Investigation reveals barriers to lesbian couples seeking fertility treatment

An investigation into NHS-funded fertility care across the UK has revealed hidden barriers for female same-sex couples.

Fertility patients in England receive varying levels of support depending on local Clinical Commissioning Groups (CCGs), with the majority requiring that couples must first prove they have struggled to conceive before accessing IVF. These rules disproportionately affect female same-sex couples – whose only option is to pay for multiple rounds of artificial insemination to demonstrate fertility issues.A report, released by the British Pregnancy Advisory Service (BPAS), detailed the extent that fertility treatment is restricted for lesbian couples.

One fertility patient told BPAS that 'The requirement of our CCG to self-fund 12 attempts to conceive means that we have ruled this out as a viable option.' With some private clinics charging over £2000 per cycle, 'we would likely have spent tens of thousands of pounds and be a few years down the line by the point we are eligible for support.'

She and her partner, both NHS workers, feel 'unsupported and discriminated against by the NHS' making her 'seriously consider whether we will be able to start a family at all'. 'This is the first time in my life that I have felt deep sadness at being gay' she added.

BPAS sent Freedom of Information Act requests to CCGs to survey the extent of the issue. The report also revealed several other key barriers to care, including restrictions on the use and funding of donated gametes, as well as postcode related restrictions. For example, over a quarter of CCGs will not fund the cost of donor sperm for IVF.

These barriers 'are striking and amount to a tax on LGBT+ families' said Dr Marta Jansa-Perez, director of embryology at BPAS Fertility. The report suggests that a 'two-tier system of care' has been created, where 'only wealthy patients can access NHS-funded fertility treatment.'

Guidance on the provision of fertility services in the UK is issued by the National Institute for Health and Care Excellence (NICE). Although CCGs do not have a statutory obligation to adhere to these guidelines, the report warns that since sexual orientation is a protected characteristic under the Equality Act 2010, the current policies may breach equality law.

These findings follow after reports from the UK's fertility regulator, the Human Fertilisation and Embryology Authority (HFEA), claiming that although the number of same-sex couples undergoing IVF saw a four-fold increase between 2009-2019, the guidelines for provision of fertility treatment still differ for same-sex couples and other family structures (see BioNews 1097). For example, only 14 percent of IVF cycles for female same-sex couples were funded by the NHS compared to 39 percent of cycles for heterosexual couples.