Planned births at home and in midwifery units are more cost-effective than giving birth in hospital, particularly for women who have given birth before University of Oxford research concludes.The research, in the British Medical Journal, compared the costs of giving birth in different places and the health outcomes for mother and baby.

More than 60,000 low-risk women in England were studied over two years.

The Royal College of Midwives says all women should receive one-to-one care.

For women having their first baby, however, planned home birth was more risky for the baby but still the most cost effective option.

The study used data from the Birthplace in England national study to calculate the cost, and health effects, of women at low-risk of complications giving birth.

It looked at planned births in obstetric units, midwifery units located in the same hospital as an obstetric unit, free-standing midwifery units not in a hospital and at home.

The study takes into account all NHS costs associated with the birth itself – such as midwifery care during labour and immediately after the birth, the cost of pain relief in hospital, and the cost of any stay in hospital or neonatal unit immediately after the birth, either by the mother or the baby.

The costs for planned home and midwifery unit births take account of any hospital care a woman may receive if she is transferred into hospital during labour or after the birth.

But the costs do not include any longer term costs, for example the life-long cost of caring for babies who suffer serious birth injuries.

The study found that the average cost per low-risk woman planning birth at the start of labour was £1,631 for an obstetric unit, compared with £1,067 at home.

When the researchers analysed women who had already given birth or who had no complicating conditions, the cost differences between planned places of birth narrowed.

The authors of the study conclude that giving women the opportunity to give birth at home or in a midwifery unit saves the NHS money and is safe for baby and mother, resulting in fewer expensive interventions.

AVERAGE COST OF BIRTH

• £1,066 – births planned at home
• £1,435 – births in freestanding midwifery units
• £1,461 – births in midwifery units alongside hospitals
• £1,631 – births in hospital obstetric unitsSource: BMJ study

The study found that individual care at home is cheaper than a planned hospital birth because hospital overheads tend to be higher and women who plan birth in an obstetric unit tend to have more interventions, such as caesarean section, which are expensive.

Urgent checks of abortion clinics ordered by the health secretary last month cost £1 million and meant hundreds of other inspections were cancelled.The Care Quality Commission (CQC) said the request at short notice from the Department of Health meant 580 pre-planned inspections were cancelled.

Time spent on planning and inspecting equated to 1,100 days, it said.

The department said the inspections had been agreed between the CQC and the health secretary.

It added that if the regulator had said more money was needed, it would have been provided.

The inspectors visited nearly 300 abortion providers in England over three days in March, and found about 50 were not complying with laws or regulations.

Several doctors were referred to the General Medical Council, and police have been investigating too, to establish whether criminal offences have been committed.

In a letter to the Department of Health, CQC chairwoman Dame Jo Williams said the urgent inspections have had “a considerable impact on our capacity to deliver our annual targets”.

“Such a request at short notice entails Operations management time in planning the visits, cancelling pre-planned inspections as well as the compliance inspector time in carrying out the visits and drafting the reports.”

Dame Jo outlined the impact on scheduled activity in the letter, saying that 320 locations would require visits, with the total number of days required – including for planning and management – being 1,100.

“This equates to a total of 580 inspections foregone and a total of 16 inspectors being utilised on a full year basis at an estimated cost of £1.0 million,” she wrote.

She also asked that the department take into account such an impact on planned work “when considering future requests and delivery within a time limited period”.

The work of abortion clinics first came under the spotlight in February when the Daily Telegraph secretly filmed doctors and alleged some were agreeing to terminate foetuses when women did not want their baby because of its gender.

Police are investigating the allegations.

The NHS has been accused of trying to save money by blocking access to surgery for smokers and obese patients as new figures show how they are routinely being denied treatments.Data shows that more than a quarter of Primary Care Trusts in England have brought in new restrictions based on patients’ lifestyle criteria in the last year.

It reveals that people are being denied IVF treatment, breast reductions and fat-loss operations based on their weight and whether they smoke.

In the case of one trust, NHS Hertfordshire, a controversial ban imposed last year on knee and hip operations for anyone with a body mass index (BMI) over 30 as well as smokers, has been extended to cover all routine surgery.

The new Hertfordshire policy, introduced in January, makes exceptions only for neurology, cardiac and cancer operations.

Freedom of Information responses from 91 PCTs, obtained by Pulse the  doctors’ magazine, show 25 have brought in new restrictions on treating obese patients or smokers since April 2011.

