Audit shows extent of IVF 'postcode lottery'

Only 16 percent of Clinical Commissioning Groups (CCGs) in England follow the national guidance on access to NHS fertility treatment, according to an audit by campaign group Fertility Fairness.

Since 2004, the National Institute for Health and Care Excellence (NICE) guidance has stated that, where the woman is aged under 40 years, couples should have access to three full cycles of IVF. One cycle is defined as one round of ovarian stimulation, followed by the transfer of any resultant fresh and frozen embryos.

However, the audit revealed a five percent increase in the number of CCGs only offering one cycle of IVF, and a corresponding fall in the number of CCGs offering two and three cycles. 

Susan Seenan, co-chair of Fertility Fairness, said: 'This is cruel and unethical and a national disgrace for the country that pioneered IVF. Infertility is a disease, and women and men who cannot become parents without medical help are as deserving of healthcare as people with other medical conditions.'

Unlike Scotland, Wales and Northern Ireland, where IVF provision is standardised, patients in England have long been subject to a 'postcode lottery' in terms of access to IVF.

Fertility Fairness reported that as a result of sustained disinvestment, several CCGs have reduced the number of fertility services they offer, while both Essex and South Norfolk no longer offer any fertility services at all. Furthermore, 10.5 percent of CCGs are currently consulting on reducing IVF provision. Almost half of all CCGs use their own definition of what constitutes a full IVF cycle, meaning they typically offer significantly reduced treatment.

Many CCGs also place strict restrictions on who is eligible for IVF, including eligibility criteria based on smoking status and body mass index (BMI). Only ten percent of CCGs provide treatment to couples with children from a previous relationship. Furthermore, nine percent of CCGs exclude women over the age of 35, despite NICE's recommendation that women under 40 should receive three cycles, and women aged 40–42 receive at least one cycle.

Public Health Minister Nicola Blackwood has said: 'I am very disappointed to learn that access to IVF treatment on the NHS has been reduced in some places, and it is unacceptable that some Clinical Commissioning Groups have stopped commissioning it completely.'

'I would strongly encourage all CCGs to implement the NICE fertility guidelines in full, as many CCGs have successfully done.'

Fertility Fairness has called for a national tariff to be implemented to help all CCGs meet the costs of treatment, allowing more to provide the recommended three cycles.