New NHS guidelines on IVF treatment to extend age limit up to 42 - what do you think?

(584 Posts)
JaneGMumsnet (MNHQ) Wed 20-Feb-13 10:26:09

Good morning,

New IVF guidelines issued by the National Institute of Health & Clinical Excellence (NICE) say that women aged up to 42 should be allowed one cycle of IVF treatment so long as it is their first attempt. Previously Nice recommended treatment up to the age of 39.

The guidelines also suggest that all couples who are struggling to conceive should get fertility treatment more quickly ? after two years of trying to conceive naturally, rather than three.

We'd love to hear what you think.

Thanks,
MNHQ

jellybeans Wed 20-Feb-13 10:29:30

I am strongly in favour of the changes. I haven't had fertility issues although had problems keeping a pregnancy and many early and late losses. It took us over a year with DC5 and was very tough. I can only imagine the heartbreak of infertility. I think of course they should be helped. 42 is not that old, I know many 'natural' pregnancies at that age. Arbitrary cut off at 40 was ridiculous.

HappyJoyful Wed 20-Feb-13 10:31:21

Very exciting news - but no idea how it will be delivered.. current guidelines have been hit and miss and a total postcode lottery.
Having undergone 5 cycles of IVF myself at one point in my area (Bucks) I was on a waiting list and was too young, finally got up the waiting list and the guidelines had changed and I was too old!
Have many friends who have also undergone IVF and what we were being offered by PCT's in way of funded cycles was so varying dependent on where we lived.
Sorry bit of garbled (rushed) response, but it put huge smile on my face this morning when watching the news to hear it being proposed at least.
Very happy to discuss views on it further as I say, well 'experienced' in the subject!

ATJabberwocky Wed 20-Feb-13 10:58:34

I am glad that the need for change has been recognised,

however it remains to be seen how this will actually work in practice with NHS budget restrictions, it will just end up in a worse 'postcode-lottery' for those who can and cannot.

5madthings Wed 20-Feb-13 11:17:24

Good news smile

BasicallySFB Wed 20-Feb-13 11:18:16

There are so many flaws in the current system that really these changes make little odds.

They're only a guideline and don't 'have' to be followed.

Many PCT areas have such stringent criteria that they don't offer IVF to that many people in reality - case in point being my own.

I met all criteria. Stage 4 endo and PCOS. No children. Trying for 8 years with no success.

But DH has 2 children (then aged 20 and 21) from his previous marriage.

So we were rejected. I had no children. That didn't matter.

Anything that improves access to IVF has to be a good thing. Many women don't find the right man to have children with until their 30s, and after several years of trying that can put you into the late 30s/early 40s before referral to a fertility specialist, then there's all the other stuff they look at before considering IVF, and that's only if you qualify under your particular Trust's guidelines. The arbitary cut-off of 40 is unrealistic.

Luckily our GP is on the Birmingham/Worcestershire border. Birmingham don't pay for one round of IVF if one of the partners has previous children. Worcester do pay for one round if one of the partners has no children so we were lucky to get one free go. Unfortunately that didn't work, but each round of IVF is a learning process for the medics. We had to pay for the other two rounds, and round three was succesful.

Good news, all women should be entitled to a chance at being a mummy.

Astley Wed 20-Feb-13 11:50:24

Totally disagree. It is noones right' or 'entitlement' to me a Mother or a Father.

Certainly not at the NHS expense.

WhenSheWasBadSheWasHopeful Wed 20-Feb-13 11:59:27

astely no one has said a person has a right to have a child. This is about the right to fertility treatment.

You do have a point about the nhs budget though. I am guessing there will be no extra funds to pay for this.

13Iggis Wed 20-Feb-13 12:00:46

But Astley as it stands the nhs CAN fund a woman up to age 39. I assume you would like to cancel this as well. (I also assume you didn't have problems conceiving, though this may be wrong)

cathan Wed 20-Feb-13 12:08:46

No one has a "right" to have a child and the older a parent is, the more likely they are to have health issues or even die before their child grows up. Given that the NHS has limited resources, I believe extending provision of IVF to older women is wrong. I would rather the money was spent on children's cancer care or improving care for the elderly.

13Iggis Wed 20-Feb-13 12:11:36

We could always pay more money into the NHS.

PolkadotCircus Wed 20-Feb-13 12:14:26

Good news but think 3 years up to the age of 30 would be better.I also think more guidance re conceiving,ttc monitoring,rigorous testing before going down the IVF route is needed.

I am an IVF mother who had to pay for all our treatment from blood tests to investigations and IVF ourselves.

It was crippling and we had to sell our flat to do so.Often women going through treatment struggle to hold down jobs as you take a lot of time off during cycles.The financial fall out lasts several years and I don't think having children if infertile should only be a possibility for the rich/richer couples.

I had a friend suffering at the same time in a far lower paid job than me-she was heartbroken seeing me enabled and at least given a chance to get pg whilst she could do nothing. Ivf is heartbreaking enough,can't even begin to think what it must be like if it isn't even a possibility.

As far as I know said friend is still childless,we lost contact when I had children,too painful I guess.sad

I agree that no one has a right or entitlement to IVF. I strongly believe that no one has a right or entitlement to healthcare of any sort at all. However, we live in a country where there is an expectation that we all put into the pot, and we all benefit.

So anyone shouting that IVF shouldn't be paid for, should also be arguing that obesity related illness, lifestyle induced cancers, and self-inflicted injuries via road traffic accidents should also not be covered by the NHS. After all, no one should have a right to treatment for something that they could have prevented should they? That money could be better spent on childhood cancer ... and maybe we could also cut out NHS care for anyone who hasn't paid taxes or NI too - that should free up some more money for the self-righteous buggars shouldn't it?

And there's actually a lot of benefit to being an older parent. My parents childmind so I can work full time and contribute fully to taxes, and I expect to continue and do the same for my daughter.

Incidentally, IVF, as a health treatment, is actually extremely cheap. A private round of IVF is about £3 - £5K. I suggest you google how much a broken leg costs to fix, or how much a traffic accident costs the country.

PolkadotCircus Wed 20-Feb-13 12:17:53

Oh and IVF I suspect is waaaay cheaper than treating years of depression x2,care for the childless elderly and endo/pcos treatment which pg can treat.There are also cancers helped by pg.

I do think the NHS should find a way to make it cheaper to do though,it's quite routine now and shouldn't cost so much.

note to self do not feed the trolls grin

Bakingtins Wed 20-Feb-13 12:18:13

In an ideal world in which the NHS was swimming in spare cash, this would be great. When they are cutting front line staff and not able to fund drugs for some life limiting conditions, I don't think this should be funded.
Women need to be made more aware that their fertility declines after 35 (and I think most are in a general sense but don't apply it to themselves).
I've been TTC for 18m and I'm 38, I wouldn't qualify anyway because I already have children, but I have to accept that I'm less fertile now than I was in my 20s and early 30s. It's hard and I have sympathy for those who are struggling TTC, but I would not expect the NHS to fund fertility treatment for me after 40.

I don't think that IVF up to the age of 42 is a particularly good use of public funds tbh. IVF does not have a particularly good success rate and is hugely invasive. But then I conceived easily three times and had all my kids by the age of 30. It's a very different story from my side of the fence isn't it? Which is why treatment should be determined only national guidance rather than individual sentiment.

PolkadotCircus Wed 20-Feb-13 12:21:32

And what World said.

I think a hardworking healthy couple(most lead v healthy lives on the ttc wagon)who have paid tax all their lives are waaaay more deserving of NHS fund age than somebody who chooses to smoke,take little exercise or to live with obesity.

Sooooo if we're going to start nit picking over NHS fundage lets draw up a list re the deserving and not so deserving......

PointyDogs Wed 20-Feb-13 12:25:34

Very happy to see this in the news, fertillity treatment should be available to anyone who needs it. At 41 or 42, plenty of women have a greater chance of success with IVF than a woman in her 20s or 30s - it totally depends on the particular medical condition the couple have, so it is blatantly unfair to discriminate on the basis of age. We started trying when I was 35, after 4 cycles of IVF (only 1 NHS funded) we finally met our amazing daughter last summer, when I was 41. My mum had me at 41, totally naturally, so who is to say I am "too old".

Infertility is a medical condition, a sickness, a life-changing disease - why should we be denied appropriate treatment?

ArielThePiraticalMermaid Wed 20-Feb-13 12:34:04

You can generally bet that the people who say that having children is not a right, or that the NHS should be paying for childhood cancers rather than helping those infertile people have a child, are not the infertile ones themselves.

From a purely personal and financial perspective, I have cost the NHS very, very little over the years, despite paying taxes from age 22. That's my good fortune and it is irrelevant. But for those saying "The NHS should not not fund IVF", it is often the case that these childless people in their 30s/early 40s have been thus far been far less of a "drain" on resources than someone with children, who naturally are the ones who the NHS spend a lot on. If you want to look at it like that. It is also usually the case that those who have been TTC for the necessary 2 to 3 years before being referred are the non-smokers and light drinkers.

I planned on starting my family at 34-ish. At nearly 38 I still don't have a child, and have been uncomfortably aware that because of delays and fuck ups with the system, my time could be running out fast.

I also agree that more should be done to get the message through that fertility declines after the mid 30s (even though for many people that is irrelevant anyway, because their problems are not age related). And by this I don't mean Daily Fail -style scaremongering, but proper education in schools. I always assumed that you were fertile until the menopause hit. It was only after starting TTC that I realised otherwise, and I am by no means an unintelligent, uninformed person.

So yes this is a good thing, though people mustn't think that the chances of IVF working at 42 are the same as at 36.

WhenSheWasBadSheWasHopeful Wed 20-Feb-13 12:39:33

ariel really good point about the chances of success being lower at 42 than at 36. It is important that people know the chances of success are quite low.

I know a friend who has just divorced (36 no kids) she is going to have some eggs frozen to give her a better shot at a successful pregnancy later on in life. But she is lucky that she can find this money, she's not loaded but can just about afford it.

Good news. Wonderful for people to have the chance to have children who have had problems doing so, I speak from personal experience.

People who are naturally fertile can often have children past 42 so 42 is really not that old at all. Who knows, those children born form IVF of women of 42 may go on to be doctors, nurses, find a cure for cancer etc etc. 42 seems very young now bearing in mind people are living into their 80s and beyond.

We did not get any of our fertility treatment paid for but I am very much in favour of people getting help with this, it is medical and it is important.

FairyJen Wed 20-Feb-13 12:40:05

My issue with this news is that I worry the post code lottery divide will worsen. I also worry about long term issues for older parents and how it will affect their children etc.

Having said that I conceived my first dc when I was 20 and the second at 25 neither was planned at all. I cannot imagine therefore the heartbreak caused by ttc for years

Yes, very good news !

My own experience is just that TTC took nearly a year. That seemed like a very long time when you didn't know if it would ever happen. So bringing it down from 3 years trying to 2 (before IVF offered) is good news ! Also previous cut-off at 40 was rather arbitary IMO - 42 seems a bit more considered.

FairyJen Wed 20-Feb-13 12:40:35

Read that back. Do I win an award for most pointless post??

PolkadotCircus Wed 20-Feb-13 12:40:45

Agree Ariel,hardly went near the doctors/A&E until I had dc,this winter I realised I'd read all the Hello mags cover to cover 4 times over!

ArielThePiraticalMermaid Wed 20-Feb-13 12:42:10

grin FairyJen

curryeater Wed 20-Feb-13 12:44:33

If fertility treatment is available on the NHS at all I agree that there should not be a 3 year wait for it, especially as there is an age cut off (whatever the age actually is)

However I think there are other more universally important things:

- Mental health services
- Nutritional or lifestyle stuff that can realistically assist with weight problems (I mean good, effective stuff, like a regular appointment with a clued up therapist who can take an overweight person through a months- or years-long process of learning to eat better and enjoy exercise - not a GP throwing crappy low-fat advice at you and then forgetting about you. Someone who is trained to look at the whole person and take their personal circumstances into account, and who is knowledgeable about a range of approaches, because the same things don't work for everyone)
- Dental treatment (costs an absolute fucking fortune!)

I think these three things are about enabling people to be healthy, whereas starting a family is not actually a part of one's own personal health. I know infertility is very painful and if there are non-invasive, inexpensive things that can be done to help, then they should be, and without shilly-shallying. But IVF is famously expensive and low-success.

I also wonder whether - tho this could sound very brutal - the emphasis that we currently have that almost all birth parents should be supported to look after their children, is misplaced. When things are seen to be irretrievably broken and a child is taken into care, it is often the case that the child is harder to place than a baby might have been. I know why we have the policies we do but it is desperately sad that while some children are damaged by long term poor parenting, at the same time, potential parents are suffering infertility and might love to adopt a baby. It is a tricky one though because how do you make the judgement that a person is not "good enough" to keep their baby and give it to someone else - realistically, someone posher and richer? Very sad

miemohrs Wed 20-Feb-13 12:46:45

Message withdrawn at poster's request.

EnjoyResponsibly Wed 20-Feb-13 12:50:09

I had 6 rounds of privately funded IVF.

My attempt at obtaining NHS treatment was lengthy, fraught with difficulty and with a latent feeling that after a lot of effort I would be turned down (Kent).

With privately funded treatment you could essentially fit 2 attempts into a year.

After 6 months of various NHS appointments I hadn't even got to the egg stimulation stage. Frankly women just don't have that sort of time when they are facing fertility issues in their late 30's.

With privately funded treatment it was possible for me to get to know my consultant and together with his expertise and my observations of my body's reaction to treatment we were able to isolate the best combinations of drugs/treatment etc.

We finally achieved a pregnancy and DS. Elated doesn't even begin to describe how we felt.

I do not believe the age limit should be extended to 42. Given all the factors I would say 40 is the appropriate limit.

I believe the NHS should provide more effective, prompt, targeted treatment to get better results for women under 40.

ArielThePiraticalMermaid Wed 20-Feb-13 12:51:13

But IVF is famously expensive and low-success

I have been told that the chances of success for people like me (no discernible problem in either partner) are relatively good, and the overall success rates are skewed downwards because of quite profound problems that other couples face. I don't know how true that is.

Someone has already said that one cycle costs about £3000, which compared to, say, a liver problem brought about through alcohol abuse, is peanuts. And long term, elderly people with no adult children I imagine "cost" more than those with children around. I am certainly not advocating procreation for the sake of having a nurse in your old age, but if we are talking about money, perhaps you should consider that.

thistlelicker Wed 20-Feb-13 12:52:28

Myself and Dh been trying for 4 years and have had two mcs! We were toldwe need Ivf but both conceptions although failed were natural! I can ony have one cycle of Ivf but can't as I've got raised bmi and insulin dependant diabetic! Sometimes nature is just against the odds

PolkadotCircus Wed 20-Feb-13 12:52:46

Freezing eggs isn't as good as freezing embryos.The thing with IVF is the fet rates are getting much better so one fresh cycle might bring some frozen too.My dc were frozen 9 years ago!

toffeelolly Wed 20-Feb-13 12:53:12

I think this is great news, it's great woman at this age get a go at ivf , all woman should have the right at one go of ivf

ArielThePiraticalMermaid Wed 20-Feb-13 12:54:42

EnjoyResponsibly, I think that's an excellent post.

I am 38 in April, with a low AMH, and I have been dicked around by the NHS for nearly a year now. I first saw the specialist last summer. Only now am I about to start IUI, which I read this morning has actually no better chance of conception than actual sex, and I am entitled to four rounds of that before the actual IVF. And apparently I have been "fast tracked".

All the while, I am aware that time is trickling away.

Some posters have talked about the problems of being an older parent, even how this will increase the liklihood of dying whilst your children are relatively young.

