Postcode lottery persists for England's fertility patients

A national audit has highlighted regional differences in IVF funding, set by local clinical commissioning groups (CCGs).

The majority of CCGs (90 percent) do not offer the National Institute for Health and Clinical Excellence (NICE)-recommended three full IVF cycles to eligible women under 40 and 74 percent do not offer the recommended one full IVF cycle to women aged 40-42, according to the findings published as part of the National Fertility Awareness Week 2021.

'Fertility patients in England are being failed by an absolute postcode lottery which denies them access to NHS-funded treatment and forces them to either find financially-crippling amounts of money for private treatment or endure the extreme distress of being childless-not-by-choice', said Gwenda Burns, the chief executive of Fertility Network UK, who published the audit. 'This is cruel and unethical and a national disgrace for the country that pioneered IVF'.

Further age restrictions apply where 23 percent of CCGs do not assist women over 35. Relationship status also affects access to IVF treatment: only 21 percent of CCGs offer fertility treatments to single women, and while 73 percent of CCGs provide same-sex couples with fertility treatment, the majority require proof of infertility in the form of 6-12 privately financed cycles of intrauterine insemination (IUI). Heterosexual couples are eligible if they have not conceived after two years of regular unprotected sex.

According to NICE, three full IVF cycles (ovarian stimulation, egg recovery, fertilisation, and transfers of all resulting viable fresh and frozen embryos) can increase the chances of a successful pregnancy by 25 percent. However, one in five CCGs has redefined a 'cycle' to limit the number of transfers.

In many areas, other restrictions are imposed, such as excluding infertile people from accessing treatment if their partner has a child from a previous relationship.

Sarah Norcross, director of the Progress Educational Trust (the charity that publishes BioNews) said: 'Former Health Minister Matt Hancock made a commitment to improve access to fertility treatment in England in July 2019 and I trust that the new Minister Sajid Javid will follow through on this promise. The long-standing hotch-potch of policies needs to be tackled once and for all and the NICE guideline fully implemented in England.'