after two years of regular, unprotected intercourse and meet other criteria. This marks a change from the 2004 guideline that suggested women over the age of 39 should not be offered IVF (as reported in BioNews 247).

Dr Tim Child, Director of Oxford's Institute of Reproductive Sciences and a member of the guideline development group, said: 'This decision was taken after considerable discussion and close analysis of the available evidence'.

The updated guideline also suggests that IVF treatment should be made available to eligible women earlier than previously recommended - after two years, rather than three years, of regular, unprotected intercourse without conceiving. Same-sex female couples and people with certain disabilities that prevent them having intercourse were also highlighted as eligible for IVF, if they have undergone six unsuccessful cycles of artificial insemination.

Issues around artificial insemination and the use of drugs to stimulate egg release were also addressed, as well as the question of how many embryos should be implanted during IVF treatment. Implanting several embryos increases the chance of multiple births, which can result in medical complications for both mother and child.

The updated guideline recommends women under the age of 37 undergoing their first cycle of IVF should have only one embryo transferred. The transfer of two embryos was suggested for further cycles of treatment and in women aged between 40 and 42.

Some fertility experts fear that the guideline may not lead to changes being applied in practice. Dr Sue Avery of the British Fertility Society told the Telegraph: 'It is now almost ten years since NICE first published guidelines on fertility treatment and we are still in the untenable position that the majority of PCTs have not fully implemented these and patients in many areas of the country are unable to access treatment'.

Financial problems faced by the NHS were highlighted as the cause, as Dr Avery told the BBC: 'It's good that there's the possibility there, but the funding does not match'.

Childless couples to get IVF on the NHS after two years instead of three: new guidance
Daily Telegraph |  20 February 2013
Clinical Guidelines - Fertility: assessment and treatment for people with fertility problems
National Institute for Health and Clinical Excellence |  20 February 2013
Greater treatment options for women with fertility problems
National Institute for Health and Clinical Excellence (press release) |  20 February 2013
Health service to fund IVF for the over-40s
Guardian |  20 February 2013
IVF should be given sooner and to older women, says NICE
BBC News |  20 February 2013
New NICE guidelines for NHS fertility treatment
NHS Choices |  20 February 2013
19 May 2014 - by Rebecca Carr 
The National Institute for Health and Care Excellence has published a set of draft statements that aim to 'eliminate' current geographical disparities in access to fertility treatment...
28 April 2014 - by Merry Varney 
In the recent case of R (on the application of Elizabeth Rose) v Thanet CCG, in which I was instructed by Elizabeth Rose, the High Court was asked to consider whether a policy denying funding for cryopreservation of oocytes – a treatment recommended by the National Institute for Health and Care Excellence (NICE) – was lawful....
27 January 2014 - by Julianna Photopoulos 
A recent survey carried out by the National Infertility Awareness Campaign (NIAC) found that 73 percent of clinical commissioning groups (CCGs) are not funding the recommended cycles of IVF treatment....
25 November 2013 - by Professor Lisa Jardine 
In stark contrast to reports in the media, the need to reduce the incidence of multiple births following IVF remains, and the policy still stands...
18 November 2013 - by Cait McDonagh 
Two women claim to have been refused IVF treatment on the NHS at St Mary's Hospital in Manchester on the basis of their sexuality...
10 December 2012 - by Ari Haque 
A couple who was refused fertility treatment on the NHS for being 'too old' has said it intends to challenge the decision in the courts, arguing that the decision amounts to age discrimination....
3 September 2012 - by Cathy Holding 
Around one in three women who are entitled to receive IVF are being denied this right, according to a survey carried out by the National Infertility Awareness Campaign (NIAC)...
18 June 2012 - by James Taylor 
As Britain's leading lesbian, gay and bisexual equality charity, Stonewall welcome the decision by the National Institute for Health and Clinical Excellence to update its fertility guidance to recognise recent changes in the law that will affect lesbian and bisexual women. The guidance, out to consultation, explicitly includes same-sex couples as an eligible group for fertility treatment...
28 May 2012 - by Dr Greg Ball 
The National Institute for Health and Clinical Excellence (NICE) has published a draft updated guideline on fertility that would see same-sex couples and women aged up to 42 eligible for fertility treatment on the NHS...
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