Bristol will offer NHS fertility services to single women and transgender people

Transgender patients and other patients who receive treatment that may impact their fertility, will be able to access fertility preservation funded by the NHS in Bristol, North Somerset and South Gloucestershire for the first time.

Single women will also be able to access NHS-funded IVF in the area covered by the Bristol, North Somerset and South Gloucestershire Integrated Care Board (ICB) for the first time from 1 April 2023. The number of privately funded intrauterine insemination (IUI) cycles women in same-sex couples will need to undergo privately in order to qualify for NHS-funded IVF will be dropped from ten to six. However, the age limit for women accessing IVF has been reduced from 40 to 39 years old, to make savings in order to fund the increased access for other groups. The ICB took over commissioning of NHS services for the area in July 2022, when legislation dissolving clinical commissioning groups took effect. It announced the changes at a Board meeting on 1 December, following a three-month consultation period that started in March 2021.

Chief nursing officer for Bristol, North Somerset and South Gloucestershire ICB Rosi Shepherd told the BBC: 'The proposals aim to provide better equity of access for local people – which was important feedback we heard during the consultation – while staying within our limited resources.'

Previously the only patients who were able to access NHS-funded gamete preservation in the area were cancer patients, but the ICB stated it would change this following legal advice from its solicitors. Bevan Brittan LLP advised the Board that offering gamete preservation to just one group of patients could result in a potential legal challenge under the Equality Act 2010. The Board also noted that there was currently a legal challenge over the requirement for female same-sex couples to undergo privately funded IUI before qualifying for NHS-funded fertility treatment.

Data on the number of transgender patients in the area who were seeking treatment that might affect their fertility was not readily available, but the Board has predicted that funding the changes to improve access to gamete preservation would cost the Integrated Care System £43,550. In addition to this they predicted that expanding NHS-funded IVF access to single women would cost an additional £34,584 a year.

This increased cost will be funded by a predicted saving of around £110,040 by reducing the age limit for accessing IVF from 40 to 39 for women. The age limit for male partners will stay the same, at 54.

Patients who qualify for NHS-funded IVF will qualify for one IVF cycle which the ICB defines as one fresh embryo transfer, and one frozen transfer if deemed clinically appropriate, which is in conflict with National Institute for Health and Care Excellence guidelines which define a full cycle as transfer of all viable embryos.