Anger at infertility treatment rationing

NINE OUT of 10 infertility specialists believe couples are unfairly being turned away for National Health Service treatment on social rather than clinical grounds.

Age limits and a bar on anyone with a child from a current or pre-existing relationship are discriminatory and run counter to the principle of providing care according to clinical need, they say.

A survey of almost 1,300 men and women who had undergone treatment found that three-quarters had had to pay for some or all of it, spending on average pounds 3,240, excluding the cost of drugs. One in four were successful in having a child.

A separate survey of 157 specialists, of whom 90 per cent were consultants, found half expected to spend less on fertility drugs this year than last. The maximum age for NHS treatment was set, on average, at 39. Both surveys were commissioned by the National Infertility Awareness Campaign.

William Ledger, clinical director of the in-vitro fertilisation (IVF) unit at the Oxford Radcliffe Hospital, said: "One in six couples will experience difficulty in their attempts to conceive. Sadly, there are few signs that NHS provision to help them with their problems is improving. Thousands of people continue to be denied a chance to have a family which is clearly a cause of psychological distress."

The survey of specialists, the first of its kind, found that one in three admitted to becoming emotionally involved in the outcome for a couple having treatment and two out of three said they felt frustrated when they were prevented from helping couples because of the lack of funding. One in five said they felt a sense of failure when treatment was unsuccessful.

Mr Ledger said: "When you are faced with a couple and you know you have something up your sleeve that could help them and then you have to deliver this whammy that it is going to cost them pounds 1,500, it is very distressing. Many couples do not realise that treatment is not available on the NHS."

NHS treatment is more widely available in the North with little provided south of a line from Birmingham to the Wash.

Mr Ledger said: "The NHS has traditionally put more money into the NHS in the North because levels of deprivation are higher. But the burden of infertility is pretty equal north and south ... there are 125 health authorities and each has drawn up its own criteria for treatment."

More than half the patients surveyed said they had become depressed and one in 20 felt suicidal as a result of the financial and emotional pressures. On average, couples spent over five years trying for a child and many felt their relationship had suffered as a result.

The findings also showed that "rationing by postcode" remains the norm for infertility treatment. One couple said: "Doctors in Bath have gone as far as they can to help us. If we lived next door in Avon we could have IVF but as it is we can't. How can this be called a national health service?"

One in 14 couples in the survey had been trying to conceive for more than 10 years. More than 70 per cent were in their thirties. Investigation and treatment had led to 27 per cent being successful, with 26 per cent taking between three and five years to conceive, and 29 per cent between six and ten years.