But I just think you're only talking about a difference of 5 or maybe 10 years here. Life is unpredictable and 5 or even 10 years really makes little difference.
But someone in mid 30's is seen as at a perfectly normal age to become a mother and then by early 40's is seen as a much older mother.
Very silly really in terms of the relationship with the baby and child (though I know there is sadly a decline in fertility)

In the 60's my Mum was referred to as an elderly prima gravida (or whatever it is ?!) when she had me at 29 !!

PolkadotCircus Wed 20-Feb-13 12:57:40

Also Ariel sometimes IVF can be used in a diagnostic way,you could be trying for years and having the egg and sperm in the dish can rule out other things.

Couples also need to move on,they may want to adopt or just get used to living a childless life,having IVF helps with both,it can give closure and many adoption agencies( for those couples suitable for adoption,not all are,most I suspect)require it before the adoption process.

EuroShagmore Wed 20-Feb-13 12:59:14

miemohrs I'm not sure why you think egg and sperm freezing is a lot less invasive than IVF - it is pretty much the same process, just spread over a longer period. You still need to have the eggs retrieved and any embryos put back later, but that than those processes being days apart they could be years apart. Also, the success rates for embryo freezing are a lot higher than for egg freezing. I will agree with you that IVF is a horribly invasive process though. I really struggled mentally with the whole thing.

In most cases, IVF is being used as a treatment for a medical problem - blocked tubes, low sperm count, ovulatory problems. If someone has paid into the NHS for years, why should those problems not be treated as they would be if they affected some body part other than the reproductive organs?

42 seems like a more reasonable cut off than 39. There are many natural pregnacies to women in their early 40s.

LexiLexi Wed 20-Feb-13 12:59:33

Great news.

I think there are both advantages and disadvantages to having older parents, personally I feel that the most important thing is to be part of a loving family regardless of age.

Very best of luck too to those on here that are ttc.

ArielThePiraticalMermaid Wed 20-Feb-13 13:00:04

Good point polkadot, the knowledge that you have tried everything you can, could give you a point at which to say "Let's move on now."

Without doing that, you could well end up costing the NHS just as much through accessing its crappy mental health services!

PolkadotCircus Wed 20-Feb-13 13:00:56

Ariel my consultant at the top clinic at the time said to bypass IUI as it would waste time.As we would be paying for either he said it was more sensible to put the money towards IVF.He was right.Having said that I know people who have conceived with IUI including twins!

ArielThePiraticalMermaid Wed 20-Feb-13 13:03:54

I think if IUI works then the chances of multiples are higher than with IVF because you can't control the number of eggs fertilised (if they are). It's one in three for twins and one in a hundred for triplets <dies at thought>

PolkadotCircus Wed 20-Feb-13 13:08:11

Ariel could you scrape the £3k together for one round whilst waiting for the IUI or do you get removed from the NHS once you've gone down the private IVF routes.

Don't give up.

I decided to give it everything I had and gave myself a date to move on from and start living my life-then the dtwins (the very last extremely ropey embryos out of 36 eggs of which only 7 fertilsed,one of which they thought wasn't worth transferring )happened after being frozen for a year.it was literally last chance saloon,we had run out of cash,physical and mental drive.

I do wonder if the mentally moving on and knowing we'd thrown everything at it and were moving excitedly towards adoption helped.

EnjoyResponsibly Wed 20-Feb-13 13:08:22

It's the time factors that are one of the major pressures.

The longer an NHS round takes, the older the prospective mother becomes.

Fertility issues increase, plus the woman knows she's racing the clock.

I honestly don't believe your chances of an NHS shot of IVF being successful are improved under these circumstances. Add in the fact that many only get a single NHS shot and the odds are being shortened totally unnecessarily.

That's NHS funding and a patients emotional well being in jeopardy, caused by easily fixable factors.

Plus this cost figure is also a part I'm very cynical about. The costs are usually based on private treatment. Presumably the NHS has much better buying power and doesn't mark up the price of drugs. I'm not an expert but I'm betting IVF on the NHS doesn't come close to 3k.

My suggestion is provide 3 rounds of IVF. One every 6 months. Cut off age 40.

Jakadaal Wed 20-Feb-13 13:08:48

As a NHS manager these headlines make my heart sink a little - there will be no more money so more creative thinking needed about how this will be funded along with all the other priorities. As an infertile woman my heart lifts. We chose to go down the adoption route - the right choice for us and the deciding factor was that I wanted to be a mummy but did not necessarily need to go through pregnancy to do that. There is a huge difference and its down to personal cost.

Just off thread a little but weigh up the costs of rounds of IVF and the cost to the country of maintaining a child in the looked after system - another debate for another time

miemohrs Wed 20-Feb-13 13:10:06

Message withdrawn at poster's request.

NanaNina Wed 20-Feb-13 13:10:33

This is a very emotive issue for obvious reasons. My son and dil had an IVF baby some years ago, who has brought such happiness for us all.

Regardless of the age issue - I remember Prof Robert Winston stressing that IVF is not a cure for infertility, and quoted the succcess rate I think as 1 in 6. I think the success rate is higher now. It was 1 in 6 when my son and dil were having IVF.

I have no evidence to back this up, but I do think that couples have an expectation that it will be successful and the awfulness of that not happening must be horrendous, especially for people who have had a great many cycles.

I think an important issue as others have said is the likely success rate of a woman over 40 having a live birth and I think it is 5% which is very low.

I suppose this outcome has to be measured against expensive drugs for cancer etc and these are often with held on the basis of whether the drug is in fact going to extend life to a significant degree. All kinds of decisions are being made by NICE and I think I err on the side of looking at outcomes and the 5% chance of a live birth for a woman over 40, and would therefore not be able to support the decision.

I am trying to be objective about a very emotive subject, which is very very difficult.

Curryeater I must take issue with you about your last para. I was a social worker and tm mgr for a LA Fostering & Adoption team and have seen the anguish of couples who are infertile and long for a child. You are quite right that older children are far more difficult to place than a baby, but there are very very few babies (without medical problems/disability etc) available for adoption, as these days single parents are able to keep their babies.

I think you are maybe unclear about the reasons why children are removed from parents, which is understandable, but you say it is "tricky, because how do you make the judgement that someone is not good enough to keep their baby and give it to someone else - posher and richer." I don't want to go into much detail because it is hi-jacking this thread, but believe me a huge amount of work by many professionals are involved in care proceedings for a child and the judge makes the decision at the end of the day. Also careful matching takes place between prospective adoptors and children, rather than "giving it to someone else"

PolkadotCircus Wed 20-Feb-13 13:12:21

Yes Ariel re triplets they put 3 of my embryos in because they were so poor, I was so old and they couldn't store the last one because the adoption agencies wouldn't allow it(I couldn't just let it perish).

My hormone levels were sky high whilst waiting for the first scan-bricking it doesn't even begin to describe what we were feeling.grin

Sadly the third didn't make it but we gave it the best chance.

Hang in there and let us know how you get on.smile

EnjoyResponsibly Wed 20-Feb-13 13:13:23

Polka and Ariel I so agree with you. What can be harder than having to make that throw the towel in decision. Time and money; the fatal wounds to hope. Easing the burden of either must surely improve the process if only from a psychological perspective.

miemohrs Wed 20-Feb-13 13:13:52

Message withdrawn at poster's request.

PolkadotCircus Wed 20-Feb-13 13:14:17

Counselling should be mandatory imvho.

It was amazing for us,not sure I'd have got through it without and it helped us to prepare for moving on in a positive way.

PolkadotCircus Wed 20-Feb-13 13:15:27

Our counselling was free at our private clinic<hollow laugh>.

EnjoyResponsibly Wed 20-Feb-13 13:17:31

I had counselling too. Very important.

EnjoyResponsibly Wed 20-Feb-13 13:20:44

Jakadaal your last comment is not an unreasonable one. Perhaps as you say better expanded in another thread, but pertinent in this discussion given the time factors we're discussing.

If you find sooner and less stressfully that an IVF solution will not resolve your fertility issues you could consider the move into adoption sooner.

gaelicsheep Wed 20-Feb-13 13:33:27

I haven't had time to read the guidelines in full. What I want to see is an end to the unequal treatment of women in the cruelly labelled "second" relationships.

Where a woman has a partner who, in whatever circumstances, has fathered a child - regardless whether that child is a part of their lives or not, and regardless of the reasons for that - fertility investigations and treatment are frequently denied. Even if the woman has a potential medical problem causing the infertility.

I know not everyone will agree but I have been there and it damned near broke my heart. Thankfully we eventually managed on our own.

Northey Wed 20-Feb-13 13:33:31

As I understand it (from NICE and the BBC), technological advances mean that the success rate now for a 42 year old is the same as the success rate was for the upper age limit (35?) when the guidelines were first drawn up. The (on average) poorer egg quality and lower egg yield is made up for by improved stimming/retrieval/culturing/reinsertion techniques. With that evidence in mind, it's a pretty uncontroversial step, as it matches the original outcome-based criteria for this procedure.

The question of whether or not to fund fertility treatment at all is a different one, and belongs in with all the stuff about whether a soldier with his groin half blown off is more or less deserving of help to create a child than a heavy smoker is deserving of help to overcome lung cancer - ie an interesting and worthwhile discussion, but not fully relevant to today's news, I think.

Incidentally, the BBC and ITV were filming in my clinic yesterday at the very moment I was having an embryo transferred into my uterus. The nurse was most concerned they would accidentally get a shot of me, legs in stirrups!

FairyJen Wed 20-Feb-13 13:33:42

Woul it also be worth considering that there should be more information ad incentive to be donors and surrogates if you are fertile?

I would love to be a surrogate and dp has often talked about sperm donation. His pesky swimmers never miss given I conceived both on the pill ad the implant 99% effective my arse

sleepyhead Wed 20-Feb-13 13:35:28

If it gives a little bit of breathing space to those couples who are sitting on the cut-off and not yet at the top of the waiting list then that's got to be a positive thing.

Obviously fertility does decline (but not at the same rate in every women which makes population statistics just that - a rate for the population, not the individual) but it doesn't just go 39=ok and suddenly the next day you're 40 and post-menopausal.

Any cut-off will be hard on the people that fall just on the other side, but a cut-off of 42 seems to me more in keeping with the number of pregnancies happening naturally in the post-35 age group (ie very, very few happening post-42 compared to few but not all that rare in the 39, 40, 41 age group).

I'm fortunate that we eventually conceived dc2 naturally the month of my 40th birthday, so whatever it was that delayed conception by 3 years obviously wasn't physically insurmountable, but I'm assuming that fertility investigations before IVF will refine the odds of the individual couple conceiving and in many cases a healthy 40 year old may have a better chance than a 35 year old couple with multiple issues.

gaelicsheep Wed 20-Feb-13 13:37:00

That is a very good point about breathing space. The pressure of trying to conceive is bound to affect success rates, so hopefully with the new guidelines that pressure on women aged 38 or 39 will be reduced.

SteIIaBeIIa Wed 20-Feb-13 13:37:43

The UK has no money. Controversial I know but I don't think IVF should be available on the NHS at all. There are so many life threatening and health destroying situations that they don't have funds for.

EuroShagmore Wed 20-Feb-13 13:38:00

nana you are considerably off on your stats. My clinic achieves a live birth rate of 3 times the 5% you quote for 40+: http://www.createhealth.org/success-rates
And it is by no means the most successful clinic out there.

On average the success rates now are about 1 in 3, and that is per cycle, so most people having 3 cycles will conceive. I think people going through IVF are well-aware of the statistics. In fact, I think the HFEA requires that the clinic gives you a sheet listing various things that you should have had explained to you and there is a space on this form where the dr should fill in what he believes your particular chances of success are. Certainly both the clinics I went to used this form.

miemohrs I came at it from the opposite side of the spectrum to you. I was expecting it to be incredibly difficult. I hate hospitals, I hate drugs and I saw needing IVF as a "failure". I stopped our first cycle half way through because I couldn't deal with it (the physical side effects of the drugs and the mental side). Our relationship didn't suffer (if anything it brought us closer) but we both did as individuals. I had one counselling session at my first clinic but I didn't find it helpful at all. I thought all clinics were required to offer counselling now? I know of one couple who came very close to splitting up post-IVF only to get a miracle natural conception after years of trying. There is no doubt that it takes its toll.

Theas18 Wed 20-Feb-13 13:39:57

Going to be a mumsnet pariah for ever now but I'm strongly opposed to these changes.

The NHS is a FINITE budget. There have to be hard choices about where the money is best spent. Treating a 43yr old with IVF is less likely to succeed compared to a 33yr old because of age factors (but also because a non concieving 43yr old has probably been through every other fertility treatment for years and failed to achieve a pregnancy).

My heart goes out to women who have to realise thy will never be a mum but what are we NOT going to use NHS money for to do this? Maybe mumsnet should choose....

Is it cutting budgets for ward cleaning and the basic HCA that actually do the real care tasks in hospital?

Is it not funding expensive cancer treatment for instance herceptin? (I know that's mainstream now but the newer ones that are coming along).

Is it saying right the NHS will only fund the cheapest version of each drug? Don't care if you " can't " swallow tablets - you eat food don't you- no expensive liquid medicine for you (OK that's tongue in cheek but YKWIM).

Go on mumsnet, who's budget would you squeeze this one out of- but don't then moan it YOU are the one sitting in a wet bed because the HCA can't change your sheets till they've done 6 other things, or your granny can't have the cancer treatment they need...

curryeater Wed 20-Feb-13 13:42:04

NanaNina, sorry if my last paragraph came across more flippantly than I meant it, I know these things are done very very carefully and consideredly. What I meant was: in the midst of my musings about how infertile couples could perhaps have their pain eased by adoption, I should also also acknowledge that for that to happen, someone (unless dead) will have to lose their child; and that is not an easy decision to make.

A lot of people on this thread seem to think that stressing medical causes of infertility justifies publically funded treatment. I don't know why that should be the case; I don't know why an arbitrary demarcation of medical = worthy, and by implication, societal causes of childlessness as less so. (I suppose it might be some sort of subconscious conflation of invalid = victim = blameless or something)

If I did not have children it would arguably be because of mental health issues, arguably because of disorganisation. I did not arrange my life towards having children (until it was nearly too late) - good stable relationship, good income, good home - because I was depressed and was not able to, and also didn't think I was worth it. If I did not have children, I would be very sad. Arguably my problems could have been solved sooner by counselling (actually what happened was a very forthright friend took me in hand, but other than her no one seemed to give a shit about the fact that I was a blatant mess in a thousand ways). Treatment was not forthcoming. Why would such a person be less deserving than someone with a blocked tube?

Similarly, if a woman who is having difficulty conceiving is told that it may be because she is overweight, it is very unlikely that she will receive any effective help to remedy this. Why is she less important than the blocked tube person?

If a person is desperate to have children but doesn't attempt to conceive because she feels that her income / housing situation is too unstable, there is no help for her either. This is a huge problem for young people. If you could have children without worrying about where they were going to live or how you could support them, maybe people wouldn't be panicking in their late 30s or 40s.

ArielThePiraticalMermaid Wed 20-Feb-13 13:42:57

Thea, this has been discussed in the thread. Perhaps you could read it and see what people's thoughts on this already have been.

Northey Wed 20-Feb-13 13:44:51

theas, a non-conceiving 33 year old will also very likely have run through all the other infertility treatments for years. They do kind of leave ivf till last...

RedToothBrush Bosnia-Herzegovina Wed 20-Feb-13 13:45:41

The NHS is SUPPOSED to give universal treatment and care.

IT DOES NOT

Whilst I welcome this, I can't help but feel this will cause even more heartbreak as women think they will now be able to have IVF on the NHS only to find out the reality that NICE is only a guideline and politics dictates whether they can actually have it, rather than the best recommended practice.

