Government pledge on IVF in tatters as units fail to cope with demand

Thousands of couples desperate to become parents will not receive free fertility treatment, despite a government pledge to offer at minimum of one cycle on the National Health Service.

Thousands of couples desperate to become parents will not receive free fertility treatment, despite a government pledge to offer at minimum of one cycle on the National Health Service.

An investigation by The Independent on Sunday can reveal that fertility services in England and Wales are in crisis, with some NHS trusts refusing to supply any treatment for certain couples.

In what has been described as a "shambles" by critics of the Government, some cash-strapped trusts will be unable to provide any treatment by the April deadline set a year ago by John Reid, the Secretary of State for Health, while others will be forced to reduce the level of treatment which they already offer.

Fifteen out of the 38 trusts surveyed said they did not have treatment in place two months before the deadline.

Selby and York trust said that after April, couples with adopted children would not qualify for treatment and Suffolk said that in future they would offer two cycles of treatment only to couples who could afford to contribute £700 towards treatment, nearly three-quarters of the total cost.

Birmingham will disqualify people who have children from a previous relationship.

Manchester PCT and Avon both already offer at least two cycles. However, they said they would have to cut back these services to only one cycle because of the expected increase in demand for IVF after April.

Both North Wales and Mid Wales said they could not afford to offer treatment and that couples would instead be referred to Liverpool.

A spokesman for the NorthWest Wales NHS trust said: "This costs money and I'm afraid that we cannot afford this service for outpatients."

Many experts believe that even one cycle of fertility treatment is inadequate. This provision falls short of the three free cycles recommended last year by the National Institute for Clinical Excellence (Nice) for couples who have a 10 per cent chance of pregnancy.

The disclosures come as increasing numbers of couples are being diagnosed with fertility problems. Almost 5,000 patients receive IVF treatment on the NHS each year, and one in seven couples face fertility problems.

Caron and Damian Barnes, who are both in their early forties and from Bangor in North Wales, decided to try for a family in 1999, but remain childless. They say their attempts to conceive have been frustrated by a lack of NHS provision for fertility treatment.

"We have spent thousands and are trying one more time. Then we will give up," said Mrs Barnes, who knows couples who have gone abroad to Spain in search of egg and sperm donors rather than join the waiting list in the UK.

"It is not fair that everywhere else you get treatment and yet in North Wales you don't and we all pay the same taxes. Even if you decide to pay yourself there are no facilities here, so you have to travel to another part of the country which makes it even more expensive."

Dr Simon Fishl, director of Nottingham-based CareFertility, said the fertility treatment crisis had worsened in some areas since last year.

He said: "It's a mixed-up, crazy and in some ways worsened situation since John Reid declared his support of the Nice guidelines."

The National Infertility Awareness Campaign (NIAC) is carrying out its own survey of trusts in an attempt to establish where treatment will be available, and the results will be published later this year.

Professor Robert Winston, the leading fertility expert, denounced the Government's one-cycle pledge as "complete nonsense" and urged ministers to spend money on researching ways of offering cheaper and more extensive treatment for couples with fertility problems.

"That is one of the reasons I'm so angry about the Human Fertilisation and Embryology Institute (HFEA), which seems to want to expand its practice when IVF is being priced out of the market," said Lord Winston, professor of fertility studies at Imperial College London.

"It's all very unsatisfactory. There is an issue as to whether we want this type of medicine and whether we want to pay for it. In some countries, like Israel, it's not unusual to offer 15 cycles of treatment," he said.

Andrew Lansley MP, the vice chair of the All-Party Parliamentary Group on Infertility, said: "I think inevitably there will still be a postcode lottery and this will be the case until the NHS routinely provides the service that Nice has recommended."

The Department of Health responded that the Nice guidance on infertility could not be implemented "over-night" and it was reviewing the role of the HFEA.

Additional reporting by Prathana Gahilota, Nayab Chohan and Jenni Silver