TV Review: Postcode Lottery

BBC1's 8 March episode of 'Postcode Lottery', presented by Dominic Littlewood, featured Sarah and Levi Johnson, a couple living in Portsmouth who want to have IVF on the NHS.

After six unsuccessful years of trying to conceive naturally, they discovered, to their dismay, they fall foul of the strict qualifying criteria set by their local PCT. Sarah is now too old (over 35) and too overweight [BMI (body mass index) above 30], and her partner Levi has a child from a previous relationship — all three are no-gos for a couple wanting IVF on the NHS in this area.

Sarah has polycystic ovaries, endometriosis and fibrosis, and was told by her fertility consultant that nothing more could be done for her — unless she had £5000 for private IVF treatment. 'That was the end of anybody doing anything for us', she said.

The couple described their situation as 'devastating' and 'heart-breaking'. Levi said it was impossible to imagine the pain Sarah felt after having been told, as he put it, 'you can't have children, that's it, go away'.

The fact IVF was pioneered in this country featured prominently in the programme. 'How is it', demanded Littlewood, 'that in a nation of medical miracles and bouncing babies, thousands more women are being denied access to this potentially life-changing treatment?'

However, he quoted statistics saying that there had been 12,714 IVF births in 2009, and that over 45,000 more women in the UK received IVF treatment in 2010. To me, this figure is astonishing — and suggests quite a lot of women are actually successfully gaining access to IVF on the NHS.

According to the programme, the National Institute for Health and Clinical Excellence recommendations for couples seeking IVF treatment on the NHS are three free cycles of treatment to women between the ages of 23 and 39. However, each PCT is allowed to set their own criteria based on the likelihood of a woman conceiving by IVF.

As the programme title suggests, the focus was on the differences in PCT criteria according to postcode. For example, women in Portsmouth must be under 35, whereas in Brighton they can be up to 39. In the Midlands, most PCTs have a maximum age policy for the male partner. Finally, according to the programme, NHS Surrey only offer IVF at the age of 39 — 'not a year younger, not a year older!' says Littlewood. (However, as reported in BioNews 633, as of April 2012, IVF on the NHS will be reinstated in Surrey).

The number of children from previous relationships also differs depending on area: in Portsmouth it's zero; in Bolton one partner is allowed one child; and in Hackney you are allowed four children from previous relationships, as long as you have none with your current partner.

For me, the main issue this programme raised was the arbitrary variations that people get caught up in because of different criteria set by individual PCTs.

Furthermore, I felt the programme was trying to imply that every couple should be given the chance to try IVF because of its miraculous, life-changing abilities. But IVF is only miraculous and life-changing if it works.

While the success rate for IVF (25 percent) was given by Littlewood, along with the acknowledgement that this 'falls sharply over the age of 35', he buried these statistics in an attack on NHS Surrey for only offering IVF at the age of 39.

So IVF is, in itself, very much a lottery. But if you don't play then you can't win.

Meanwhile, Sarah and Levi both appear to believe bureaucracy is the only thing standing in the way of a pregnancy.

In her closing comment she said: 'There is somebody out there who can help us, and so I'll just keep fighting — until eventually I get my child'.

And indeed she is fighting, in March 2011, Sarah started an online petition calling for IVF criteria to be made uniform across the UK. She aims to reach a thousand signatures before presenting it to Downing Street (1).

Levi summed up their feelings: 'Just one child, it's not a lot to ask for, is it?'