Dr Clare Gerada, head of the Royal College of GPs, said some of the restrictions, particularly for IVF, were “dreadful”.

She added: “It’s becoming the deserving and the undeserving. I think it’s discriminatory and I find it astonishing.  The Government should determine what should be applied universally.”

The figures showed that the Peninsula health technology commissioning group, covering Cornwall, Devon, Torbay and Plymouth, is now banning both men and women from undergoing IVF treatment unless they have been non-smokers for at least six months.

Men and women must also have a BMI of between 19 and 29.9 before they will be given certain fertility drugs.

The two PCTs covering County Durham and Darlington will not treat people for varicose veins unless they have a BMI of 30 or under, the figures also show.

The figures also showed that the three PCTs covering North Essex must not accept referrals for joint replacement surgery from people with a BMI of 40 or over.

Furthermore, all patients who smoke in the region must be referred to stop-smoking services before they will be considered for stomach surgery, breast reconstruction, breast reduction, scar revision surgery or nipple inversion treatment.

In Lincolnshire, as of June last year, patients must have had a stable BMI of 18 to 25 for at least a year before they will be considered for breast reductions.

Meanwhile, hip and knee replacements will not be given to patients who have a BMI greater than 35, or current smokers.

In Bedfordshire, access to hip and knee replacements is denied to patients with a BMI of 35 or over until after they have lost 10% of their initial body weight or moved below a BMI of 35.

Before July last year, there was no BMI cut-off in the region.

Steve Nowottny, deputy editor of Pulse, said: “Rationing in the NHS is nothing new – but PCTs and clinical commissioning groups are increasingly taking the decision to ration care based on patients’ lifestyle choices.

“In some cases there may be genuine clinical justification for rationing treatment on these grounds. But there is a growing suspicion that some PCTs are now blocking access to surgery for smokers and the obese simply to help achieve ever greater efficiency savings.

“Such a policy has disturbing implications – and GPs are increasingly uneasy about the NHS providing a second-class service to patients with less healthy lifestyles.”

Pro-life campaigners have welcomed publication of an article arguing killing newborns should be “permissible”, saying it showed there was no moral difference between abortion and infanticide.The article, which argued newborns and foetuses were only “potential persons” and not “actual persons”, has provoked a storm of protest.

The authors, whose piece was published in the Journal of Medical Ethics, have received death threats for suggesting that “what we call after-birth abortion (killing a newborn) should be permissible in all the cases where abortion is, including cases where the newborn is not disabled”.

Many believe such possibilities should never be raised – even within the confines of an ethics journal.

However, some anti-abortionists have welcomed its publication, saying it casts a bright light on what abortion actually is.

Anthony Ozimic, from the Society for the Protection of Unborn Children (SPUC), said the article, which he described as a “chilling promotion of infanticide”, showed how abortion was “creating a culture of death”.

While he was appalled at the suggestion that newborns should be killed for their parents’ convenience, he nevertheless said it showed the logical framework behind infanticide and abortion was the same.

He said: “The paper proves what pro-lifers have long been arguing: that the common arguments for abortion also justify infanticide.

“There is no difference in moral status between a child one day before birth and a child one day after birth.  Birth is merely a change of location, not a change from non-personhood to personhood.”

He continued: “All human beings, regardless of age, location or capacities, are regarded in international law as equal members of the human family and thus as having an equal right to life.”

The authors, ethicists Dr Alberto Giubilini and Dr Francesca Minerva, argued: “The moral status of an infant is equivalent to that of a foetus in the sense that both lack those properties that justify the attribution of a right to life to an individual.”

Rather than being “actual persons”, newborns were “potential persons”. They explained: “Both a foetus and a newborn certainly are human beings and potential persons, but neither is a ‘person’ in the sense of ‘subject of a moral right to life’.

“We take ‘person’ to mean an individual who is capable of attributing to her own existence some (at least) basic value such that being deprived of this existence represents a loss to her.”

As such they argued it was “not possible to damage a newborn by preventing her from developing the potentiality to become a person in the morally relevant sense”.

“Actual persons” could be harmed by being killed, in that they were prevented from accomplishing “aims”.

But they argued: “Now, hardly can a newborn be said to have aims as the future we imagine for it is merely a projection of our own minds.”

Parents should be able to have the baby killed if it turned out to be disabled without their knowing before birth, they said, citing the example that only 64 per cent of Down’s syndrome cases in Europe were diagnosed by prenatal testing.

