come and give me some advice on timing private and NHS IVF cycles in a year

[lozster]

I'm in need of some advice - my problem is basically this: good news - I have just heard that my application for NHS funding for IVF (2 rounds) has been approved. Bad news - as I'm 39 I have just 10 months to use it before the PCT decides I'm too old and withdraws the money. More bad news - the waiting list is currently about 12 months though the PCT tells me there may be some flexibility. I've read that IVF is best considered in rounds of 3. I can afford to pay for one cycle privately and could possibly afford a second (final) cycle but definitely couldn't pay for all 3. The PCT advises me that combining NHS and private treatment is fine within a total of 3 cycles so no problem there.

My conundrum is this, when do I elect to go private and realistically how many cycles of IVF could I have in about 1 year? I'm due to see the NHS consultant in July for the first time - to date I've only seen a registrar and a nurse. I'm reluctant to do anything before seeing him as I have so many questions about results to tests I've had to date, whether IVF is suitable for me, will he treat me more quickly because of my age etc. Realistically I'm hoping to get 1 NHS cycle. In principle going private does not prejudice this but in practice I'm concerned that if I have a private round that fails I may have to wait a few cycles before I can have a further round NHS or otherwise. Can anyone advise me even on how many cycles of IVF you could have, or would want to have in one year? also, am I foolish for even waiting until July for my NHS consultant appointment?

BTW I know I'm lucky even to get the NHS funding allocated and to be able to afford 1 or 2 rounds - things could be worse, but I'd still appreciate some words of wisdom :)

[natalie204]

Congratulations on getting accepted for nhs ivf. I dont have any info for you sorry but was wondering what the requirements for nhs funded ivf where please

[gardenpixie]

Hi Lozster I am just about to start IVF on the NHS (quite excited!) and we were told that, should a cycle not work, we'd need to wait 2 months to give my body a chance to get back to "normal" before going again.

Also, have you considered freezing any embryos that you don't use first time round? A frozen embryo transfer has slightly lower chances of success but it means you won't need all the drugs, they just follow your natural cycle.

I know things are different for every PCT but we were told that if we paid for IVF privately, it would mean we were no longer eligible for NHS funding so it might be worth double checking that with your GP or the PCT directly.

Good luck!

Natalie there are two lots of criteria you need to watch out for - the first is the basic NHS criteria and the second is your PCT criteria. The NHS ones include:

• TTC for 3yrs or more
  
• Neither partner to have kids already
  
• Woman to be 39 or younger (I think this is an NHS criterion rather than a PCT one but I can't remember for sure)
  
• Woman to have a BMI under 35
  
• Neither partner to smoke (my DH has to have been fag free for three months before we start our treatment)
  
• Neither partner to have HIV, Hep B or C
  
• Female patner to be immune to rubella
  

In addition, my PCT stipulated my BMI had to be under 30 and there was something about other immunities as well (but I can't remember what, sorry)!

Hope that helps!

[lozster]

Hi Pixie - thanks - that's just the info I was looking for! Yes, I've checked with the PCT about having private treatment whilst remaining on the NHS waiting list - I have written confirmation that this is ok so long as you only combine private to NHS 1:2 or 2:1. I think I'll be lucky to get one round to be honest! If the first round was NHS then the NHS would pick up the cost of freezing any embryo's making any further rounds cheaper for me.

Natalie, the criteria for my PCT are similar to Pixie's plus I think there was a criteria of no previous sterilisation. Sorry - I've just tried to find the web page where this info used to be and I just can't find it. It's so confusing isn't it? I'd advise getting the number/e-mail of your PCT to get up to date info as there is a lot of old stuff on the web and PCT are dropping IVF by the minute at the moment. My PCT replied to my e-mail within an hour (signing off with a cheery 'goodluck!' - well at least I hope it was cheery not as in 'you're gonna need it!!') so no complaints there.

[BagofHolly]

From what I've heard in NHS funding circles, fertility services are likely to be one of the first areas to suffer cuts should there be a further shakeup in commissioning. On that basis, it's best to push as hard as you can to get your NHS go first. The PCTs currently have the right to write their own criteria, even if it's totally at odds with the current NHS NICE guidelines, and there's nothing to stop any PCT changing their inclusion criteria or even refusing to fund at all.

The other BIG factor for you is your age. Aside from how you fund your treatment, age is the single biggest factor in ivf success/failure so at 39 I'd say your first priority is to get cracking, regardless of who pays for it.

I personally don't subscribe to the notion of looking at it over 3 cycles. Doesn't make sense to me - it's essentially relying on cumulative odds when actually if you choose a very successful clinic in the first place, you need less cycles.
At 39, I'd pick the clinic with the highest success rates and get a preliminary consultation there NOW. Ask everything you need, see what they think your individual chances are, per cycle of a live birth and see how that compares to the clinic your NHS go will be at. That way you can put a true value on the NHS provision.

We started thus journey when I was 37 and despite being offered 3 NHS goes, chose to bypass this totally and go privately to a clinic whose success rate was 3x that of the NHS place. It's obviously not the cheapest option but it meant we were giving ourselves the best shot with my best level of fertility. As a result we now have 3 children, from 2 cycles (just had twins!).

All the stats are on the HFEA website. V best of luck! X