A call has been made for childless couples to be offered greater access to IVF after a survey found only one London borough was meeting NHS guidelines.
The National Institute for Health and Care Excellence (NICE), the clinical body that decides whether the NHS can afford treatments, called on clinical commissioning groups (CCGs) to stop restricting the fertility treatment.
It said IVF, which costs around £3,000 per cycle, was a “core part of NHS services” and said patients should not be subject to a postcode lottery.
Research by the campaign group Fertility Fairness found that Camden was the only one of 32 CCGs in the capital to offer the recommended three cycles, while Islington offers two. All other areas offer only one cycle.
The group downgraded the claims of seven east London CCGs – Barking and Dagenham, City and Hackney, Havering, Newham, Redbridge, Tower Hamlets and Waltham Forest – to offer three cycles. It found they offered only “three embryo transfers in total” – which could include a fresh embryo and two frozen embryos harvested from the same initial procedure.
Susan Seenan, chief executive of Infertility Network UK and co-chair of Fertility Fairness, told me: “It’s unfair that access to IVF depends on where you live, when national guidance says you should get up to three cycles.
“Not that many people need the third, but there are a few that do. The psychological impact of not having that third puts so much pressure on the woman that it can make a big difference.
”From speaking to patients, it’s very apparent that knowing they have only got one cycle or two causes a great deal of stress. It’s wrong for a CCG to say they don’t agree with the guidance. NICE are the body of experts. They have done all the research.”
NICE has no power to compel CCGs to follow its guidelines, leaving local GPs who control each area’s NHS budget free to decide whether to prioritise fertility treatment. This forces many women, especially those aged over 40, who face additional restrictions on IVF on the NHS, to spend vast sums at private clinics.
The move by NICE involved it issuing tougher “quality standards” stating that the NHS should provide three full cycles of IVF for women under 40 who have failed to get pregnant after two years of trying. Women aged 40-42 should receive one full cycle if certain criteria are met.
Fewer than one in five CCGs across the country offer three full cycles. Last month, Mid Essex CCG said it would no longer provide any specialist fertility services except in “exceptional clinical cases”.
Normally one or two eggs are implanted at a time. A full cycle of IVF is defined as the use of any additional fertilised eggs that are frozen rather than implanted. No all women produce eggs of good enough quality to be frozen for future use.
Professor Gillian Leng, deputy chief executive and director of health and social care at NICE, said: “Infertility can have a potentially devastating effect on people’s lives. It can cause significant distress, depression and possibly lead to the breakdown of relationships. It is unacceptable that parts of England are choosing to ignore NICE recommendations for treating infertility. This perpetuates a postcode lottery and creates inequalities in healthcare across the country.”