IVF Fertility Treatment Criteria in the UK

In the last few months of 2017, the local Clinical Commissioning Groups (CCGs) of Bristol, North Somerset, and South Gloucestershire stepped back from their joint proposal to reduce the access to in vitro fertilisation to women struggling with infertility. After the widespread outcry received during a public consultation on the matter between July and September, no changes were made to the availability of IVF treatment based on postcode and age. However, the CCGs have long been attempting to change access to fertility treatments due to budget constraints passed down from the NHS and government, and there is likely change coming in the upcoming years.

Recent Proposed Changes

In vitro fertilisation is a widely successful fertility treatment that involves extracting healthy eggs from a woman’s ovaries, fertilising the egg, and implanting it back into the womb so that it may grow and develop. Over the last three decades, IVF has been responsible for more than a quarter of a million births in the UK alone, and more than 5 million throughout the world. Despite this success rate and its ability to allow women to conceive a child when they are otherwise unable to do so, local CCGs have been battling to find the balance between free IVF options and cost reduction exercises. The latest proposed changes to free in vitro fertilisation access highlights this fight.

Bristol, North Somerset, and South Gloucestershire CCGs introduced a proposal to change the policy regarding fertility treatments available at no cost to women in these postcodes. The proposed changes included restricting in vitro fertilisation treatment to those between the ages of 30 and 35 only, with exceptions being made only when exceptional circumstances were in place. The shift was intended to transition fertility treatment funding from criteria based access to a prior approval system, essentially removing the ability of clinicians to move forward with treatment without seeking approval for funding ahead of time. The change proposed estimated a cost savings of nearly £1 million to the NHS – a figure many felt was not high enough to justify the sweeping change.

Under current eligibility requirements for receiving in vitro fertilisation treatment at no cost, women must be under the age of 40 and have a partner who is younger than 54. There are no restrictions for couples with previous children, and depending on location, up to three cycles of IVF may be provided to help a woman conceive. The proposed changes by the local CCGs suggesting reducing the upper age limit from 40 down to 35, decreasing the age of the partner from 54 to 52, and limiting access to individuals with living children.

Looking Ahead to IVF in the UK

The proposed reduction in eligibility requirements for women looking to IVF as a solution to infertility would be a devastating mistake. Under the current access, in vitro fertilisation would help more than 400 women conceive; the updated restrictions would cut that number in half, leaving many women and their partners to fund the cost of IVF out of their own pocket or opt not to have the process completed at all. There is an emotional toll experienced by prospective mothers when infertility is in play, and IVF is often the only healthy, affordable solution for many. Without access to IVF through the NHS and local CCGs, the mental anguish of not having a viable solution may lead to further decline of health and well-being for hundreds of women.

While the proposed access changes were vehemently fought by patient advocates, medical professional groups, and the public at large, and ultimately, thrown out, there is a clear path of cost reduction in sight for local CCGs. The National Institute for Health and Care Excellence (NICE) offers guidance for in vitro fertilisation throughout the UK, stating that women between the ages of 30 and 40 should be offered up to three full cycles of treatment, so long as they have tried to conceive naturally for at least two years. The changes proposed by CCGs is in stark opposition to this guidance, all based on the need to cut costs across the board. While money-saving efforts are admirable within the health system, taking away the ability of women to conceive a child through IVF is far from it.

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