Mid and South Essex ICB standardises IVF access

Mid and South Essex Integrated Care Board (ICB) has made access to NHS-funded IVF consistent across the area, following a review.

Previously, access to NHS-funded fertility treatment varied across the region as different clinical commissioning groups (CCGs) had implemented different policies (see BioNews 1032, 773, 764 and 608). In July 2022, ICBs replaced CCGs as NHS service commissioners in England. One of the first actions by the newly formed Mid and South Essex ICB was to launch a pre-consultation with affected patients on the provision of NHS services for which eligibility was inconsistent across the area in August 2022 (see BioNews 1157). It subsequently ran a consultation on proposed policies between 31 October 2022 and 19 December 2022. The ICB has now confirmed that access to NHS-funded IVF will be standardised across the whole area, which includes Basildon, Brentwood and Thurrock, from 1 April 2023.

Bourn Hall, a private fertility clinic which pioneered IVF in the UK, now with branches across Essex, Suffolk and Cambridgeshire, responded to the news by saying it was reviewing its patient list to see if any were now eligible for NHS treatment. 'Many people that require fertility treatment have been living in limbo waiting to see if NHS IVF treatment will be reinstated' said Professor Arpita Ray, clinical lead at Bourn Hall Essex. 'The decision to remove the postcode lottery in mid and south Essex now makes it possible for them to seek the help they so desperately need to start their families.'

Eligible couples, where the partner who will carry the pregnancy is aged 23 to 39, will be offered a maximum of two cycles of IVF (with or without ICSI). If the partner is aged between 40-42, a maximum of one cycle will be offered. Female same-sex couples will now be able to access NHS-funded IVF treatment following six unsuccessful cycles of intrauterine insemination, in parts of Essex where they weren't before, including mid Essex, Basildon and Brentwood.

However, the ICB's definition of a full cycle of IVF is not compliant with the National Institute for Health and Care Excellence (NICE) evidence-based guidance. The ICB review is defining a full cycle as up to one fresh and one frozen embryo transfer. This will include the cost of freezing and storage. For patients who do not achieve a live birth with the fresh embryo transfer, the transfer of one frozen embryo will be funded. Any previous IVF cycles, whether self- or NHS-funded, will count towards the total number offered by the ICB.

NICE states a full cycle to be the transfer of any resultant fresh and frozen embryo(s) after one episode of ovarian stimulation, instead of the only one fresh and one frozen transfer the ICB has outlined. Furthermore, NICE recommends three full cycles of IVF (with or without ICSI) for women under 40, whereas the ICB is only offering two.