In my PCT there is NO IVF. Not for anyone. Well if you can afford it of course... So if you were 41 or 42 this makes fuck all difference.

We need to put even more pressure on the politicians Trust Management to actually follow what NICE say so that care is universal.

sleepyhead Wed 20-Feb-13 13:46:52

Theas18 - where are you getting 43 from? The cut off proposed is 42.

To calculate the cost implications you'd need to know how many extra cycles of IVF would actually arise from this guidance. Firstly, it's just guidance and it could well be that PCTs (or their replacement) decide that no, they won't fund IVF for this age group, as would be their entitlement.

There are many things the NHS funds that people would question the value of. It tends to be something that is heavily influenced by your personal perspective - eg in the case of expensive cancer drugs many of us would question the value of a drug that gives on average an extra two weeks of life expectancy. If it's your life, or your loved one, then you have a different view on that.

ArielThePiraticalMermaid Wed 20-Feb-13 13:49:09

Go on mumsnet, who's budget would you squeeze this one out of- but don't then moan it YOU are the one sitting in a wet bed because the HCA can't change your sheets till they've done 6 other things, or your granny can't have the cancer treatment they need...

So if I have IVF on the NHS at 40, and my granny is left in wet sheets, it is somehow my fault? confused.

I see what you're saying here, but would you say the same to the person who has overeaten all their life and has heart disease/cancer/stroke, or the smoker who needs lung cancer treatment, or the drunk guy who gets glassed, or the drink driver who needs scraping off the road? Because that's where your logic goes.

Theas18 Wed 20-Feb-13 13:49:25

Sorry 42 not 43 but the broad argument is the same

sleepyhead Wed 20-Feb-13 13:55:45

I doubt you'll be able to employ many elderly care nurses for the cost of these (hypothetical) extra rounds of IVF tbh.

The elderly care budget is around 80% of NHS spending and arguably needs to be higher. What else do you propose we cut, because cutting fertility treatment will be a drop in the ocean.

RedToothBrush Bosnia-Herzegovina Wed 20-Feb-13 13:55:59

Theas, my feeling about rationing of care is this:

Why do NICE recommend treatments? They do so in part because the alternatives are very often MORE expensive or have a detrimental effect on the person concerned, which have a knock on effect on their health.

So why are they recommending that treatment be available? Think about it and think about it HARD.

You CAN NOT ration healthcare to anyone without there being an effect. It is impossible. This goes for IVF as much as the granny with cancer. Its just that one is deemed more politically acceptable than the other; not that the need is necessarily less.

And I do believe there is enough money in the NHS. I just think the NHS is a speculator example of how to waste money by pissing it up the wall and just generally is abused by members of the public and staff.

5madthings Wed 20-Feb-13 13:56:59

Is counselling not mandarory?! I donated eggs last year and it was mandatory fir that. It was an invasive process but my egg recipient had twins!! I dont see tge point of pitting funding for ivf etc against cancer treatment. They are both important.

I was lucky enough to concieve easily and i am veru grateful for that blessing and so i donated eggs to give someone else a chance to have a child. I have seen the heartache of fertility problems and ivf via friends and wanted to do something to help. Ultimately its just luck if you have babies easily, i got lucky and wanted to share that luck. I woukd never begrudge the nhs paying for fertility treatment, just pleased we have the ability to help through science and wish it was more available.

Goid luck to any ladies ttc and going through fertility issues xxx

evilgiraffe Wed 20-Feb-13 13:58:16

I'm not convinced by the higher age - success rates of IVF fall with age, and as has been said, IVF is not a guaranteed cure for infertility.

However, making an attempt to get couples through the doors earlier would be hugely beneficial. DH and I are both just 30 and have been TTC for three years - we've just had our IVF referral and will be going to our first appointment in March. It is a hellishly long time to wait - and from about 18 months in neither of us had much hope that anything would happen without medical intervention. We suffer from "unexplained infertility", so there's nothing theoretically wrong with either of us, but yet we are not parents.

If this prolonged stress and severe emotional/mental distress could be reduced for anyone going through this, I welcome it. If nothing else, the chance to try IVF brings closure. DH and I are lucky enough that the postcode lottery allows us three cycles on the NHS, and we have been saving such that we may potentially be able to do another three privately. After that, the line is drawn and we can think about adoption knowing we've tried our best.

Stringing the referral process out not only makes IVF less likely to work (by performing it on an older woman), but also prolongs the deeply distressing situation of TTC while infertile.

SteIIaBeIIa Wed 20-Feb-13 13:59:59

This is another of these "entitlement" issues isn't it? Women feel they are "entitled" to be mothers. Well we're not. Some of us do and some of us don't.

It's not something that taxpayers should be contributing towards IMO - especially in these times when there is NO MONEY.

RedToothBrush Bosnia-Herzegovina Wed 20-Feb-13 14:03:03

This is another of these "entitlement" issues isn't it?

No. No, its not actually.

ArielThePiraticalMermaid Wed 20-Feb-13 14:04:35

Stella, do you have children?

gaelicsheep Wed 20-Feb-13 14:06:37

Are you a mother Stella. Not being rude, just that you'd be amazed how your viewpoint changes if you find yourself facing childlessness.

evilgiraffe Wed 20-Feb-13 14:12:13

Entitlement? No. Mental health issue? Absolutely. Perhaps if the money doesn't go to IVF it should go to infertility-related mental health services instead. Until you have lived it you cannot imagine how all-consuming infertility is. I have to look away from pregnant strangers, I have to grit my teeth to spend time with my friends with new families. I cry every time my period comes - and have done for years. Reading this thread is deeply upsetting, even the accounts of people in the same situation.

No, I don't feel entitled. But I do feel desperate.

SteIIaBeIIa Wed 20-Feb-13 14:14:58

Ariel - yes I do have a child.

gaelicsheep Wed 20-Feb-13 14:15:55

Then sorry Stella, you're not qualife

gaelicsheep Wed 20-Feb-13 14:17:57

Then sorry Stella, you're not qualifird to comment.

End of lunch now. Evilgiraffe - I am sending unMumsnetty (((hugs))) and I do hope things work out. xx

ArielThePiraticalMermaid Wed 20-Feb-13 14:18:20

Then I have no wish to be rude, but I don't think your opinion is a valid one. How on earth do you know how "entitled" I and my other infertile friends feel?

The feelings are very complex, but entitled doesn't come into them.

RedToothBrush Bosnia-Herzegovina Wed 20-Feb-13 14:18:52

evilgiraffe, I'm glad you mentioned mental health.

I am mildly amused by the person upthread who said that mental health was a more important issue than fertility. Conveniently missing the link between mental health problems and infertility.

Why, did NICE recommend this? I haven't read it, but I'll put money on there being something about depression in the document and being a consideration that NICE made.

If someone does know if this is the case, I would be interested.

miemohrs Wed 20-Feb-13 14:19:57

Message withdrawn at poster's request.

EuroShagmore Wed 20-Feb-13 14:20:43

I never felt entitled to IVF. I do however think that when one objectively considers all of the things the NHS funds (which goes far beyond the life saving cancer treatment that is always mentioned on these threads) fertiilty treatment should be funded. The reality is that because of the waiting that has been mentioned and the strict criteria, many people who need IVF will end up paying for it anyway. I'd love to know the % of IVF cycles in this country that are privately funded. I bet it is huge.

Northey Wed 20-Feb-13 14:22:39

stella, I'm not sure anyone is really "entitled" to anything, healthcare-wise. For example, if your child became sick, is she "entitled" to regain health, either naturally or through medical intervention? If she were deaf, would she be "entitled" to test and hearing aids? No-one has a God-given right to hear, yet as a society we chose to use some of our taxes helping people to do so. We as a society decide who is "entitled" to what, and that goes for your child's antibiotics as much as it does for my ivf.

curryeater Wed 20-Feb-13 14:26:28

redtoothbrush, it was me, and I totally acknowledge the link between infertility and mental health problems. which is why I said it. I think there is a very complex interface here between the mental, physical and the actually non-medical and I don't think this is being acknowledged.

btw it is stupid to say that someone with children can't have an opinion. Really? Do you think only the unwillingly childless people at NICE should be a part of making these decisions? Do you think that people who may or may not have children but don't really care can't be a part of it either?

You can't write policy based on feelings, certainly not the feelings of only some people. Which is what you are suggesting.

Lots of people aren't happy for lots of reasons. I want to write a book and it kills me that I will never ever have the time. I just can't earn a living and write. My heart bleeds. I have to look away from the facebook updates of my friends who are published. Every time I see another shit book marketed all over the place, knowing that mine would be better, I have to lock myself away and cry. Am I the only person who is allowed to make decisions about arts grants? If some author on a govt panel said, "frankly, curry, I do not think you are entitled to £12k for 6 months off to write your book" should I snap back, "Have YOU written a book? Yes? WELL YOU DON'T GET TO HAVE AN OPINION!"

FrankellyMyDearIDontGiveADamn Wed 20-Feb-13 14:26:37

Agree that anyone who managed to conceive without intervention is not qualified to comment on women "feeling entitled to have children".

Do you have any idea how utterly all consuming infertility is? How it haunts your every waking thought? How it is such a primal, guttural desire to have a child and know that the odds are stacked against you?

Do you know what it's like to feel like a piece of you dies every time you see a negative test/your period shows up?

Unless you have been through the pain of infertility you cannot understand what it is like, so kindly keep your opinions to yourself.

FrankellyMyDearIDontGiveADamn Wed 20-Feb-13 14:28:04

Curry, are you honestly comparing the pain and heartache of infertility to not being able to write a book??!!! hmm

evilgiraffe Wed 20-Feb-13 14:33:30

Thank you, gaelicsheep smile

RedToothBrush - I think the mental health side of it is largely ignored. Granted, we've not started in on IVF yet, but I have had lots of tests done and been to the infertility clinic many times. The closest we ever got to acknowledgement of the toll on mental health was being allowed to hide in a nurses' room after being told we were infertile - I could barely stand unaided and sobbed on DH for a long time before getting it together enough to walk away. Of course, the infertility clinic is part of the maternity hospital, which meant walking past innumerable pregnant ladies and small children. I am in tears now just thinking about how painful that was, and that happened last May. Any help would have been gratefully received, rather than "go home, keep trying, come back when you've been unsuccessful for three years".

It is quite a relief just to have been referred now, even though I have no idea what happens next and it's still a month until the initial appointment.

Northey Wed 20-Feb-13 14:34:17

curry, I think the "not qualified to comment" thing was more in relation to someone with children saying that people without children felt entitled. It's not that people with children don't have a valid opinion to offer, it's that that opinion isn't on the feelings and drivers of someone who is infertile - they simply won't know.

ArielThePiraticalMermaid Wed 20-Feb-13 14:36:11

Curry, it is not a biological imperative to write a book. I don't imagine you feel like a failure as a woman, because you haven't had one published.

I think the reason why stella's opinion was dismissed was because she was so dismissive of other people's opinion. Others have voiced similar opinions to hers and they didn't do it so brusquely in such brutal language. All opinions are welcomed in my opinion, as long as they are well thought out and give some thought to the audience, which is likely to contain a fair few women facing infertility.

It would be very nice if this very sensitive topic was discussed, well, sensitively, and not in your usual AIBU free for all manner.

LindaMcCartneySausage Wed 20-Feb-13 14:36:57

I have one DS conceived through IVF on cycle 4. Previous cycles resulted in 1 miscarriage, 1 failed cycle and 1 ectopic pregnancy, which had to be terminated with methotrexate. I'm also thrilled to be 38 weeks pregnant with DC2, a frozen embryo transfer, conceived and frozen after our first IVF cycle. In all, I've done 5 rounds of drug treatments.

I'm pleased that they are raising the IVF age limit, but feel it's a very hollow headline. NHS Trusts do not have to follow the guidelines, there is likely no money in the pot for this initiative and the postcode lottery will continue. Raising the age limit will not be as effective as speeding up the referral and testing process which is required prior to any IVF cycle and the waiting lists. Maternal age is the single biggest factor in IVF success. It takes months and months on the NHS waiting lists which many women in their late 30's do not have time for.

We were in Westminster PCT and were lucky to have 2 x NHS funded cycles, the others we funded ourself. We started TTC naturally when I was 31. In our case it was very clear cut - DH had very low sperm count and out chances of natural conception were virtually nil. I had clockwork cycles and no issues, but still had to go through over a year of NHS tests, which could have been completed (medically speaking) in 1 or 2 months to confirm that my reproductive faculties were perfectly ok. It then took 4 cycles to get DS - you can only do 2, maaaaaayyyybe, 3 at a pinch in a year. I'm now 37. It's a loooooong process.

evilgiraffe Wed 20-Feb-13 14:37:03

Curry, I believe RedToothBrush spoke to me, because I commented about mental health.

I am currently trying to write a book, as it happens. It is really fucking hard, but it doesn't even come close to the pain of being infertile. Comparing a career choice with a fundamental biological drive is laughable.

BasicallySFB Wed 20-Feb-13 14:37:41

Friends who've had IVF tell me that, even though it didn't (for all bar 2 of 5) work, their MH was improved because they'd been able to try, every option possible.

Fortunately, given the arbitrary rule applied to deny us IVF (as said up thread, my DH had 2 older children from a precious relationship), I have one of the leading gynae's in the country caring for me. He has done my last 6 major surgeries (I've had 8 in total). At number 6 i lost an ovary. After number 7, he was able to clear my endometriosis-blocked tube and most of the endo. Despite this never impacting on fertility for us before, this time it did - and we were blessed with my beautiful DS.

It costs a damned site more to treat my endo (surgery every 18 months, at least 2 nights in hospital, follow up drugs that are insanely expensive) than 1 round of IVF.

1 round of IVF and a pregnancy would have helped my endo enormously.

And my mental health.

But you're quite right - those of us who face the heartbreak of infertility should just man up and stop feeling so entitled...

HappyJoyful Wed 20-Feb-13 14:37:42

evilgiraffe, couldn't run without posting a word of support. Wish I could wave a magic wand and take away the pain. I had 5 cycles of IVF and now am very blessed to have a 2 yr old DD but the knowledge of those feelings of longing and yearning are never far from my mind and the pain that women going through this are never far from my thoughts.

I have huge issues (and anger/rage) with people using the word 'entitlement' when it comes to IVF. Sorry, but as others say, anyone implying that's how someone having IVF feels or that that is what it's about - their entitlement to treatment as absolutely no idea whatsoever.

evilgiraffe Wed 20-Feb-13 14:38:25

Speaking of AIBU, why is this post in Site Stuff? It's an odd place for it, surely? In The News might be better? <shrug>

FairyJen Wed 20-Feb-13 14:39:12

evilgiraffe would you consider adoption or a surrogate/ donor? Sorry if I've misread your personal circs

Northey Wed 20-Feb-13 14:41:54

I imagine someone from MNHQ has been asked to be on a discussion programme about it later, and so they need to canvas thoughts to properly represent the opinions raised on the site. So it's sort of site stuff <tails off lamely>

evilgiraffe Wed 20-Feb-13 14:44:03

It's nice to hear success stories, HappyJoyful! And thank you smile There are a lot of infertile people on this thread and MN in general, and any support is welcomed.

FairyJen - I don't think I could do surrogacy or donation, though I've not really thought about it. Adoption is almost certainly the route we will go down if IVF fails us, but of course that takes years too - and we can't start any of it now as we're still TTC so not eligible even for adoption paperwork.

SteIIaBeIIa Wed 20-Feb-13 14:49:43

Frankley Unless you have been through the pain of infertility you cannot understand what it is like, so kindly keep your opinions to yourself.

Several short sighted women on this thread then. Yes, I have a child but there are other ways to have a child than by giving birth.