Once such children were born there was “no choice for the parents but to keep the child”, they wrote.

“To bring up such children might be an unbearable burden on the family and on society as a whole, when the state economically provides for their care.”

However, they did not argue that some baby killings were more justifiable than others – their fundamental point was that, morally, there was no difference to abortion as already practised.

They preferred to use the phrase “after-birth abortion” rather than “infanticide” to “emphasise that the moral status of the individual killed is comparable with that of a fetus”.

The authors argued: “The alleged right of individuals (such as foetuses and newborns) to develop their potentiality … is over-ridden by the interests of actual people (parents, family, society) to pursue their own well-being because, as we have just argued, merely potential people cannot be harmed by not being brought into existence.”

“Actual people’s well-being could be threatened by the new (even if healthy) child requiring energy, money and care which the family might happen to be in short supply of.

“Sometimes this situation can be prevented through abortion, but in some cases this is not possible. In these cases, since non-persons have no moral rights to life, there are no reasons for banning after-birth abortions.”

While accepting that many people would disagree with their arguments, Prof Savulescu commented: “The goal of the Journal of Medical Ethics is not to present the Truth or promote some one moral view. It is to present well reasoned argument based on widely accepted premises.”

Speaking to The Daily Telegraph, he added: “This “debate” has been an example of “witch ethics” – a group of people know who the witch is and seek to burn her. It is one of the most dangerous human tendencies we have. It leads to lynching and genocide.

“Rather than argue and engage, there is a drive is to silence and, in the extreme, kill, based on their own moral certainty. That is not the sort of society we should live in.”

He said the journal would consider publishing an article positing that, if there was no moral difference between abortion and killing newborns, then abortion too should be illegal.

From: http://www.telegraph.co.uk/Killing-babies-article-reveals-the-truth-of-abortion-say-pro-lifers

Penny pinching NHS managers have introduced new viagra prescription guidelines which could limit thousands of couples to having sex once a fortnight.New policy documents advise GPs in parts of the country that patients in need of Viagra or similar drugs should be limited to two pills per month, down from the normal prescription of four.

Although the policy was described as a “recommendation” by NHS authorities, local medical committees told the GPs’ magazine Pulse in GPs slam secrecy over evidence for Viagra rationing restrictions it was being handed down to family doctors as an “edict”.

Erectile dysfunction medication is already stringently limited on the NHS and can only be prescribed to patients with certain conditions such as diabetes, multiple sclerosis and prostate cancer.

According to the NHS some 2.2 million prescriptions for erectile dysfunction drugs were issued last year, with 14.5 million tablets issued at a cost of about £78 million.

NHS guidance acknowledges that there “appears to be no clinical reason to restrict the number of tablets” but it adds that, according to research, the average person has sex four times a month.  The average frequency of sexual intercourse in the 40 to 60 age range is once a week.”

The new policy is aimed at economising on non-essential treatments, recommending that the minimum effective dose be prescribed “two times per month using the drug with the lowest acquisition cost.”

The guidance applies to sildenafil (Viagra), vardenafil (Levitra) and tadalafil (Cialis).

Richard Hoey, editor of Pulse, said: “Ask most doctors and they will say that being able to live a satisfactory sex life is a key part of health and wellbeing, but the NHS has never recognised that in its policy on treatment for erectile dysfunction.

“Limiting patients to drugs like Viagra just twice a month is to treat sex like an unnecessary luxury, and completely fails to recognise the degree of anguish it can cause some men with erectile dysfunction.”

Erectile dysfunction is very common in middle aged and older men, with an estimated 50 per cent of those between 40 and 70 experiencing the condition to some degree.

Viagra and other medications can be bought privately, but the cost of about £40 for eight pills can be prohibitive, and patients must also pay for a private prescription.

The new prescription guidelines were drawn up by South Central Priorities Committees, which covers primary care trusts (PCTs) in Milton Keynes, Oxfordshire, Berkshire East, Berkshire West and Buckinghamshire.

The ‘morning after pill’ which was being offered over the phone in a controversial new scheme over the Christmas period is “not effective” when a woman is most fertile, a consultant gynaecologist has warned.Dr Kate Guthrie said Levonelle One Step, the form of emergency contraception being offered by the British Pregnancy Advice Service (bpas), was “not effective” for up to five days around ovulation.

Dr Guthrie, a member of the Faculty of Sexual and Reproductive Health, was concerned that women could take the pill during these days and wrongly think they would avoid pregnancy.

