There has been much talk lately of the poor availability of IVF (in vitro fertilisation) treatment. But how much IVF do we need? According to a report published in the UK in 1994, a population of 100,000 people needs 40 cycles of IVF. Assuming this proportion to be correct, it seems therefore that France and the UK provide a satisfactory number of treatments, since in both countries there are more than 40 IVF cycles per 100,000 of the population performed each year.
But who pays for these cycles? In France, the state pays for four IVF cycles per couple, with a possibility of more at the gynaecologist in charge's discretion. In the UK, however, there is no national policy. Each region, or health authority, is responsible for its own health budget and therefore makes its own decision about IVF provision. Health authorities in some parts of the UK provide two cycles of state-funded IVF; but others provide none at all. This is what is commonly known as a 'postcode lottery'.
But in countries where the state does pay, some patients are denied IVF for other reasons. In Germany, for instance, where insurance companies pay about 70 per cent of the cost of four cycles, there are fewer cycles performed and the insurance companies may dictate their own patient selection process based not on clinical criteria. In the UK, health authorities also have a patient selection process based upon criteria such as age and marital status. This means that even if you are lucky enough to live in a region that provides IVF, you may be denied it for other reasoning of treatments in several countries with different health systems shows that only a state subsidised system allows fair and equitable access to couples in need. In the UK, there is still a lack of political will to improve access systematically across the country. With human rights legislation coming into force in the UK later this year, the government may well find cases from patients wanting fertility treatment, claiming that the National Health Service is not caring for them.
The 'postcode lottery' in IVF
Image by Alan Handyside via the Wellcome Collection. Depicts a human egg soon after fertilisation, with the two parental pronuclei clearly visible.
There has been much talk lately of the poor availability of in vitro fertilisation (IVF) treatment. But how much IVF do we need? According to a report published in the UK in 1994, a population of 100,000 people needs 40 cycles of IVF. Assuming this proportion to be correct, it...
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