ArielThePiraticalMermaid Wed 20-Feb-13 14:51:30

Stella please. This is not a thread to start a fight on.

RedToothBrush Bosnia-Herzegovina Wed 20-Feb-13 14:52:19

Right there is a section about psychological impact of infertility in the guidance. This is the section in full because I think its relevant and since its not changed much since the 2004 version and its not a headline grabber:

The relationship between psychological stress and fertility problems is complex. Individual response to stress situations will vary. Three cohort studies have reported an association between work-related stress and a lower probability of conception in women. However, the association in men is less clear. Psychological stress can affect a couple’s relationship and libido, which may impact upon their chance of conception. A higher frequency of male sexual disturbances including loss of libido and a decrease in the frequency of sexual intercourse has been observed in couples undergoing fertility diagnostic and treatment procedures.

Infertility is regarded as an upsetting and difficult life experience for some women, with a subpopulation of women reporting elevated levels of anxiety and depression in some studies; however, another study did not find such an association. In one study, the psychological symptoms of anxiety and depression associated with infertility were found to be similar to those associated with other serious medical conditions such as heart disease, cancer, hypertension and infection with HIV. A study in Sweden reported that almost 50% of women said they needed professional help and support to deal with their anxiety and problems in their marital relationship two years after tubal reconstructive surgery.

Two RCTs have shown that group psychological interventions such as cognitive behavioural therapy and support prevent distress and improve pregnancy rates (55% in a cognitive behavioural therapy group versus 54% in a support group versus 20% in a routine care group) in women with less than two years’ duration of infertility.

Psychiatric morbidity was reported to be positively associated with the experience of infertility and the number of treatment cycles, affecting more women than men. The psychological state of couples undergoing IVF may vary at different stages of treatment, the most stressful stages being waiting for the outcome of treatment and finding out that IVF has been unsuccessful.

An RCT that evaluated the use of information and information combined with counselling for couples undergoing IVF treatment showed no significant differences between the two groups in terms of psychological symptoms and satisfaction.

Four surveys have reported that most patients feel that access to a support group and counselling would be beneficial. Some felt that psychological support should be available at all stages of infertility treatment and investigation. An unpublished survey found that few GPs offered counselling or identified methods of support, but two-thirds of couples attending an infertility clinic said they would accept psychological assistance if offered.

In another study, 70% of patients said they would request counselling if it were available free of charge. Despite this, overall uptake of counselling is low at between 18% and 25%. It has been suggested that less distressed patients may not wish to receive counselling, and some may cope well with support from their spouses and family. Two-thirds of patients undergoing IVF treatment reported reading newspaper or magazine articles and watching television programmes about the psychological aspects of infertility, even though few participated in a support group or sought counselling before treatment. This suggests that, for some patients, information about local and national support groups and booklets on the psychological aspects of treatment, in addition to medical information, may be beneficial.

The emotional consequences of anxiety and stress can be reduced by adequate provision of clear information about all aspects of investigations and treatment, involving both partners as an integral part of the management plan. The impact of psychological stress should be acknowledged throughout the care of the couple with fertility problems with offers of counselling. Counselling involves a professional relationship between a qualified counsellor and a patient, who may be an individual, a couple or a group of people. This relationship is contained within a formal counselling contract agreed and understood by both parties. The counsellor has no other relationship with the client. Nurses, doctors and scientists in fertility clinics offer support and emotional help to couples as part of their professional role, but it is necessary to recognise this as using counselling skills within an existing role.

In considering the counselling needs of their patients, health professionals need to take account of evidence that suggests that couples may deny experiencing difficulties in their relationship, which may prevent them seeking help. People who experience problems with fertility are often very vulnerable. This may lead them to be overly compliant with suggestions made by their clinical team, for example, going ahead with treatments despite having reservations or simply requiring more time to reflect on all the implications.

The HFEA Code of Practice218 (HFEA 2008) identifies three distinct types of counselling, all of which should be clearly distinguished from information exchange.

Implication counselling aims to enable the client to understand the implications of proposed treatments and consequent actions for themselves, their families and for any children born as a result and anyone else affected by the donation or treatment.

Support counselling aims to give emotional support at times of particular stress, for example, when there is a failure to achieve a pregnancy. This may occur at any stage before, during and after donation or treatment.

Therapeutic counselling aims to help people cope with the consequences of infertility and treatment, to resolve problems which these may cause, and to adjust their expectations so that they can cope with the outcome of treatment, whatever that may be.

The HFEA Code of Practice states that people seeking licensed treatment or consenting to the use or storage of embryos, or the donation or storage of gametes, or the use of gametes or embryos posthumously, must be given ‘a suitable opportunity to receive proper counselling about the implications of taking the proposed steps’ before they consent.

Counsellors should have professional counselling qualifications and the ability to work in accordance with the Human Fertily and Embryology Act 15. They should abide by a professional code of practice, such as the Ethical Framework for Good Practice in Counselling and Psychotherapy used by the British Association for Counselling and Psychotherapy, with a commitment to regular supervision.

If there is need for genetic counselling an appropriate referral should be made to a qualified genetic counsellor. Genetic counsellors should have recognised training, either through a Masters Programme in Genetic Counselling or a nursing qualification with additional relevant academic qualifications.

Recommendations
* When couples have fertility problems, both partners should be informed that stress in the male and/or female partner can affect the couple’s relationship and is likely to reduce libido and frequency of intercourse which can contribute to the fertility problems. [2004, amended 2013]

* People who experience fertility problems should be informed that they may find it helpful to contact a fertility support group. [2004]

* People who experience fertility problems should be offered counselling because fertility problems themselves, and the investigation and treatment of fertility problems, can cause psychological stress. [2004]

* Counselling should be offered before, during and after investigation and treatment, irrespective of the outcome of these procedures. [2004]

* Counselling should be provided by someone who is not directly involved in the management of the individual’s and/or couple’s fertility problems. [2004, amended 2013]

FairyJen Wed 20-Feb-13 14:54:21

No one wants my rent a womb sad

Marylou2 Wed 20-Feb-13 14:54:25

Our daughter was born 6 years ago when I was 37 via an NHS funded cycle. It was a postcode lottery then and is even worse now. My local PCT has pulled all funding for IVF and I believe that any increased pressure on an overstretched service will lead other authorities to do the same. As these NICE guidelines are not binding I wonder how the newly formed Clinical Commissioning groups might interpret them.
I would say to anyone waiting for IVF,just find the money and get it done as soon as you can. Unfortunately if you can't afford a cycle of IVF you can't afford to raise a child. Very harsh but so true.

FairyJen Wed 20-Feb-13 14:57:00

marylou I disagree with your financial comment. I'm paying for two children but couldn't produce 3k just like that! confused

Northey Wed 20-Feb-13 14:57:24

Who said there wasn't, stella? <genuinely confused> It still means you are not childless, which is the point. Unless you are saying that biological childlessness is different from childlessness in general ie those who adopted somehow don't count as proper parents, which you can possibly mean.

ArielThePiraticalMermaid Wed 20-Feb-13 14:59:03

MaryLou2, people are paying upwards of £6000 for a cycle of private IVF. There are lots of people who are parents who do not have that kind of money kicking around that can just be "found". When do you have to shell out that kind of money in one go for a child? Yes they cost an awful lot more than that in the long run, but not in one go.

BalmainMummy Wed 20-Feb-13 15:01:56

I think that every woman should have the right to a treatment of IVF for their first baby. Im 24 and it took me 6 months to fall pregnant and those months were some of the most stressful of my life. Its gutting not falling pregnant when your heart is set on it and you cant think about anything else but falling pregnant. Its all consuming. I know that time was on my side, but some women dont feel that consuming need until later on, or dont meet the right man to have babies with. And i think its better to wait until you meet the right person and can have a proper family environment.

People bash older mothers all the time but my mum had me at 39 after trying for almost two years, she waited until she met the right man and they have been together for 27 years and I had a stable family life. Id much prefer an older mother to have a baby in a stable family environment than a younger mother who was jumping between boyfriends. My mum was the best mother and still is the best and at 63 she is still very active and we have a fantastic relationship. If I hadent met my husband at 21, then I probably would be have been an older mother too. And would hope that Id have the right to IVF

HappyJoyful Wed 20-Feb-13 15:02:31

evilgiraffe, might have missed something, but just grasped you are just at the point of referal to have IVF.. there is tonnes and tonnes of hope and possibility for you that it will work. Feel free to send me a pm if you need any advice or support. You have lots of chances of success too just like the women on this thread that are saying they have had IVF babies.

marylou, sorry, think it's a bit flippant to say that if you can't afford a cycle of IVF that you can't afford to raise a child.. IVF requires lump sums of hard cash- I've got a 2 year old and we certainly don't have £5k sitting around to 'raise' her loads of people live hand to mouth and successfully raise children. I don't however, disagree with the sentiment that I'd try to 'find' the money if I could - credit card, re-mortgage, beg/borrow friends or family.. loans, take in lodgers, I know people that have done all of that.

RedToothBrush Bosnia-Herzegovina Wed 20-Feb-13 15:05:10

Yes they cost an awful lot more than that in the long run, but not in one go.

Quite. And if you find out at a certain age that you need IVF then you may not have the time to raise that money.

My personal circumstances are, that we could definitely afford a child, given we have a higher household income than most of our friends with children and most of them aren't badly paid. We could not raise £6000 like that, if we did ever need IVF. Realistically I think it would take a year or two to really save hard to get that kind of money - all the time reducing your chances of success.

We might be able to take out a loan, but thats not the way to start a family either, is it? And doesn't that in itself add to the stress and therefore may make it harder to conceive anyway?

FairyJen Wed 20-Feb-13 15:05:38

Look at it from the other side, abortion is available for women of any age... I know the cost is higher for ivf but I think if your desire for a child is so great that you would go through the process help should be there for you.

evilgiraffe Wed 20-Feb-13 15:07:59

FairyJen you made me giggle at "rent-a-womb" grin I have never even considered surrogacy - not having any sisters or SILs it's never occurred to me as a possibility.

RedToothBrush - really interesting info there, thank you. Much of that is depressimgly familiar. I was particularly shocked by levels of anxiety/depression due to infertility being comparable to those due to heart disease, cancer and HIV in one study. That's terrifying.

EuroShagmore Wed 20-Feb-13 15:08:15

I also disagree with marylou's comment. How many couples conceiving the old fashioned way do you think have a spare lump sum of £3-10k sitting around the month they conceive?

FairyJen Wed 20-Feb-13 15:09:32

I was signed up to a clinic a couple of years ago. No one wanted me! I then pulled out as fell pregnant but it did feel a bit like joining a dating website and getting no dates sad

I try not to take it personally grin

SteIIaBeIIa Wed 20-Feb-13 15:11:06

Message deleted by Mumsnet for breaking our Talk Guidelines. Replies may also be deleted.

ArielThePiraticalMermaid Wed 20-Feb-13 15:11:58

<doesn't engage>

FairyJen Wed 20-Feb-13 15:14:14

Message deleted by Mumsnet for breaking our Talk Guidelines. Replies may also be deleted.

RedToothBrush Bosnia-Herzegovina Wed 20-Feb-13 15:15:01

evilgiraffe that was the figure that shocked me most too, but I wanted to post the whole section, as not to be accused of being selective and to also point out what NICEs recommendations about counselling were, as judging by a few comments on this thread, people's experience seems to differ on that as much as the age limit varies from place to place.

BasicallySFB Wed 20-Feb-13 15:17:43

Message deleted by Mumsnet for breaking our Talk Guidelines. Replies may also be deleted.

evilgiraffe Wed 20-Feb-13 15:24:16

It is interesting how varied the care is, RedToothBrush. The postcode lottery gets me three cycles, but we've not been offered any mental health services, or advised to seek them out (or where to look for them). We have been told that stress is a contributory factor to infertility, but that hardly helps much...

higgle Wed 20-Feb-13 15:24:53

I support the changes, and don't think that overall they would cost the NHS large amounts in comparison to treatment of some lifestyle choices illnesses that there is never any argument about. I know I couldn't go through the anguish of fertility treatment myself though, I'm not emotionally strong enough. When it looked as if DS1 might be an only child I investigate adoption from abroad as an option instead - though I now know that can bring lots of anguish in the procedures too.

SteIIaBeIIa Wed 20-Feb-13 15:28:10

Basically - if you read my post carefully you will see that I didn't say needing IVF was about a sense of entitlement I said that lots of women feel that having a child is a sense of entitlement.

Having a child is not an entitlement for anyone.

I am not entitled, you are not entitled. Anyone who hopes for a child and has a child is lucky.

I am lucky.

JethroTull Wed 20-Feb-13 15:32:07

There's been lots of intelligent responses on this thread as well as the 'not so intelligent'.

From my perspective of both recent involvement with both NHS & the private sector, I'd would have just liked the NHS to have been more honest. We were 'under investigation' for almost 2.5 years with appointments months & months appart. Had the NHS said at appointment 2 - you will undoubtedly need IVF however at the moment this PCT has no funding & isn't likely to have funding for another 18 months' we would have made the decision to go private then (We were extremely lucky to have this option I know). But they didn't say this, they strung us along, giving us hope.

I'd also like the NHS to acknowledge that low AMH is a factor in infertility. It wasn't mentioned to me even though it is clear on my results. When these results were passed to our private consultant it was the first thing she picked up on.

No, it's not anyones right to have a child but in a country where we have a NHS it is surely a 'right' to have infertility investigated. Where do you draw the line - do obese people no longer deserve the right for medication for obesity caused diabetes? Smokers for lung cancer? Drinkers for alcohol related disease?

evilgiraffe Wed 20-Feb-13 15:35:09

You are indeed lucky, SteIIa. But unless your child is a result of assisted conception or adoption, you probably don't know how it feels to face a future without children, and how desolate that experience is. Therefore, claiming as you did that women feel entitled to have children is erroneous. Some people may, but suggesting all do is simply incorrect, as well as callous and unhelpful to boot.

HelenMumsnet (MNHQ) Wed 20-Feb-13 15:37:14

evilgiraffe

Speaking of AIBU, why is this post in Site Stuff? It's an odd place for it, surely? In The News might be better? <shrug>

Afternoon. When we're canvassing MN opinion, we tend always to post in Site Stuff.

FrankellyMyDearIDontGiveADamn Wed 20-Feb-13 15:37:43

But invariably the people saying that lots of women have a sense of entitlement over children are those that already have them.

It's not about a sense of entitlement, it is about a deep, primeval urge that takes over your life.

Northey Wed 20-Feb-13 15:38:04

I don't think anyone misunderstood your post about entitlement, stella, they just disagreed with it and explained why they did.

ArielThePiraticalMermaid Wed 20-Feb-13 15:41:58

Good point Jethro. It was only through having been on MN so long that I'd even heard of AMH let alone known that my result was low. The NHS consultant didn't even think to mention it until I said "Um...that looks low!" And as for the GP, she tried to send me along telling me not to worry because lots of celebrities have babies in their late thirties and forties, and she honestly didn't think there was a problem.

evilgiraffe Wed 20-Feb-13 15:44:53

Aha, thanks Helen!

SteIIaBeIIa Wed 20-Feb-13 15:51:21

Evil - My child is adopted. Are you satisfied now?

I'm opting out of this conversation now before I out myself.

AmberSocks Wed 20-Feb-13 15:52:07

i think its great and think it should be made higher,maybe up to 45?

BasicallySFB Wed 20-Feb-13 15:52:44

SteIIa - You said:
'This is another one of those "entitlement" issues isn't it? Women feel they are "entitled" to be mothers. Well we're not. Some of us do and some of us don't.'