She said: “There’s very clear evidence showing that it’s not effective in the couple of days running up to ovulation, and probably not very effective in the 36 hours afterwards.”

The aim of the bpas scheme is to cut the number of women seeking abortions over the festive season.

The idea is that women will be able to pop the pill on the morning after accidentally having unprotected sex, rather than having to get an appointment, which can be difficult over the Christmas break.

Part of the rationale is, as bpas puts it, “the sooner the morning after pill is taken after unprotected sex, the more effective it is.”

Dr Guthrie, who works in East Yorkshire, agreed with that, saying that Levonelle should always be taken within 72 hours of sex.

However, she was concerned that women would not be sufficiently informed of Levonelle’s limitations.

While she welcomed immediate access to emergency contraception, she said: “You have to know how effective or ineffective it is.”

Guidance from the faculty, published this August, states that Levonelle “has been shown to be no better than placebo at suppressing ovulation when given immediately prior to ovulation, and is not thought to be effective once the process of fertilisation has occurred”.

Dr Guthrie said that, if a woman has had unprotected sex at this time of the menstrual cycle, she should see a doctor about obtaining another form of emergency contraception.

The majority of women having IVF treatment still have two embryos implanted in the womb despite clinics being warned of the risks of multiple pregnancies and having targets to reduce them.Two thirds of women having IVF treatment have two embyos placed in the womb, increasing the likelihood of them having twins, figures from the regulator have shown.

It comes after the Daily Telegraph revealed that 100 feotuses were aborted last year because they were part of a multiple pregnancy which carries greater risks of birth defects and complications.

The latest figures from the Human Fertilisation and Embryology Authority have shown that multiple pregnancies are reducing and are down from over one quarter in 2008 to one fifth last year.

Clinics have been told that women under 37 should be advised that it is normally best for them to have one embryo put back into the womb at a time.

However the HFEA data show that 64 per cent of women had two embryos put back in the womb last year.

Only one in six opted for a single embryo and a similar proportion had no choice because only one embryo was produced.

In 2010, 45,264 women had a total of 57,652 cycles, an increase of almost six per cent on the previous year.

This year clinics were set a target that no more than 15 per cent of their births be twins or triplets.

Tony Rutherford, chairman of the British Fertility Society, said the multiple pregnancy rate has dropped significantly as the number of single embryo transfers has increased from nine per cent to almost one in four now.

But he added: “There has been significant improvements but it is nowhere near enough to reach the 10 per cent multiple pregnancy rate target set by the HFEA in 2007.

“The targets are achievable, the philospohy behind it is absolutely correct and by doing so we will protect the health of mothers and their babies following IVF.”

Mr Rutherford said in Sweden the single embryo transfer rate was 70 per cent and the multiple pregnancy rate was five per cent.

From: http://www.telegraph.co.uk/IVF-women-still-receiving-two-embryos-despite-twin-risk

All women who are trying to have a baby should take special ‘conception’ vitamin supplements after a study found fertility patients were twice as likely to get pregnant if they were taking them.The research involved women who were having treatment to boost their fertility but as there were no side effects from taking the vitamins, scientists said all women who are trying to conceive should consider them.

In the study half of women were given a multivitamin and mineral tablet to take each day and half were given folic acid, recommended by government to prevent abnormalities in the baby.

Four weeks later they then had a fertility drug treatment.

Women on the vitamins were more likely to conceive and 60 per cent were still pregnant three months later compared to 25 per cent on folic acid.

They were also likely to fall pregnant after fewer fertility treatments with three quarters conceiving on their first cycle, compared with less than one in five of those on folic acid, it was found.

The study conducted by researchers at Warwick University involving 56 women attending University College London and the Royal Free Hospital fertility units.

The women, who were mostly from an affluent background, all had healthy diets at the beginning of the study and later blood tests showed those on the multivitamin had higher levels of micronutrients than those only taking folic acid.

Lead author Dr Rina Agrawal, consultant obstetrician and gynaecologist and Associate Professor in Reproductive Medicine, said: “All women considering pregnancy should take a specifically formulated prenatal micronutrient supplement to optimise their chances of conception.”

She said it is not known what components of the vitamin tablet had the effects on pregnancy but the Pregnacare Conception product used contained a range of vitamins, minerals, antioxidants and substances linked to ovarian function and blood flow to the reproductive organs.

The findings are being published in the Reproductive BioMedicine Online journal.

