Couples are still being refused IVF treatment in a postcode lottery
Regional disparities mean that the same woman can be too old for treatment in one part of the country and too young in another. Two trusts have provided no IVF treatment in the previous two years.
Research suggests that eight out of ten primary care trusts are still failing to follow government recommendations set out in 2004 by the National Institute for Curbing Expenditure (NICE), allowing women three free cycles of IVF.
Other eligibility criteria, such as whether one of the couple has a child from a previous relationship, smoking habits and weight, also vary widely, the study shows.
The study, by Grant Shapps, the Conservative MP for Welwyn Hatfield, who has campaigned for better access to fertility treatment, was based on an 80 per cent response rate from trusts in England. It found that provision was worse than two years ago.
In the East Midlands, every trust offered one full cycle of treatment but, in the South East, 41 per cent did not offer IVF to women aged 23 to 39, as set out in the NICE guidance. Some trusts, such as North Lincolnshire, offered IVF only to women between 37 and 39, whereas at least four trusts have an upper age limit of 37. One in eight was failing to comply with guidelines on a woman’s age.
In the East Midlands, no trust would offer treatment to couples in which one partner had a child but 70 per cent would in the North East. Overall, 54 per cent of trusts excluded couples from IVF if one partner had a child from a previous relationship.
Almost half of all trusts said that they wanted couples to have been in a relationship for more than three years. Others wanted one or two years while some asked only if the relationship was “stable”. While many trusts refused IVF to couples who smoked, some allowed treatment if the man was the smoker.
The 2004 NICE guidance said that the NHS should fund three cycles of IVF for women under 40. John Reid, then the Health Secretary, said that couples would be offered one free IVF cycle by April 2005, with a view to three cycles being offered in the future.
By 2007 this was still not happening. Dawn Primarolo, the Health Minister, wrote to trusts in that year saying that they should be looking to fund three cycles.
Experts have said that the drive to cut the number of multiple births is also being hampered by the lack of access to free IVF. Couples who have the chance of only one cycle on the NHS might wish to have more than one embryo transferred.
The NICE guidance also said that trusts should allow frozen embryos to be transferred as part of one cycle. But very few offered this.
Mr Shapps said that the study, compiled from freedom of information requests, showed that IVF “remains a postcode lottery in this country”. He added: “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.”
Clare Lewis-Jones, chief executive of the charity Infertility Network UK, said that although there had been an improvement recently in the provision of treatment by some trusts there remained a totally unjustifiable and unfair variation in the criteria used to determine whether couples could have treatment. “This proves that five years on from the issue of the NICE guideline, patients are still facing a postcode lottery when it comes to accessing NHS fertility treatment.”
She urged trusts to accept recommendations laid down in a document, Standardising Access Criteria to NHS Fertility Treatment, produced by Infertility Network UK and funded by the Department of Health.