Hoping to avoid another deletion - I find that to be an upsetting perspective on infertility, and on the processes that many women have to go through to become a mother. Because it's not about 'entitlement' at all - 'entitlement' to treatment or to being a mother.

It's about, as was very eloquently said above, a deep, biological urge, that can be life consuming, life destroying and life devastating - in process and outcome.

I am incredibly lucky to have DS, after years and years and years of painful, invasive and very unpleasant treatments. I'm incredibly lucky in lots of other areas too, in having a lovely DH for example. There's very little I feel 'entitled' to (bar the occasional toilet break at work!) - being a mother was never something I felt 'entitled' to be. It was something I desperately craved being.

Northey Wed 20-Feb-13 15:55:31

Right, stella, so when you were going through the adoption process, did you have a "sense of entitlement" to have a child?

BasicallySFB Wed 20-Feb-13 15:56:01

Byway back to the original point - good news, in theory. In practice...remains to be seen, but unlikely to be particularly widely implemented given current financial situation of the NHS.

curryeater Wed 20-Feb-13 15:58:50

I think that it is far more important that the treatment available is nationally, realistically consistent; and that it is not waited for for too long; than what the guidelines actually are (within reason).

and actually, without wanting to be flippant, nobody has any idea what is painful to me or what makes me feel like a failure, any more than vice versa.

FairyJen Wed 20-Feb-13 16:00:19

stella may I ask why you chose adoption rarer than another option? Was it an issue with the ivf process or just personal choice? I only ask as I think many people see adoption as a last resort iykwim and a lot of children fester in foster care because of this. I do wander if this figure will actually go up now older women can get ivf via the nhs.

AmberSocks Wed 20-Feb-13 16:00:39

I dont understand why people say having chidren isnt a right,of course it is,and if you cant do it naturally for whatever reason then you should be able to get help with that,on the nhs.

Startail Wed 20-Feb-13 16:02:26

Since Df had her DS at almost 43 and DH and his DSIS were born either side of their mums 40th that seems very reasonable to me.

DMIL was the best advert for having your DC late in life you could possibly meet, she died suddenly at 77, still riding every week and still able to stick on her walking boots and stride up hills I'd rather walk round.

Northey Wed 20-Feb-13 16:02:35

I completely agree, curry. My clinic takes NHS referrals from three neighbouring PCTs. I get one NHS cycle. The woman in the stirrups five minutes later gets three. I know different areas have different funding priorities, but this is all SE England and I really don't believe the demographics of these two areas are so different as to warrant that.

evilgiraffe Wed 20-Feb-13 16:10:22

Indeed, Northey - the variety of care across the country is baffling.

FairyJen - I think you're right, adoption is often (usually?) seen as a last resort. I know DH and I wouldn't choose to adopt as a first choice, but we probably will if IVF fails. That's probably because of the biological drive - I can't get away from the all-consuming need to conceive a child with DH, and raise that child with him. I honestly don't know how closely adoption compares, though I believe that adoption (parictularly as a first choice) is staggeringly altruistic.

RedToothBrush Bosnia-Herzegovina Wed 20-Feb-13 16:11:15

Being a mother and being a woman are still somehow connected in the mindset of many and in our society as a whole.

To be unable to be a mother, is often accompanied by a deep feeling of somehow being less of a woman. Its not true, but you've still grown up with the sense of expectation placed on your shoulders. And particularly once your friends start having children, the questions start being asked about when - not if - you will have children. People can not understand the desire not to have children. People who express this opinion are often looked at and treated with suspicion or patronisingly told they will change their mind and that their body clock with go off etc, etc.

Its not entitlement. Its what is expected of you on top of your own desires. So to have the ability to conceive naturally taken away from you and then have the double blow of having IVF as an option also taken away from you by the same society that places this expectation and demand on you is just cruel. Especially since it is something that you can not help and is not a choice, when so many health related illnesses out there are lifestyle choices.

I think these double standards within our society are both blinkered and unhelpful. Its, why I deeply dispute the word 'entitled' in this context.

The whole area of rights and entitlement is so very difficult anyway isn't it ?

The American constitution famously came up with "life, liberty, and the pursuit of happiness"

I'd find it difficult to say what I felt I had a right to, especially health wise. But I think having a health service free at the point of need is something I'd want to safeguard in this country.

I think it's quite right that that should include some treatment for those suffering with infertility, which could so easily have been me.

Good luck to those for whom this might offer some further hope.

BasicallySFB Wed 20-Feb-13 16:14:52

What redtoothbrush said.

FairyJen Wed 20-Feb-13 16:25:05

I think entitlement could be right tho. I mean everybody has the right to lead a full, satisfying and happy life. That is a right we are entitled to otherwise just what is the point to it all??

So if having children be it naturally, through ivf, surrogacy or adoption etc is part of havin said fulfilled life then surely that makes it an entitlement and rightly so?

LittleMissHocusPocus Wed 20-Feb-13 16:31:05

I don't understand the viewpoint held by some people here that infertility - whatever the reason - is not an "illness" and should therefore not be NHS funded.

Pregnancy and childbirth (for example) are themselves not "illnesses" yet it is expected and accepted by the vast majority of people that scans, tests and giving birth are provided for by the NHS in the majority of cases.

As it should be, of course. But equally then, so should fertility treatment, certainly up to an age where it is still perfectly possible to have children 'naturally' - my own Auntie was conceived naturally when my Gran was 42. I therefore think the new guidelines are a good thing.

I do not feel entitled to have children, but I do think I am entitled as the next person to the chance to have children.

And for what it's worth, had I had kids with the person I was with for most of my 20s (and so supposedly at my most fertile) I would have ended up bringing them into a hugely unsuitable relationship, struggling financially, and those poor hypothetical kids would have had a god-awful father.

Would that have been better? 'Cost' the country less?

evilgiraffe Wed 20-Feb-13 16:34:41

I do not feel entitled to have children, but I do think I am entitled as the next person to the chance to have children.

That's a good way of putting it, Little.

midastouch Wed 20-Feb-13 16:45:48

I will get slated for my opinion but i don't think they should increase it, theres a reason your fertility decreases with age its well known that you have increased risks for you and baby as you get older. The nhs isnt for people who left it too late imho but then i also resent it being used for drug addicts, alcoholics and those who have conditions through smoking

Xenia Wed 20-Feb-13 16:46:14

We are supposedly in a time of huge economic need with vastly stretched resources. There may be a case for saying no fertility treatment of anyone on the NHS, but not this latest move. However I would support any change which means the rules are absolutely identical including over prescription charges wherever you live even in Scotland and Wales.

Adoption isn't always a solution either. You have to wait a year after fertility treatment to apply, and if, as in many cases where IVF is a last resort, you're anywhere near the age of 40, then you won't be able to adopt a baby but will only be "allowed" an older child who has probably already been damaged by the care system and will therefore require a huge amount of attention, understanding and specialist care. (I speak from experience here.) Once I found out that we were too old to adopt a baby, and having close personal experience of how challenging damaged children can be, I knew that adoption was not a path open to us.

VivaLeBeaver Wed 20-Feb-13 16:51:11

I don't agree with extending it, sorry. Like others have said in times when the NHS can't fund life saving cancer treatments I think its a poor choice to fund this over such stuff.

If people have got past their mid/late 30s without trying for a child then they've left it too late through their choice. If they haven't left it too late then they'll have had IVF before the age of 39. If anything I think the age should be lowered. Its not like there's not enough publicity about how hard it can be to get pregnant the longer you leave it.

Samu2 Wed 20-Feb-13 16:56:36

My ex husbands wife was turned down for IVF. My ex got cancer and froze his sperm before chemo but they won't allow her to have IVF because she is a step mum to three of my children.

I would love to see that change. I do think we are lucky to have IVF on the NHS but I don't think she is less worthy of getting a chance because she has step children.

EnjoyResponsibly Wed 20-Feb-13 16:58:49

Tell you one thing. If I'd had children in my "peak" years with the man I was with in my twenties, my children and I would be costing the State a damn site more in benefits than a couple of rounds of IVF in my 30s with my devoted DH.

evilgiraffe Wed 20-Feb-13 17:00:31

For those disagreeing with the extended age range (I'm in two minds about this myself) - what about the other new suggestion, that referral for IVF should come after two rather than three years of unsuccessful TTC?

I thnk shorter referral times will have a far greater impact anyway, to be honest. I would have loved to be referred this time last year instead of now.

12ylnon Wed 20-Feb-13 17:00:45

This is going to get lost.

I'm very torn on this issue i'm afraid and i don't think my response will be popular. I don't want to offend anyone and this is just my own experiences and views.

I know exactly what it's like to go though the absolute pain and dispare of infertility (albeit at the age of 23). I'm luckily now pregnant with our second and last child. I'm so grateful that i found the person that i wanted to have children with at a fairly young age and we made various sacrifices so that we could have them in our 20s as i knew that i didn't want children past 30.

I also know what it's like to have older parents. My mother was in her 40s when she had me (not by IVF), my dad was 7 years older than her. My mum died when i was 13 and i barely remember her and my dad is now 68 and i'm facing the very real possibility that within the next 10 years, i'm probably going to have to take on a major role in looking after him. I'm in my mid 20s, so this is actually quite a scary thought for me. I so so desperately wish that my parents had been younger when they had me, i really do. I also have a friend who's the same age as me who is in a similar situation. He really struggled through university as his father was already retired by that time and couldn't offer any significant financial support.

I'm honestly not sure our parents fully thought this through when they decided to have us and if they did.... well... it was a really half baked idea!

I'm very much an 'each to their own' kind of person and support every woman's decision to be a parent (so in that respect, i think the new NHS guidelines give people a greater chance of achieving this and they are right to do so), but i just think that people shouldn't necessarily take up the offer of IVF at the age of 42 as i'm just not convinced that they fully take into account the true consequences of being an older parent.

Xenia Wed 20-Feb-13 17:01:26

I don't agree Enjoy. Many many women like I do support our children entirely alone and cost the state not a penny. Many many women work hard to fund IVF treatment.

Anyway this is all about Cameron having made a huge mess of the female vote and losing it never mind the tiny number of women in cabinet posts. Unless he does a lot more for women (and £1k a year childcare tax relief when childcare costs £25k a year full time is no help) he will not get re-elected.

curryeater Wed 20-Feb-13 17:05:34

I think it is astonishing that there is a sense of infinite resources with respect to this issue, yet there is such a firm (mistaken, in my view) general belief that other cuts are necessary.

Housing benefit, DLA, etc - all of these things are for people who struggle to get by without them - children are an enhancement to life. I don't get it, I am very surprised to see this.

I think geographical disparities between treatment available are very unfair, but I struggle to see why this is something that is more deserving of public funds than other things.

I also struggle to see why "medical" childlessness is seen to trump everything else, in some quasi-moral way. I also struggle with the fact that, for women, the having-babies thing occupies such a high ground. There are many sorts of legitimate emotional pain and practical and physical difficulties which people in general can suffer; no one gives a shit if I can't get a decent job or have crippling depression, but when I was struggling physically in pregnancy, strangers moved heaven and earth to help me (bless them). I am so grateful for my children and so grateful for the general public recognition of what a massive thing it is to bear children and look after small children, but you know, if you have had depression, it is not the hardest thing in the world, and I don't get why not-having-them should be seen - for women - as the worst thing in the world.

worldgonecrazy in our area you can adopt a baby up to age 50. I'm not sure adoption is necessarily a solution for people who would like to have a baby. Everyone is different. Just wanted to say about the age thing in case anyone was interested.

VivaLeBeaver Wed 20-Feb-13 17:09:41

I do agree with the waiting time for referral going down from 3 years of ttc to 2 years. If its not happening after 2 years chances are you're going to need help. And by the time you've waited, had tests, etc its probably going to be 3 years!

evilgiraffe Wed 20-Feb-13 17:11:43

As was said earlier, curryeater - it is extremely hard to understand if you have not been in the position of trying to conceive whilst being infertile. As mentioned in RedToothBrush's post of the NICE comments on the psychiatric effect of infertility, it is a huge burden to bear. To me, it feels more like intense grief than anything else.

Whether you can understand it or not, it is the case for an enormous number of people. I would not wish it on anyone.

ArielThePiraticalMermaid Wed 20-Feb-13 17:11:48

The nhs isnt for people who left it too late imho

If people have got past their mid/late 30s without trying for a child then they've left it too late through their choice

There are anecdotes on this thread where people have started trying for children well inside what is considered to be "too late", but due to waiting lists and incompetence, have not been able to complete the treatment before the present cut off.

I started TTC at 34, and if I was still listening to my GP, I would only now be starting the referral process, a month before my 38th birthday, so much did she try and convince me that things were "probably fine" (granted I could have sought help earlier)

Also, it's frequently not about leaving it "too late" and when you see friends around you conceiving their first child in their mid 30s quite easily, it's very easy to think that you are fine. By the time you realise no it isn't fine, you are one of those selfish career women who deserve no sympathy or funding because you left it too late, despite having paid tax since your early 20s.

evilgiraffe Wed 20-Feb-13 17:13:25

Psychological effect, not psychiatric, my apologies.

LineRunner Wed 20-Feb-13 17:16:31

I have never experienced fertility problems but I support these changes to the guidelines, both raising the age to 42 and shortening the referral time. It gives greater parity.

EuroShagmore Wed 20-Feb-13 17:30:16

Xenia, were your births on the NHS? How much do you think 5 of those cost? Did you think about the implications for NHS finances before you conceived? I do however agree that there should be no postcode lottery for health services. The disparity is ridiculous.

Viva you said "If people have got past their mid/late 30s without trying for a child then they've left it too late through their choice." Have you not read the thread? There are loads of posts about how long it takes to get through the system. I very much doubt that anyone gets to 42 and thinks "ooo, I'd quite like a baby now" and starts hammering on the door of the IVF clinic. I can think of one woman from the conception boards who was trying for 10 years, adopted a child and recently became pregnant at 40 from (private) IVF. It's hardly like it suddenly occurred to her that she might like a child.

curryeater I agree with evilgiraffe. Infertility is like an all-consuming kind of grief. It is without a doubt the hardest thing I have gone through, and both my parents have had cancer, and I have watched them go through horrific treatments and awful times. I'm not at all surprised by the long quoted passage a couple of pages back about the psychological effects of infertiltiy.

DeepRedBetty Wed 20-Feb-13 17:34:41

I'm not qualified to argue about what is an appropriate age limit, or how many cycles should be funded, or if the NHS should be involved at all. Our ddtwins were unplanned, the direct result of a monumental piss-up contraception failure. The issue to me is that it all depends on which health authority area you're in. I know 'postcode lottery' affects quite a few common medical conditions, but IVF does seem to be one where the differences are particularly glaring. Just knowing that whether you're in Brighton, Bournemouth or Blackpool, you'll get the same help, would be wonderful. Even if it was no help at all, at least everyone would know where they stood.

I appreciate the postcode lottery and the ethics of what the NHS should even fund in the first place are not what are up for discussion here.

EnjoyResponsibly Wed 20-Feb-13 17:37:07

Xenia whilst I'm always interested and comforted by your work own financial capability, can I just say that I self funded 6 rounds of IVF. So i know exactly the cost. would you like to see the invoices? Also I work now to support the resulting DS.

ILikeBirds Wed 20-Feb-13 17:39:41

I would prefer to see something that would ensure universal treatment offered across the country than a raising of the age in guidelines which may or may not be followed.

curryeater Wed 20-Feb-13 17:39:42

I do not doubt or question the all-consuming grief of infertility. But is grief a medical issue?

EnjoyResponsibly Wed 20-Feb-13 17:42:11

Curry no, but neither is gastric band surgery. There's probably far fewer of these than IVF treatments to be fair, but there's a lot of non-essential costs in the NHS. Why should it be fertility treatments that get the push when a person could just go on a diet?