Dr Allan Pacey, Senior Lecturer in Andrology at the University of Sheffield said “The influence of nutrition on our fertility is of general interest to the public and professionals, but there are relatively few studies which have examined this systematically and few which have shown direct benefits of taking supplements to enhance things.”

“Therefore, on the face of it, this study is interesting but we should acknowledge that this is a relatively small number of patients and the study would need to be repeated in a larger trial before we could be certain of the results.

“I can’t help but thinking that for most people, just general dietary advice would achieve the same effect and a good basket of fresh fruit and vegetables from the greengrocer each week would have much the same effect if their diet was poor.”

Glenys Jones, a Nutritionist at the Medical Research Council’s Human Nutrition Research said: “This is an interesting study and supports the body of evidence that diet plays an important role in supporting women’s health and their fertility.

“However this study alone cannot result in the general recommendation that all women undergoing fertility treatment should take a preconception multivitamin as it is a very small single study and further large-scale research is required to investigate if this is reproducible in a larger more diverse group of women.”

Catherine Collins, Principal Dietician, St Georges Hospital NHS Trust said: “Although the researchers claimed their diets were nutritionally adequate no robust data was provided to confirm this – a major concern for any trial making nutritional claims.

“We know that broad-spectrum supplements can correct dietary deficiencies and boost blood levels of iron, B12, folic acid and vitamin D – as was shown in this study which suggests these women had low intakes pre-conception.

“As this study was of women with conception problems there’s no evidence to suggest every woman considering pregnancy should take them.

“Similarly, n-acetyl cysteine and arginine have been shown to improve the efficacy of IVF treatments in a small number of studies, but there’s no evidence to support their use in natural conception. However, the nutritional advice for women contemplating pregnancy remains unchanged – take folic acid supplements until 12 weeks of pregnancy and if you decide on a multi-nutrient supplement for nutritional insurance make sure it’s one suitable for pregnancy, as the vitamin A content is lowered to ensure safety of the developing baby.

From: http://www.telegraph.co.uk/Women-trying-to-conceive-should-take-vitamins-researchers

Caesareans are to be offered to all pregnant women who ask for them, new guidelines state, amid concerns that some are too scared to give birth naturally on Britain’s overstretched labour wards.A lack of support is leading to “traumatic” natural births, say experts, resulting in women fearing a repeat experience.

Studies show that up to 10 per cent of women in Britain suffer from a serious fear of natural childbirth, called tokophobia.

Now the National Institute for Curbing Expenditure (NICE) is recommending that women should always have the right to a caesarean, even if they have no physical or mental health need.

The guidelines, state: “For women requesting a CS [caesarean section], if after discussion and offer of support (including perinatal mental health support for women with anxiety about childbirth), a vaginal birth is still not an acceptable option, offer a planned CS.”

Malcolm Griffiths, a consultant obstetrician and gynaecologist at Luton and Dunstable Hospital, who chaired the guidelines development group, said most women were not interested in having a caesarean.

“It is a major operation, about as major as a hysterectomy,” he said.

Nonetheless, 25 per cent of births in Britain are now by caesarean. Between a third and a half of them are pre-planned.

Figures show that rates in Nordic countries are much lower, at about 15 per cent.

Many obstetricians want the UK rate to come down, but believe that is impossible without better midwifery services.

Mr Griffiths said: “I think probably key to the difference is support during labour, with one-to-one midwifery care and support in Nordic countries.”

Better midwifery care was “key to reducing the caesarean rate”, he added.

Nina Khazaezadeh, a consultant midwife at St Thomas’ Hospital in London and a member of the guidelines panel, said some women opted for caesareans because they feared childbirth after a “traumatic” first experience in an understaffed ward – a condition known as “secondary tokophobia”.

She said: “We might see a rise in secondary tokophobia where women have already had a birth that they have found very traumatic, and the perceived lack of support will have had an impact on their decisions for the next pregnancy.”

Cathy Warwick, chief executive of the Royal College of Midwives, said: “There is very clear evidence that one-to-one support in labour reduces caesarean rates”.

However, she welcomed the new Nice guidelines, saying it was “absolutely acceptable” that a woman who feared childbirth should be offered a caesarean.

Coincidentally, the RCM publishes a new report today claiming that England faces “massive midwife shortages” and needs another 5,000 of them.

Even though numbers have increased since 2001, they have “failed to keep pace with the rocketing number and increasing complexity of births”, it warns.

