BBC Radio 4, Thursday 2 May 2013
Presented by Kate Silverton
Silverton is well known for reading the BBC news, so I was interested to
listen to her short report on how IVF has become such a big business. With the
UK spending £500 million on IVF every year, she wanted to know why it should cost so much. Coming to this with personal knowledge
of having had four IVF attempts but eventually conceiving naturally, she was concerned with how IVF can drastically change
people's lives and the lack of transparency about the costs associated with it.
Silverton covered the issue of the costs of private treatment with Mr Hossam Abdalla, the clinical director of the Lister Fertility Clinic, where she had received fertility treatment. Although he said that they tried to be transparent, it seemed that costs could still be confusing for patients. Silverton then spoke to a patient undergoing IVF treatment about the need to get a loan to cover the costs, and how this can be stressful as the success of treatment isn't guaranteed.
Clare Lewis-Jones, from Infertility Network UK, explained that there was still a postcode lottery, with only 25 percent of people able to access the three cycles from the NHS that the National Institute for Health and Care Excellence (NICE) had recommended. She made a valid comment that with the change from primary care trusts (PCTs) to clinical commissioning groups (CCGs), there was a worry about the future and funding of IVF.
Other ways of helping with costs of treatment were also looked at, such as egg sharing. Although egg sharing has helped many couples achieve pregnancies, as Clare Lewis-Jones pointed out, there is still a considerable residual worry about why women come forward to share their eggs. Are they doing it just to access IVF? For the donors who don’t get pregnant, what are the implications for the future?
Professor Geeta Nargund spoke about another, cheaper option, natural IVF, where the one egg released monthly is collected and fertilised. Without the need for expensive fertility drugs and cycle monitoring, it is much cheaper than conventional IVF, but as its effectiveness is currently unknown, NICE has not recommended it as an option for NHS patients.
The idea of capping costs was discussed with Professor Nargund, who was in favour of it, as it would reduce confusion for patients unsure whether to receive treatment privately or on the NHS. However, Mr Abdalla felt it would not work, as it would require standards to be consistent across the UK. Clare Lewis-Jones felt that people should stop worrying about the private sector and concentrate on sorting out the NHS treatments recommended by NICE.
Overall, it was too short a programme to do justice to this serious issue, at only 12 minutes long. It came over that many patients couldn’t understand why it should be so expensive. Kate Silverton ended the report saying she didn’t understand why the costs couldn't be capped. I think that people in this business also ask these questions themselves: why some clinics charge more than others, and how the NHS clinics can charge PCTs/CCGs less than some private clinics charge their private patients. Many of these important questions still go unanswered.