RedToothBrush Bosnia-Herzegovina Wed 20-Feb-13 17:43:04

I would prefer to see something that would ensure universal treatment offered across the country than a raising of the age in guidelines which may or may not be followed

Thats not NICE's remit though. NICE's remit is merely to recommend best practice. It would take government policy to change the enforcement of such recommendations. Personally I am of the opinion that what is actually is the point of NICE if it can just be ignored whenever it takes the political whim of whichever PCT is ignoring it. It is one of the biggest failings of the NHS and not one of the major three parties is doing anything to address this.

FrankellyMyDearIDontGiveADamn Wed 20-Feb-13 17:51:03

Recent research has found that a diagnosis of infertility is as hard on a person as the diagnosis of a terminal illness or the death of a loved one. The pain it causes is not to be belittled.

As someone once said to me, if you had diabetes you would seek help from a Dr; if you were short-sighted you would get glasses to correct the problem. Infertility is not a self-inflicted problem, so why is it that couples should not seek help for it?

VivaLeBeaver Wed 20-Feb-13 17:53:44

Gastric band surgery actually can very much be deemed a medical issue. It's cheaper for the Nhs to give someone with significant writ issues a gastric band than it is to deal with all obesity related complications such as diabetes further down the line. So gastric bands save the Nhs money.

BasicallySFB Wed 20-Feb-13 17:54:30

redtoothbrush - you talk so much sense smile

And frankelly - that's so true. It's far beyond a minor upset - it can be (for some) absolutely soul destroying. In part confounded by the societal expectations as addressed above, and the sheer unfairness of the treatment incoherence depending on PCT.

Tailtwister Wed 20-Feb-13 18:02:53

Yet again adoption is being bandied about like it's the solution to everything. Not everyone is suitable to adopt (regardless of age). Surely these children deserve parents who actually want to adopt them, not those whose default position is adoption when they can't have their own biological children. Of course there are couples who are infertile and are well suited to be adoptive parents, but it shouldn't be the get out clause for infertility.

As for the extension on age limit, I agree with it. Take for example our situation. We married when I was 30 and tried to conceive unassisted for 3 years. We then sought help and had the initial investigations carried out on the NHS. That took around 1 year. Then we started our first cycle (self funded), when I was nearly 35, the next when I was 36 and the final, successful cycle at 37. DS1 was born a few months before I turned 38. If we had waited for NHS funding, it would be likely I would have been close to 40 before our 3rd attempt.

captainmoll Wed 20-Feb-13 18:08:45

I think it's really important to try very hard to separate the medical facts behind this debate from the social/political emotive baggage. I'd be interested in responses to these little hypothectical questions:

If women had evolved so that we had no menopause, what age would be considered 'too old' to be a good mother?

If men had a menopause - I mean an absolute cessation of sperm production, rather than the average fertility slump in levels - what would your opinion about fertility treatments for them be like?

(In the latter case, personally, I suspect fertility treatment would be less taboo, better funded, more widely available regardless of age).

I was interested to see that 12ylon you mentioned your fathers age as well as your mothers. It's seems pretty unusual whenever I find this topic being debated. The focus is very much on the age of the mother. I do see your point, and it's a fair one given your experience. However, as life expectancy steadily increases, and better treatments for the medical problems that go along with this improve, it will hopefully become less of an issue.

If IVF for older women is disallowed bcause of clear medical facts around failure of the pregnancy, or health damage to the mother (beyond the usual risks of pregnancy, which, let's face it, is already fraught with peril), then let's assess the argument on that basis.

I do feel though, that so often the argument comes from a place of societal and political prejudice; that a woman can be deemed to be past it, while a man can make babies at any time of life. It's problematic, to say the least, and for me it raises a whole bunch of issues and questions that go well beyond arguments about budgets and health.

I am behind these recommendations. Women are capable of conceiving naturally at this age - it is biologically possible. I also think it should be available sooner, and that postcode lotteries should be erased. There should be better counselling, and perhaps a drive to encourage younger women who know they wish to put energy into their careers first to freeze eggs; to plan their potential motherhood as a carefully considered part of their futures with as much validity and information behind that decision as behind their working life.

Sheila Wed 20-Feb-13 18:10:19

Firstly, I think everyone who is a taxpayer has a right to an opinion on what the NHS budget is spent on.

Secondly, however heartbreaking childlessness might be, it is not a life threatening condition, unlike obesity , alcoholism etc.

If the NHS had an infinite budget then fine, but I'd rather see the money go towards better care for Alzheimer's sufferers, for example.

EuroShagmore Wed 20-Feb-13 18:10:28

curryeater that wasn't the point I was addressing, but now you mention it the NHS does many things besides trying to cure medical conditions. It helps people to stop smoking, it offers contraception, it provides gluten-free foodstuffs on prescription for children who need it, it provides facilities for childbirth and pregnancy.

The fact remains however that infertility is in the vast majority of cases caused by some sort of medical condition affecting one or both partners. Why shouldn't that be treated? The treatment preferred by the NHS is IVF, because it resolves a multitude of issues. Personally I would have preferred to be properly diagnosed and treated for the specific issue affecting my fertility, rather than dumped in the "unexplained" category and referred for IVF. But that doesn't seem to be considered cost effective because IVF will probably deal with the underlying issue, whatever it may be.

PolkadotCircus Wed 20-Feb-13 18:12:50

Re gastric band sorry it costs ££££££,is risky and life changing. I think also it could lead to laziness ie patients sitting back and not getting to grips with their weight issue themselves and leaving it to the NHS to make less food end up in their stomachs.

FrankellyMyDearIDontGiveADamn Wed 20-Feb-13 18:13:56

Sheila, but you could argue that conditions like alcoholism and obesity are often self-inflicted. Infertility is not.

Sheila Wed 20-Feb-13 18:18:12

Frankelly yes but medical care isn't dependent on whether a condition is self inflicted or not, fortunately.

VivaLeBeaver Wed 20-Feb-13 18:18:14

But infertility if left untreated doesn't cost the Nhs money.

Unfortunately the majority of pct funding decisions are based on whether its value for money.

Gastric bands are 5k private, so will cost the Nhs less I'd imagine. Not sure how much ivf is,......12k a cycle?

RedToothBrush Bosnia-Herzegovina Wed 20-Feb-13 18:19:06

You could also argue that since infertility is linked to mental health that it might be life threatening too, in extreme examples.

EuroShagmore Wed 20-Feb-13 18:19:33

Viva a privately-funded cycle at my NHS clinic was just over £3k. Of course, the NHS would pay less than that.

Sheila Wed 20-Feb-13 18:20:41

Red, yes it might be, but I don't think we should build healthcare around a possibility.

RedToothBrush Bosnia-Herzegovina Wed 20-Feb-13 18:22:46

Red, yes it might be, but I don't think we should build healthcare around a possibility

Really??! You don't think it is?! Healthcare is ALL about managing risk!

FrankellyMyDearIDontGiveADamn Wed 20-Feb-13 18:23:21

My fertility clinic charges about £3k per IVF cycle too.

If we're saying that infertility treatment is non-essential, then the same goes for non-reconstructive plastic surgery. If the "damage to self-esteem/mental health" cannot count towards IVF then it shouldn't count for anything else either.

Northey Wed 20-Feb-13 18:25:51

Frankelly yes but medical care isn't dependent on whether a condition is self inflicted or not, fortunately.

No, but it could be made so, if what we are doing is looking to save money. There are all sorts of criteria we could introduce.

I don't think that IVF up to the age of 42 is a particularly good use of public funds tbh

This is what I think. The NHS is short of money already with life saving treatments limited. A line needs to be drawn somewhere and, personally, I think 42 is far too high.

RedToothBrush Bosnia-Herzegovina Wed 20-Feb-13 18:28:39

How many years of mental health treatment would you need to clock up £3k?

PolkadotCircus Wed 20-Feb-13 18:31:18

Viva yes infertility left untreated does cost money-2x treatment for depression,care for the childless elderly,pcos and endo improve hugely with pg,some cancers are higher in childless women.

PolkadotCircus Wed 20-Feb-13 18:32:59

IVF is 3k and infertility isn't a choice -smoking and most obesity/lack of exercise illnesses are.

RedToothBrush Bosnia-Herzegovina Wed 20-Feb-13 18:33:23

Precisely Polka. The short sighteness of people saying "we can't afford it" is annoying. Its not as simple as the obvious price tag.

Northey Wed 20-Feb-13 18:34:57

dragon, success rate for 42 year olds now is the same as it was for under 35 year olds when that criterion was set. What is the difference between giving someone that shot when they are 35 and giving it to them when they are 42?

What is the difference between giving someone that shot when they are 35 and giving it to them when they are 42?

The cost of funding the treatment for more people. That should be obvious.

Northey Wed 20-Feb-13 18:47:46

Heaven forbid that more people should be helped. Let's cancel school hearing tests too. That'll save the cost of a few hearing aids.

So are you ok with the other suggestions here that referral times should be shortened? That would have the same effect of getting people treated before the current age cut off.

expatinscotland Wed 20-Feb-13 18:52:09

Fantastic! A mate of mine has been referred after losing her only child, conceived with fertility treatment, to cancer. She's 39. Hope their next cycle is a success - they are fantastic parents!

Clearly you think the NHS is a bottomless pit of money, Northey.

Sheila Wed 20-Feb-13 18:57:14

I'm sure there are plenty of people (including me) who would argue that alcoholism is a disease not a lifestyle choice, and, as I said before, it's life threatening, whereas infertility isn't.

Northey Wed 20-Feb-13 19:00:08

That isn't a reasonable assumption to make, dragon and certainly doesn't work as an answer to anything i have said.

RedToothBrush Bosnia-Herzegovina Wed 20-Feb-13 19:00:10

Clearly you think the NHS is a bottomless pit of money, Northey

Its not, but then equally, rationing can't be done on price tags and short term financing either.

Long term cost effectiveness is far preferable than short term yearly budgets. Which means that decisions being made on short term yearly budgets could easily be costing us all a lot, lot more over a 5year period or even a twenty year period.

This is one of the other massive issues of the NHS - short termism and passing the costs off to other departments and not tracing this...

Whats the saying about buying good shoes, built to last?

Northey Wed 20-Feb-13 19:01:58

What about the example of partial deafness, sheila, or the desire breast reconstruction after mastectomy? Neither of those is life-threatening. Do you think they should be untreated too?

FrankellyMyDearIDontGiveADamn Wed 20-Feb-13 19:02:53

But is infertility not a disease that needs treating? I have Polycystic Ovaries meaning, like it sounds, my ovaries are covered in cysts which inhibit normal hormone production. Why is one disease more deserving than another? Not all diseases are life-threatening: eczema is not, so shall we give up treating that?

Obviously there have to be lines drawn in the sand and im not advocating unlimited IVF for anyone who wants it, but fertility treatments do seem to take an awful lot of bashing whenever NHS funding is discussed.

Northey Wed 20-Feb-13 19:08:35

Alzheimer's isn't life-threatening. IBS isn't life-threatening. Hell; a broken leg isn't life-threatening. All those things are addressed with measures that are paid for from the health budget.

Sheila Wed 20-Feb-13 19:16:05

childlessness is not a disease - the causes of it might be, but you can treat these without providing IVF.

Matildaduck Wed 20-Feb-13 19:24:19

Sadly it's all about success rates with IVf.

I think it would be good if you could pay towards your ivf if your chances are slim. To be told no is horrific. To be told well its not that likely but if you want to you can pay x% towards we'll let you have three goes.

Then it wouldn't be so expensive.

Northey Wed 20-Feb-13 19:27:14

The cause of my childlessness is having only one Fallopian tube, which is scarred shut. It would be rather more expensive to treat that than it would be to give me ivf.

evilgiraffe Wed 20-Feb-13 19:28:59

How do you propose diagnosing and treating all these myriad problems, Sheila? IVF is the go-to answer because it's cheaper than finding out the real problem, and may well be the only answer anyway.

What do you propose the NHS do with me and DH - we are "unexplained", but at the age of thirty and three years TTC with nary a sniff of a pregnancy, we are quite clearly infertile. How many tests can be done? The doctors don't know what's wrong, but they have a half-decent chance of solving the unknown problem with IVF, so why can't we try it?

Allthingspretty Wed 20-Feb-13 19:35:36

I dont know what it feels like to want a child so much that you would go through ivf.

I personally dont agree with the chamges to the guidelines.

PolkadotCircus Wed 20-Feb-13 19:39:40

Well if you did you would agree.

beginnings Wed 20-Feb-13 19:41:16

I have one DD who was the result of my fourth IVF cycle. The first was on the NHS. We were offered two by our PCT but the clinic wanted to follow the same protocol for the second go even though they told me it wouldn't work. We went privately. For those who say you can only do one or two cycles a year, that's not true, I did four in eight months.

Evilgiraffe I'm not sure that trying IVF instead of doing much testing is always the right way forward. In my opinion, the issue with these guidelines is that they're not putting the money where it would be most sensibly spent. The NHS, in my experience, is way behind the private sector in terms of testing and research but (rightly) will only follow clinically tested protocols. For instance, the NHS do not yet test for levels of anti mullerian hormone in women. The private clinics do it as a matter of course and it's a very strong indicator for levels of ovarian reserve which is an important factor in deciding what protocol to follow in many cases. In addition, the NHS doesn't do the level of immunology testing that the private sector does. If I had had the two sets of tests I detail here, at a cost privately of £550, it is perfectly possible that my first round of IVF would have worked. That would have saved the NHS potentially, and me definitely, a vast amount of money. The NHS protocols still seem to follow the premise that IVF is designed to help people with blocked tubes who otherwise are fertile. That isn't the case for a lot of people seeking fertility treatment.

I was just 32 when I started trying to conceive and 35 when DD was born so I started late, but not that late.

Phineyj Wed 20-Feb-13 19:43:57

In my opinion this change to the guidelines is pretty much pointless (although reasonable clinically -- success rates at older ages have increased quite a bit). It's already nearly impossible to access NHS IVF in most areas and the wait to see a specialist is about a year in our area and then a year in between appointments. I doubt it's very different elsewhere.

We paid for two rounds of IVF privately, the second successful. We were treated abroad as our consultant was honest with us and explained the treatment we needed would mean waiting at least 2 more years in the UK but would be available immediately in other countries. Although I was several years under the age cut-off when we realised there was a problem, it seemed very likely that once we'd got through the NHS delaying tactics that I'd be too old, and that was without the issue of additional waiting time for our specific treatment. It seemed insane to travel thousands of miles for a couple of outpatient procedures, but it was basically our only option other than giving up (we applied for adoption by the way...were told we couldn't be considered as we hadn't given up hope of birth children..it is a Catch 42).

However, stopping IVF on the NHS altogether would essentially be saying that only well off people with the misfortune to be infertile can do anything about it -- which would be very unfair. It would also be a great shame on the country which invented IVF.

I also think people should bear in mind that IVF is the only NHS treatment which has the potential to create future taxpayers!

What I think would be more helpful, rather than increasing the age cut off when in reality the numbers accessing NHS treatment will remain vanishing small, would be a requirement for every PCT area to have a clinic in primary care that would give neutral, evidence-based advice on fertility to those who need it, going through all the options and their costs (including pointing couples towards counselling, and adoption where appropriate). I lost count of the GPs we saw, and hardly any were helpful or even seemed to know anything about infertility, which is astonishing when you think how many patients must present with it.

I agree with the poster above that GPs & specialists should be honest about how unlikely it is IVF treatment would be provided in any timely way. However, the NHS could bulk purchase IVF services and then pass the cost onto patients, or means test? At the moment there seem to be clinics making excessive profits out of vulnerable people, a lack of quality control and it is very difficult for the layperson to know how much to spend, what treatment is best or what the true chance of success is. And that's before you even get into the fact that you can travel abroad for these treatments, at which point HFEA basically wash their hands of you.