The number of births has risen by 22 per cent in a decade, with midwives having to deal with 120,000 more in 2010 than in 2001.

Mothers also tend to be older and heavier than in the past, which both raise the chance of complications.

Belinda Phipps, chief executive of NCT, said: “Most women want a straightforward birth, some need a caesarean. When women are treated with respect, and are offered support and information tailored to their concerns, very few of them will choose a caesarean birth unless there are clear health reasons.

“However, our services fail women badly at the moment, with midwifery numbers well below the level required to guarantee safe and satisfying care.”

She went on: “If caesarean rates go up following the change to the guidelines, it will be evidence that women are not getting the quality of midwifery support they need.”

The guidelines do recommend that a woman requesting a caesarean should be made to talk about her fear of childbirth before an operation is granted.

From: http://www.telegraph.co.uk/Caesareans-to-be-offered-to-all-amid-fears-over-midwife-shortages

Single women are being offered fertility treatment by almost a fifth of NHS trusts casting doubt on the Government’s family friendly credentials.Women not in relationships are receiving publicly funded IVF despite official guidance that suggests support should go to couples who have been trying without success to have a baby for several years.

Meanwhile in other parts of the country married couples are being denied help in starting a family, forcing them to spend thousands of pounds on private treatment.

It comes after a Labour nanny state law removed the requirement for fertility doctors to consider a child’s need to have a male role model before going ahead with IVF.

Critics say the Government, which David Cameron promised would be “the most family friendly we’ve ever had in this country”, should tackle the postcode lottery of IVF provision and ensure that the needs of children are put first.

Frank Field, the Labour MP who carried out a high-profile review into poverty and life chances last year, said: “It’s clearly wrong that while couples in stable relationships can’t get IVF and in other areas, single women can.

“It’s really important that Government ministers speak up for children who are the ones left out of this. It needs someone in a position of authority to reflect what most taxpayers think.”

The Rt Rev Michael Nazir-Ali, the former Bishop of Rochester who once chaired the ethics committee of Britain’s fertility watchdog, said: “The irony is that at the very time research is showing the need for both parents, we are writing fathers out of the legislation.

“It’s one thing for a mother to find herself a single parent because of tragic circumstances. It’s quite another to plan for a situation where the child comes into the world without having a father or any possibility of having a father.”

Most local health authorities stipulate that couples must have been in a relationship for two or three years to qualify for IVF treatment.

That requirement is based on guidance issued in 2004 by the National Institute for Curbing Expenditure (Nice), the NHS rationing body,.

It states: “Couples in which the woman is aged 23–39 years at the time of treatment and who have an identified cause for their fertility problems … or who have infertility of at least three years’ duration, should be offered up to three stimulated cycles of in vitro fertilisation treatment.”

The document does note that the guidelines do not address social criteria “for example, whether it is single women or same-sex couples who are seeking treatment”.

However the Human Fertilisation and Embryology Act 2008 removed the reference to “the need for a father” when considering the welfare of the child when considering fertility treatment, replacing it with “the need for supportive parenting”.

Gareth Johnson MP, who chairs the All Party Parliamentary Group on Infertility, said that trusts offering the service to single women were going against one of the guiding principles of IVF, “that you are treating an infertile couple, not an infertile individual”.

Mr Johnson, the Conservative MP for Dartford, said: “Speaking in a personal capacity, if you are going for IVF, you are trying to create a baby, so there should be some evidence of a stable background, which you would expect to be a couple.”

Earlier this year he led an APPG report that found startling differences between what health authorities offered in terms of IVF.

It found three-quarters of Primary Care Trusts were failing to offer three cycles of IVF, as stipulated by Nice. Each cycle comprises a woman’s ovaries being stimulated to produce eggs, which are then fertilised in vitro and implanted in the womb. Spare eggs should be frozen for use if the first attempt fails.

The report found five trusts offered no IVF at all – Warrington, West Sussex, Stockport, North Staffordshire and North Yorkshire and York. Since then, NHS West Sussex has decided to start funding IVF again.

Many trusts have also started putting in place further barriers to IVF funding – for example demanding obese women lose weight – in part to limit demand as health budgets tighten.

Against a background of increasingly scarce provision, as the NHS tries to save £20billion by 2015, Mr Johnson said the decision to offer IVF to single women was misplaced.

From: http://www.telegraph.co.uk/Single-women-being-offered-IVF-on-the-NHS