'Postcode lottery' remains for couples seeking help on IVF

One in 70 babies born in the UK are conceived artificially but NHS services cannot keep up

Michael Savage,Political Correspondent
Thursday 06 August 2009 00:00

Couples seeking to start a family using IVF treatment still face a postcode lottery in obtaining help on the NHS, new figures reveal today.

Fresh evidence uncovering huge disparities in the help given to aspiring parents across Britain showed that more than 80 per cent of primary care trusts (PCTs) are still failing to meet official guidelines on providing IVF treatment, introduced five years ago. Two PCTs even refused to provide any IVF treatment last year, according to documents obtained under the Freedom of Information Act.

Guidelines introduced by the National Institute for Health and Clinical Excellence (Nice) in 2004 said patients should be offered a full three cycles of IVF treatment.

About 40,000 cycles of IVF treatment are performed in Britain each year, but with a single cycle costing PCTs as much as £5,000, thousands of couples are turned down. As many as three-quarters of the couples who undergo IVF each year are forced to resort to the private sector.

One in 70 babies born in the UK are now conceived artificially.

Patients in the East Midlands were found to be currently limited to one full cycle of the treatment. In London, a little over a quarter of PCTs said they funded the full three cycles.

An eighth of the 80 per cent of PCTs who provided information also failed to meet national guidelines on the age limit for treatment. Two-fifths of South-east PCTs admitted they did not provide IVF to all women aged 23-39, in breach of Nice guidelines. More than half also said they excluded couples in which one partner already had a child from a previous relationship.

Patients under the care of North Staffordshire PCT are still refused any IVF treatment, with officials within the trust blaming a budget squeeze. "We commission services within allocated funds based on priorities set to meet the needs of our local population," a spokesman said. "We will continue to review IVF along with all our service developments."

North Lincolnshire PCT refused to provide any treatment until this year, but now limits help to women aged between 37 and 39.

PCTs in Southampton, Portsmouth and the Isle of Wight, restricted access to treatment to women over the age of 36, despite most medical experts estimating that the chances of conceiving through IVF fall by up to 35 per cent after the age of 35.

Government advisers have already urged ministers to force PCTs to do more for patients needing IVF treatment. Last year, the Expert Group on Commissioning NHS Infertility Provision said fertility care was still "viewed as a relatively low priority".

Grant Shapps, the Tory MP who carried out the research and whose three children were born following IVF treatment, said it was clear that a postcode lottery remained in place.

"Budgets are tight and the NHS must set its priorities, but it is wrong to raise expectations in couples who are desperate to start a family only for them to find out later that they won't get the real help they expected," he said. "Going through IVF is mentally and physically exhausting enough without these additional pressures."

Last night, PCTs came under renewed pressure to improve IVF provision. Nice urged trusts to offer three cycles of treatment "as quickly as possible". PCTs also came under pressure from the Human Fertilisation and Embryology Authority (HFEA), which demanded "fair access" to fertility services. "We would encourage all primary care trusts to follow the Nice clinical guidelines including the provision of three full cycles of treatment," an HFEA spokeswoman said.

Clare Lewis-Jones, chief executive of Infertility Network UK, said that a "totally unjustifiable and unfair variation" in IVF provision remained in place across Britain. "It is totally unacceptable that patients are denied treatment simply because of where they live or on the basis of their age, or indeed whether or not they fit the various definitions of 'childlessness' adopted by the PCTs."

A Department of Health spokesman said that the Government's own survey revealed that the NHS was "making good progress in implementing Nice guidelines and in providing fair and consistent access to IVF".

He added: "The option to become a parent is something most of us expect to have. People who cannot conceive naturally should have access to NHS treatment, just as they would for any other clinical need."

Case study: 'To punish would-be mums seems incredibly cruel'

Gary Smith, 35, and his wife Dana, 36, began their application for IVF treatment with few problems. But at the eleventh hour, were told they were ineligible because he already had a child from a previous relationship.

"It caused a lot of emotional turmoil for my wife. She thought she was being unfairly punished, and you can imagine the dynamic of the situation. My wife is the most wonderful person in the world, but for her not to feel resentful was very, very challenging. To punish the would-be mum seems incredibly cruel."

Gary realised that they would have to move home to stand a chance of being granted a cycle of IVF treatment and began to research the differing criteria used across Britain.

"We haven't got the sort of cash to afford private treatment," he said. "I went from PCT to PCT. The criteria varied hugely. In some we were eligible for one cycle, others for three, and some for none."

He drew up a shortlist of locations from which he could commute to his work in Essex, and his wife could continue working in London. "It was a done deal really. I even got to the stage of telling my daughter, that Dana and I were going to have to move away," he said. But just before they sold up, their luck turned.

"Suddenly, our PCT said it was changing its criteria and that we would be eligible. The happy ending is that we've got our first appointment at the end of August."

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