Of course no-one has a right to have a child but surely at the very least we have the right, in a country with an NHS, to be able access impartial, honest advice and not to be denied access to a proven treatment where we meet the clinical criteria, simply because of where we happen to live.

timidviper Wed 20-Feb-13 19:54:38

I work in healthcare and know how difficult the juggling is with healthcare budgets. In a perfect world I would think this is a great idea but sadly this world is not perfect, we have a finite pot of money and, weighing in the likelihood of poor success rates and increased risks of complications which could incur even more costs, I would probably prefer that money go to other areas with a higher measurable success rate.

evilgiraffe Wed 20-Feb-13 19:56:29

beginnings - I was thinking from a purely financial point of view. IVF is the go-to because it has a reaonable chance of success, and is cheaper than testing for a whole host of different potential issues.

Phineyj - yes, it would be incredibly helpful to be able to see someone for advice. My GP is neither knowledgeable not interested in fertility problems, but thankfully is co-operative with referral requests. We are prepared for our IVF appointment next month to give us a long wait before treatment can start - in which case we'll go private despite meeting NHS criteria and living in a PCT that offers us three cycles. We may be young, but we're already three years in and don't want any more needless delays.

CaliBee Wed 20-Feb-13 20:01:57

I think its a shame that the government have seemingly only extended the IVF service...correct me if I'm wrong. IVF may not be the best way forward for all 40 plus women. An extension to all fertility services would have been more useful I feel.

MrsDeVere Wed 20-Feb-13 20:07:10

I have read most of the thread.
I am disappointed but not surprised to see the same arguments being trotted out.
Infertile women are to blame for people being denied cancer treatment.
Infertile women should not be so entitled
Infertile women should adopt
Infertility is not life threatening.

Budgets across the NHS are not as simple as '1 round of IVF = I less course of chemo'
Desire and even desperation does not = sense of entitlement
Adoption is NOT the same as giving birth and there are very few babies available for adoption. Adoption is a separate and distinct issue.
The NHS treats a vast array of non life threatening conditions. Many of these conditions could be treated without medical intervention but we still often use the quickest and most expensive treatments regardless.

Fund IVF for women up to 45. Make it uniform across the county and speed up access to prevent unnecessary delays.

beginnings Wed 20-Feb-13 20:08:49

evilgiraffe I'm thinking from a financial point of view too. The tests I had (a number of which I had on the NHS by the way, the private clinic just told me what to ask for and I was lucky enough that my surgery were prepared to do them, although there was an approval process for one of them) all added up to a LOT less than an IVF cycle.

Conversely, when I pitched up at Guy's for my first NHS cycle (which was cancelled as I didn't respond well to the stimulating drugs), the only test they did was for FSH and then went straight for IVF. I think that's mad.

evilgiraffe Wed 20-Feb-13 20:14:47

Fair enough - although if the results had suggested you'd needed IVF anyway...? <shrug> I don't know, I'm not an economist.

Hear, hear, MrsDeV.

beginnings Wed 20-Feb-13 20:25:26

Well, that's a whole other story. I'm currently pregnant with number 2 with no fertility treatment but am taking the drugs that I was prescribed during early pregnancy the last time which may well be why this one is sticking and my first two pregnancies didn't. So, did I need IVF? Would other better courses of investigation have helped? I don't know.....

MrsDeV, I completely agree with you up until your last sentence and would have been heartbroken had I never had children. The two and half years I spent trying to conceive were the hardest of my life and much shorter than most other peoples waiting times.

But, the NHS does have to think about how to apply resources and, in my experience, IVF is too quick an option. GPs are horribly uninformed about infertility treatment - and don't get me started on their ability to deal with the process of getting treatment - let's improve that, and testing, and then maybe people will get quicker, better help. IVF is no fun. I wouldn't wish it on my worst enemy.

zzzzz Wed 20-Feb-13 20:27:34

I welcome the change..

beginnings Wed 20-Feb-13 20:33:32

side note - best of luck evilgiraffe I hope your appointment goes well and you have success soon.

johnnybear71 Wed 20-Feb-13 20:35:32

Ok so I'm ready to be slammed and please this is just my opinion and I don't wish to offend or belittle anyone's feelings....I feel for those women who can not conceive and as a father i understand that urge to want to be a parent....however surely its time for us as species to stop "playing god" (I'm atheist). We have over 7 Billion people on the planet who are finding it hard to find food and this is only going to get worse....Now please I do understand that having you own child is very important but surely if it is not meant to be then its not meant to be....There are so many children in care needing a forever home and I know its not the same but men (and women) have always been there as step parents so why not just take the step...I couldn't imagine being without my kids and like i said I really do with my heart feel for childless couples but I also feel for those mother and fatherless children in the care system stuck there for years waiting for a mummy and daddy to look after them....I hope I haven't upset to many people and hope the following links are helpful to anyone wishing to adopt...xxx
www.adopting.org/adoptions/older-parent-adoption-adopting-after-40.html
www.barnardos.org.uk

williaminajetfighter Wed 20-Feb-13 20:38:38

I'm very in favor of the changes even though, as others have said, they are just guidelines that don't need to be followed.

While I appreciate that budgets in the NHS are tight and not infinite, I've seen the waste of NHS health promotion programs and money spent on projects that don't always work. Or the duplication in health promotion like the 10 different posters at my doctors office, produced by 10 different organizations all promoting breastfeeding. Why so much duplication of effort? Don't even get me started on PFI schemes. By comparison I think an investment in IVF services seems reasonable.

It also seems that infertility is a growing problem and it would be wrong for the NHS to ignore it. Also offering IVF up to 42 seems a fairly reasonable request for couples when the fact is that many couples aren't in a position to TTC until they are in stable jobs and can afford homes, which stats show is often late 30s.

Another point --- so much care is spent on the elderly and not all treatments work or are effective. Can you imagine if the elderly over a certain age were denied treatment because it was less likely to work, due to their age or condition? eg. can you imagine if they created a policy that 'after 85 your chances of survival are slimmer and your body has deteriorated to such an extent that we won't treat you for XX and XX'. It may be that this is decided on a one-off basis by realistic health professionals in discussion with family, but a blanket policy??!! People would be up in arms because 'some 85 year olds are very healthy' and others, of course, are not... and issues about equity and fairness would abound. How different is a policy re: IVF?

MrsDeVere Wed 20-Feb-13 20:41:22

johnnybear are your children adopted?

evilgiraffe Wed 20-Feb-13 20:41:25

Is it playing god? Or is it addressing a medical problem? Would you deny treatment of another type of organ failure? At what point do you decide that it's not meant to be? Many people would say that failed IVF is where they draw the line. As MrsDeVere said, adoption is not the same as giving birth, and is a separate issue.

PolkadotCircus Wed 20-Feb-13 20:43:06

Johnnycake being infertile doesn't automatically make you a suitable adoptive parent.

PolkadotCircus Wed 20-Feb-13 20:43:36

Johnnybear not Johnnycake-damn IPad!

MrsDeVere Wed 20-Feb-13 20:43:44

beginnings you have far more knowledge than I so I will concede your point smile
I suppose what I meant is that the most effective treatments for each person should be more readily available. Whether that be IVF or something else. It all seems such a lottery at present.

evilgiraffe Wed 20-Feb-13 20:46:47

Oh, and thank you, beginnings, I am 50% terrified and 50% excited about the first appointment!

beginnings Wed 20-Feb-13 20:51:18

MrsDeVere that puts it perfectly. It's about the most effective treatment for each person, not broad brush headline grabbing policies. It's about GPs and other HCPs taking the time to listen and take action on the basis of patient need rather than a checklist and taking the time to inform themselves of the best options if they don't know them.

Sigh.....a girl can dream, can't she?

I completely and utterly recognise the pressure that primary care HCPs are under and the above is no way meant as a criticism. In my experience in most cases it's the system that's broken, not the effort and commitment of individuals.

beginnings Wed 20-Feb-13 20:53:10

Of course you are evilgiraffe! If you've not sought support on some of the assisted conception threads here yet, do. The women here are great. Or PM me if you want to ask about questions or anything - my main experience is obviously limited to me but I know a lot of people who have had assisted conception treatment for lots of different reasons.

Hijack over!

evilgiraffe Wed 20-Feb-13 20:57:08

Never fear, I have the support of two separate quiches on MN (is that even allowed?!) as well as RL people, so hopefully will be okay. Thank you for the offer though smile

gaelicsheep Wed 20-Feb-13 21:00:09

I wonder if the people advocating adoption as the solution have ever looked into it themselves.

1) There are very few babies and very stringent restrictions in place before you even have a hope of adopting a baby. The fact there are very few babies is a GOOD thing.
2) Beyond newborn babies, when you are looking at adopting a young child you are opening yourself up to dealing with a huge number of difficulties with the child's mental health, possibly physical health, delayed development etc. caused by the trauma they have been through. It is not something to be considered lightly.
3) If the adoption people even sniff that you still hanker after your own baby or that adoption is your second best option you will be very lucky to get as far as an adoption panel - rightly so.

Now of course if the comments last night about families with more than 10 children are anything to go by, the problem of the number of babies and children up for adoption could be solved in one fell swoop, but I don't think anyone seriously believes that is desirable.

We were just embarking on the road towards adoption when I fell pregnant naturally (after trying for 4 years). We'd had our first meeting with an adoption lady (can't remember the appropriate job title!) and done a fair bit of research so I know just a little about it. We read enough to begin to have very serious second thoughts that it was the right thing for us, and that was not because we were not desperate for a child, because we were! But being desperate doesn't even begin to qualify you to be suitable for the very special commitment of adopting a child.

OliviaMumsnet (MNHQ) Wed 20-Feb-13 21:00:39

AHEM

FrankellyMyDearIDontGiveADamn Wed 20-Feb-13 21:02:24

Agree that the time it takes to get assessed/start treatment takes far too long.

It's been 2 years since I first went to see my GP with concerns about my fertility. In those two years I've had just 3 appointments with a fertility specialist, 1 operation (laparoscopy), 5 rounds of Clomid and have just come to the end of a second round of ovulation induction. But from talking to others it seems I've been lucky to get that much. Surely that can't be right in this day and age.

gaelicsheep Wed 20-Feb-13 21:03:26

Hello OliviaMumsnet?

CaipirinhasAllRound Wed 20-Feb-13 21:03:53

It's a recommendation only, it doesn't mean anything will actually change.

Having just found out on Sunday that my one funded NHS IVF attempt has failed, I now have to pay for any future attempts, which is understandable. I am 35, have been trying to conceive for over 3 years and neither my husband or I have any children. Other than 2 days last week when I had faint positive lines on 2 pregnancy tests, I have never been pregnant.
I agree that I shouldn't expect to be able to have a baby, but I want one. I also don't expect the NHS to have to keep paying for me as I know it's not essential treatment. But as my doctor pointed out to me, not everything the NHS pay for is essential treatment, broken limbs from skiing accidents for example. I don't have to have a baby, you don't have to go skiing

ArielThePiraticalMermaid Wed 20-Feb-13 21:10:27

Would you like a cough sweet Olivia? grin

johnnybear71 Wed 20-Feb-13 21:17:39

Maybe if we actually stopped with all the life preserving treatments maybe we could sustain our time on this planet...I've lost family and a child and still I believe that for the sake of "feelings" we are destroying the place we live in...Why would anyone go through years of pain (both physical and emotional) 1000's (sometimes 10's of thousands) of pounds? when there are so many children waiting is beyond me, i wish i could adopt but they wouldn't give a single gay dad of 4 the time of day.....People say "you just don't know what you're getting with an adopted child" (sorry for this bit) so fucking what!! you don't know what you're getting when you conceive naturally or through IVF so why does it matter...of course if you want a "designer baby" (oh yes this is where its going for the sake of "science") then crack on with it but if what you have is love for a child then go love a child....x

johnnybear71 Wed 20-Feb-13 21:18:35

THIS COUNTRY NEEDS FOSTER PARENTS TOO......!!!!!!!

rodandtheemu Wed 20-Feb-13 21:21:16

IVF is nothing short of miraculous. I know from first hand experience. You cant judge people for wanting this untill you have walked a mile in there shoes.

Most people wont even see it any way due to the post code lottery.

CaipirinhasAllRound Wed 20-Feb-13 21:22:47

Nice post johnny
You wouldn't be without your children but me wanting my own children is me wanting a designer baby?

PolkadotCircus Wed 20-Feb-13 21:24:32

Johnny my children aren't designer children anymore than those conceived naturally are.hmm

The fact is many children in care need specific types of people as parents,their challenges are far harder to handle than those of children not dealt a shite hand in life.Not all parents are equipped to deal with these kids,they just aren't,very few are I suspect.

BasicallySFB Wed 20-Feb-13 21:24:47

johnnybear - do you really, honestly think adoption is that simple? Practically, emotionally, physically? Really?

It's not like popping to the Children Shop and picking a child.

Love is not all you need to be an adoptive mother or father.

Seriously. I find it to be a really offensive attitude towards the countless people who are battling infertility currently. Of only it were as simple as you paint it.

Skyebluesapphire Wed 20-Feb-13 21:26:47

The comments about leaving it too late are a bit harsh. i didn't meet my XH until I turned 30. If I had had a child before then, just to be the "right age", I would have been a single parent for the sake of having a child. I married at 33 and had my first and only child at 36. Not by choice, but just because that's how my life panned out.

XH had a very low sperm count and hypospadius, I had endometriosis. We were very lucky to conceive, but if we hadn't I wouldnt have had IVF as I was too overweight and wouldn't have been considered for it. If I had been ten years younger I would have gone for it.

I have one friend who is 42 and had 3 miscarriages. Despite her age, they wouldnt do any tests until she had had 3 of them. She had tests, nothing wrong.

Another friend was turned down for IVF for various reasons. She then developed endometrial and ovarian cancer and had a full hysterectomy at the age of 34, so no chance at all of having her own kids.

I think that IVF should be available to all, so that everybody could have one child if they need assistance to conceive. It should not be a postcode lottery, it should be the same across the country.

ArielThePiraticalMermaid Wed 20-Feb-13 21:27:00

There have been debates about over population in the last few days, Johnny.

Perhap you should find it so we can stick to the topic at hand.

ArielThePiraticalMermaid Wed 20-Feb-13 21:28:19

And PS there's no need to shout.

evilgiraffe Wed 20-Feb-13 21:30:20

"Dad of four" is probably the biggest factor against you, Johnnybear. That is a large family, and I can imagine it would be daunting for an adopted child to join you, though I'm sure you're more than capable of providing a loving home.

DH and I will probably try adoption if IVF fails. Until then, though, I would dearly love to pass my own genes on - I think we're worth it. I couldn't give a damn about "designing" a child, but conceiving one at all would be a huge deal for us.

Olivia, are you okay? I'm confused.

gaelicsheep Wed 20-Feb-13 21:31:08

Frankly the issues of infertility/IVF treatment and adoption/fostering are totally unrelated and do not merit extended discussion on the same thread. They are not either/or options.

Children who need families need families who want THEM. They don't need families who want them to make up for not having their own. Fostering in particular would be totally unsuitable for a family who have been desperate to have their own child.

expatinscotland Wed 20-Feb-13 21:32:08

'Maybe if we actually stopped with all the life preserving treatments maybe we could sustain our time on this planet...'

Words fail me.

