IVF: How NHS funding for fertility treatment is becoming harder to access in the UK – iNews

If a doctor told you there was a 30 per cent chance that exercise could fix your back pain, you might be pessimistic about your chances of recovery. But those are the odds relied on by millions of couples struggling to conceive, to fulfil their dreams of starting a family through IVF.

There are few areas of medicine where the final outcome is as important as it would be for IVF patients, says fertility expert ProfessorLuciano Nardo, the founder of NOW-fertility. Having a chance of less than 50 per cent to have a baby is seen as acceptable. Technically, there is NHS support available for fertility treatment but it is becoming harder to access.

The proportion of NHS-funded IVF treatments fell from 40 per cent to 32 per cent in England between 2014 and 2019, latest data from the Human Fertilisation and Embryology Authority (HFEA) shows.

In Wales, the fall was 42 per cent to 39 per cent in the same period. In Northern Ireland, 50 per cent of cycles were funded in 2014. In 2019, the rate was 34 per cent. Only Scotland recorded a rise, from 58 per cent to 62 per cent for 2014 to 2019.

The British Pregnancy Advisory Service blames this decline on a postcode lottery as local Clinical Commissioning Groups, which approve NHS IVF treatment funding, make their own interpretations of guidance from the National Institute for Health and Care Excellence (NICE). This means some women are refused treatment, even if eligible under NICE guidelines, because of the CCG policy where they live.

An extra barrier results from NICE guidance that requires lesbian couples and single women to have had six failed rounds of self-funded artificial insemination. Instagram influencers Whitney and Megan Bacon-Evans, campaigning for fairer fertility treatment for same-sex partners, highlight that most heterosexual couples qualify after two years of unprotected sex. Albeit a long time, this has no additional cost, they say.

Gay men are mostly unable to get NHS support for fertility issues and, as with straight couples, cannot get state funding for surrogacy, except in Scotland.

NICE recommends that women under 40 should be offered three cycles of IVF treatment if they have been trying to get pregnant for two years. This falls to one cycle for women aged 40 to 42. CCGs may have their own criteria, such as an age range, or if you already have children, and your weight. Fertility Network UK (fertilitynetworkuk.org) has a list of the eligibility criteria of CCGs in England and their equivalents in Scotland, Wales and Northern Ireland, but it is best to check locally with your GP and relevant commissioning group.

IVF clinics are regulated and licensed by the HFEA. There are 120 in the UK that provide IVF and other fertility treatments; 71 are mainly private and 49 provide NHS support, although the HFEA says many do both. Search for clinics, check their success rates and the treatments they offer at hfea.gov.uk. You dont need to go through the NHS and can self-fund if support isnt available or you dont want to wait for appointments. There is, however, no regulation on prices.

Fertility Network UK says the headline figures quoted on fertility clinic websites are often far lower than the eventual cost, as they may not include drugs or follow-up appointments. Self-funders cant get any state support but some clinics may offer refunds if you arent pregnant after a certain number of cycles.

There are also organisations such as Access Fertility which assesses patients and partners with clinics to offer fixed-price treatments and refunds if you dont have a baby. It is worth checking if this means paying more per cycle. Success rates and costs are important when comparing clinics but patients should also check the emotional support on offer. All clinics are supposed to offer counselling but it is worth finding reviews to find out more.

Professor Nardo predicts that IVF could get cheaper in the future as clinics make better use of artificial intelligence and machine learning. These tools are already used in labs when assessing embryos but once clinics start using it to build and spot anonymised trends among patients, it could be easier to define treatments, which could bring the cost down.

There are also firms offering alternatives, such as Ba Fertility. It is producing medically approved fertility and artificial insemination testing kits that can be used at home, for 300. The ongoing risk for couples is how long they can afford to wait both emotionally and financially.

The Competition and Markets Authority (CMA) expressed concerns earlier this year about patients being been unable to compare prices and facing unfair additional costs they didnt expect among private IVF clinics.

In one example, 87 clinics were last year found to be charging up to 800 extra for treatments such as assisted hatching and time-lapse imaging, despite the HFEA saying there is no evidence that this improves successrates. The CMA is due to review how clinics are complying with rules on making costs and success rates clear and fair from December.

Dr Ippokratis Sarris, a consultant at London clinic Kings Fertility, says most clinics are aware of the importance of showing accurate success rates but warns that the same rules should apply to unregulated alternative therapies, such as taking nutrients, so that unsubstantiated claims are not made. Fertility treatment is an emotional and complex journey, and patients should not feel at any point that they are exploited or misled, he says.

This is not just about upfront clarity in costs but also about ensuring an honest portrayal of the evidence of efficacy behind any fertility treatment claim.

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IVF: How NHS funding for fertility treatment is becoming harder to access in the UK - iNews