ArielThePiraticalMermaid Wed 20-Feb-13 21:37:05

Take no notice expat. It's just a stupid, ill thought out comment x

livingzuid Netherlands Wed 20-Feb-13 21:38:07

Have read this with great interest and a got bit emotional, so hope you will forgive the long post. It always astonishes me how different things are across the Channel. In The Netherlands where I am, many women don't start families until they are in their 40s which is considered absolutely fine. We pay for our health insurance same as we would our NI and I am entitled to three rounds of IVF all included in my package and it wouldn't be a problem for me to start this in my 40s if I so choose. Granted, we pay a bit extra every month for an enhanced deal (it's sort of state but private at the same time and you have to pay, I don't really understand it), but for us it is worth the extra 30 a month which covers all sorts of other things as well such as free eye and dental care!

Yes, it's a much smaller population here but I think France and Germany too have very good IVF schemes.

At the (grand) age of 34 after having met my dream man two years ago (after a divorce), we had been trying for a year and a half when I trotted down to our GP and got an immediate referral to a specialist gynecological unit and an appointment within 2 weeks. On forums I have read, I've seen people complain of waiting lists of six months confused personally I didn't think that was too bad! I know of women who traveled to Belgium to clinics as it was a) faster and b) cheaper. Not sure if there isn't some sort of reciprocal agreement either but I could be wrong.

I am sure there are expats and Dutch ladies on this forum who would say I am looking at the system a bit too much with rose-tinted spectacles, but from my experiences here it has been so much more straightforward. It's mainly that the outlook is just so totally different and it's just accepted that yes, as a woman you would like the opportunity to at least try for a family with your loved one.

When trying, I felt like a complete and total failure as a woman every time my period arrived. It was the most dejected, depressing awful feeling in the world that I couldn't give the man I loved babies. Having gone from a marriage where I couldn't ever stomach the thought of children to where I so badly wanted to provide the man I love with a family and not being able to do so broke me every month.

To some of the posts here who say it is only natural to not get pregnant if it just isn't going to happen, well my pragmatic, ruthless side would agree - that was my opinion with my ex. But now I totally understand that desire and feel a bit ashamed of my past opinion.

I nearly went through the pain of IVF (and who knows, I may still have to). I have had a friend who went through it with heartbreaking results on the first time. With my health issues, should my DH and I be denied the chance of a IVF because it would impact on my health too much? Who has the right to make that decision apart from us - we go into it eyes wide open. What IVF continues to do is offer hope. I would not want to take that away from anyone.

I am thrilled that the UK is bending a bit on this issue. I wish it would look to its neighbors to see if there are some lessons to be learnt on providing such care and save families and ladies spending 10000s.

Sheila Wed 20-Feb-13 21:38:25

Mrs DV - Why does it follow that because someone is desperate for a child the NHS must obviously enable them to have one?

Hard not to see that as entitled.

GinAndSlimlinePlease Wed 20-Feb-13 21:40:08

I'm biased from personal experience, so I agree with the revised guidelines. as others have said though, what really matters is how your pct applies them.

I've got fertility problems. It sucks. It is really upsetting. And the reasons are medical, not because I'm too old. in fact, my DH and I started ttc before we were married because we expected some problems. If we hadn't, we'd just be going through everything a year later and older.

I don't see myself as any more entitled for fertility treatment as I was for broken bones. In fact, I think it's amazing we live in a country with the NHS. And any IVF treatment I receive will be a blessing.

This is a really sensitive issue for those of us suffering from infertility. And trust me, having ivf is not a decision taken lightly.

PolkadotCircus Wed 20-Feb-13 21:40:30

Hard not to see wanting treatment after you have ruined your health by choice with cigarettes,food,alcohol or laziness as entitled.

gaelicsheep Wed 20-Feb-13 21:41:57

Sheila - you talk as if a child was a lifestyle item, like a car or a nice house. Now maybe to people who can pop them out without a second thought that's all they are, I do sometimes wonder the way people talk on here. But really it is an incredibly foolish and heartless way to talk to women who long for children they may never have.

Sheila Wed 20-Feb-13 21:42:03

Polka- alcoholism is a disease, childlessness is not.

gaelicsheep Wed 20-Feb-13 21:43:29

You have no f*cking idea

ArielThePiraticalMermaid Wed 20-Feb-13 21:43:42

Sheila I find your lack of comprehension and empathy startling.

I have paid into the NHS since I was 22. I have barely used it (before 2012 usual screening and a bout of bronchitis).

Is it the word "desperate" which troubles you? Does this indicate desire and want and therefore entitlement?

PolkadotCircus Wed 20-Feb-13 21:44:13

Errr. I think you'll find pcos,endo and depression cased by childlessness are.

evilgiraffe Wed 20-Feb-13 21:45:15

Enable them to try to have one, Sheila. It's a basic human drive, you can't just turn it off - believe me, I'd be a lot happier if I could.

Livingzuid - really interesting perspective, thank you. The Dutch are clearly way ahead of us! The thought of a two-week wait for an appointment sounds like some sort of fantasy land. Maybe we should emigrate, I have a Belgian friend who could teach me Dutch...

thixotropic Wed 20-Feb-13 21:45:19

I just think it's bloody outrageous that if the man has kids from a previous relationship, no matter if estranged or adults, then some trusts wont fund IVF.

I was gobsmacked when a good friend had to pay for her own IVF because her dh had grown up 2 kids with his first wife.

How the Fuck can that be the same for the woman as having her own child?

And yet if shed moved 5 miles over the border, 3 cycles on the NHS.

Bonkers.

It would be good if it was the same for everyone.

johnnybear71 Wed 20-Feb-13 21:45:38

I wish everyone trying for a baby all the luck in the world and of course they should try everything available...and I'm sorry if anyone is offended but i still stick to my own beliefs...we didnt have this option a few years ago and for as painful as it people got on with it...what is the emotional cost to the women (and their partners) who go through it time and time again and it fails...what is the success rates?...what are the dangers?...what is the average costs?....We have spent millions of years evolving and a part of that is the survival of the fittest...ok so here we go on johnnybear bashing but its still a fact...we are trying to bend nature to our own means and I think if you just take a look past our own tiny world then maybe we could see that this is just another way of increasing the population...we are bringing more children in to a world that will not be able to cope...I know I must sound like a heartless b******d but I can see the future and its not bright..its very dark in its the next couple of generations will be the ones fighting for survival....i urge you to take a look at the following link and see the numbers out there and show you how much is left....again I'm sorry for any distress I may have caused but the fact is we are bringing more people in to a dying world without thought..xx
www.worldometers.info/

gaelicsheep Wed 20-Feb-13 21:47:15

thixotropic - yes you may have seen earlier we fell foul of that. Kids were nearly grown up and estranged due to poisonous ex (will not go there). And yet they claimed that was enough reason not to even investigate my fertility problems (which included a great deal of pain).

Sheila Wed 20-Feb-13 21:47:17

I'm not criticising anyone for wanting a child desperately, and I feel compassion for women in this situation, but that is a separate issue from whether IVF should be provided by the NHS.

GinAndSlimlinePlease Wed 20-Feb-13 21:47:22

err, Sheila, actually the causes of my infertility are diseases.

Why don't you go do some research other than the daily fail and then come back and discuss?

gaelicsheep Wed 20-Feb-13 21:48:29

In the GP actually sat there with us both in his office, me complaining of two weeks of pain every month, that we'd been trying to conceive for over a year. He sat there and told me to take paracetamol for the pain.

ArielThePiraticalMermaid Wed 20-Feb-13 21:49:06

Yes thank you Johnny.

You obviously feel strongly about this, which is fine, but perhaps you could create your own thread about it.

evilgiraffe Wed 20-Feb-13 21:51:11

I appreciate people have differing points of view on this, but if people could remember how deeply upsetting even thinking about this topic is to many others, it would help. As I said earlier, being infertile is like being in a permanent state of grief. Wording your comments accordingly would be both helpful and kind, even if you disagree with IVF for older women, or anyone at all.

PolkadotCircus Wed 20-Feb-13 21:51:33

So let me get this right you as a father of 4 have the right to use up the world's resources with your oversized family but a couple wanting an IVF baby don't.hmm

Oh and it isn't bending nature,the same happens in the Petri dish as that in the body.It is a very mundane procedure,less nature bending than a lot of cancer treatments I suspect.

Sheila Wed 20-Feb-13 21:53:14

Ginandslim maybe you could read my earlier posts and then come back and discuss?

You have raised the level of debate no end there.

GinAndSlimlinePlease Wed 20-Feb-13 21:53:15

well said evilgiraffe

expatinscotland Wed 20-Feb-13 21:54:26

Since you care so much about overpopulation, johnnybear, I'm puzzled as to why you fathered 4 children.

BlackSwan Wed 20-Feb-13 21:55:10

All this just serves to increase the strain on the NHS. Not just for the IVF session, but also for the resulting pregnancies/births or terminations. I'm completely against it.

Our bodies don't give us a blank cheque - neither should the NHS.

GinAndSlimlinePlease Wed 20-Feb-13 21:55:33

I did read your earlier posts actually Sheila, and found them ill educated. Having children would improve one of my conditions actually.

zzzzz Wed 20-Feb-13 21:57:23

I'm puzzled as to why johnybear thinks naturally conceived children have more right to the Earths resources than ones born as a result of assisted conception.

Oh and I'm straight and have four children as a result of IVF.

livingzuid Netherlands Wed 20-Feb-13 21:57:27

evilgiraffe hehehe it's not the easiest language but the Dutch speak English as well, if not better, than me so I'm very fortunate! Been here just over a year and I can still only just about twist my tongue around the basics and count to 10 which isn't much blush English tends to be used in most international countries.

I know that a lot of women do travel from the UK to Belgium to be treated, although that is privately of course. The NHS is wonderful, don't get me wrong, but the outlook here is so much more helpful to women and families (in my experience anyway). Less ageist - and I do feel that putting an age limit of 42 on IVF is far too low, particularly with the advances in medicine and care in this day and age.

ArielThePiraticalMermaid Wed 20-Feb-13 21:59:14

What do you think the NHS should be used for BlackSwan?

gaelicsheep Wed 20-Feb-13 21:59:35

No the people who increase the strain on the NHS are, in no particular order:

boy racers
other stupid drivers of which there are too many
Friday/Saturday night drunks (male and female) out clubbing
said drunks becoming violent outside clubs
drug dealers (NB dealers, not addicts)
smokers (said with a heavy heart since DH is one, although this too is an addiction)

etc
etc

Women who long for motherhood are not the root cause of the problem.

Sheila Wed 20-Feb-13 22:00:52

Well i'm sure that you'll agree ginand slim (since you're so well educated) that insulting someone's level of education and reading matter isn't a terribly intelligent or polite way of making a convincing argument.

livingzuid Netherlands Wed 20-Feb-13 22:02:39

dammit companies not countries sad

Sheila Wed 20-Feb-13 22:03:29

I am sad to see that there is very little tolerance of alternative opinions on this thread, to the extent that unless you are an infertile woman your views aren't deemed valid.

BasicallySFB Wed 20-Feb-13 22:03:54

Fucking. Hell.

I probably need to bow out now before I get my second ever MN deletion.

The total misunderstanding and lack of basic willingness to hear people's really heartbreaking experiences is quite astonishing. I (naively) never realised that fertility issues could bring out such strong opinions.

I second those who are discussing what other lifestyle / life altering
but not medically necessary treatments should be rationed. Breast reconstruction post mastectomy? Of course. No need for it after all. Treatment for skin conditions? Well it's only a bit itchy / disfiguring / uncomfortable. The person who has been in a fight on a Saturday night after too many pints and needs stitches? A plaster would do.

Bollocks to the psychological and emotional consequences.

You're quite right johnnybear - survival of the fittest means I should not have had treatment that enable my beautiful, clever, funny little DS to be born.

Sheila Wed 20-Feb-13 22:05:07

Oh FFS

johnnybear71 Wed 20-Feb-13 22:06:32

ok ill leave this thread as its obviously a little to emotional for me...and to answer a few insults...I'm 41 and my youngest is 18...so I grew up and can see that having FIVE children (i lost one child to flu) was to much for this world to cope with...People urge to be a mum or dad is powerful and at times overwhelming but the fact remains that the world is over populated and its YOUR children who will deal with it...Naturally or IVF conceived is irrelevant to the fact that there are just many people...I won't have to fight for a loaf of bread but i fear my grand children may....I wish all those trying the very best and hope you get lucky...I'm not bashing a person just the system that makes it possible....xxx

evilgiraffe Wed 20-Feb-13 22:06:55

There have been several different opinions, Sheila. Almost all of them have been tactful. Yours is not one of them, I'm afraid.

Phineyj Wed 20-Feb-13 22:07:40

Johnny the logical conclusion of your point of view is that everyone should be strictly controlled regarding reproduction, not just the infertile.

Sheila Wed 20-Feb-13 22:12:02

Really evil? Seems to me that any posters who haven't agreed 100% with the idea that IVF availability on the NHS have been shouted down and told that unless they have experienced infertility they should keep their opinions to themselves.

gaelicsheep Wed 20-Feb-13 22:13:58

No it's generally been posters who have mentioned the word "entitlement" in an accusing way, and you were one of them Sheila.

BasicallySFB Wed 20-Feb-13 22:14:40

I'm usually a little calmer than this - and of course I think that reconstructive surgery / skin conditions etc etc should be treated. The same way I think infertility (both cause and consequence) should be. Because as was very well argued up thread, the psychological impact of infertility can be just as difficult as any range of other conditions and treatments. The psychological cost (financial, emotional and relational) can be massive. It's not as simple as 'treat / don't treat'.

Both options have financial implications - which NICE will have considered very carefully before making a recommendation towards sooner, and at a later age, treatment.

ArielThePiraticalMermaid Wed 20-Feb-13 22:15:23

That's not true. One person was told her opinion wasn't valid (yes, those were the words) because she had been staggeringly rude.

TheDoctrineOfSciAndNatureClub Wed 20-Feb-13 22:16:50

I support the recommendations, particularly the shorter timescale.

LineRunner Wed 20-Feb-13 22:18:01

I did post upthread but maybe it is worth my posting again.

I haven't had fertility problems. I am a taxpayer.

I think the new guidlelines are long overdue, to get some fairness and parity in place across the country.

johnnybear71 Wed 20-Feb-13 22:18:17

well Phineyj I think you're nearer to the truth than you realise...how do you feed 20-30-40 billion people?....its not if they force controlled reproduction...its when they will....think ill start that thread as my opinion has evolved into something worth a discussion and has slightly hijacked this thread...I am sorry if i've upset anyone and anyone who knows me knows that its something i try not to do...good luck if you're trying and I understand why..xxx

SorrelForbes Wed 20-Feb-13 22:18:34

On the whole, I think this is welcome news. On a personal note, I feel rather sad as I turned 43 two months ago and was turned down for IVF aged 40 due to my age.

GinAndSlimlinePlease Wed 20-Feb-13 22:22:14

I'm bowing out of this thread. I have no problem with people having different views, but the insensitivity of some posters is difficult to handle.

Going on this thread whilst miscarrying my miracle baby was clearly silly.

Hopefully I won't miscarry my ivf baby, imagine the extra cost that would put on the NHS shock How very selfish that would be

ArielThePiraticalMermaid Wed 20-Feb-13 22:23:06

Take care Gin x

RedToothBrush Bosnia-Herzegovina Wed 20-Feb-13 22:26:39

Gin, look after yourself.

LineRunner Wed 20-Feb-13 22:28:01

Take care, Gin. Ignore the nasties.

MrsDeVere Wed 20-Feb-13 22:29:25

The fucking irony of a man who has had the privilidge of fathering FIVE children and has never adopted, lecturing women who are infertile on adoption.

The 'a single gay dad wouldn't get a look in' is a cop out.

It sounds to me as if you have very limited understanding of adoption and would be far better education yourself rather than seeking to educate others.

I AM an adoptive mother. It IS NOT THE SAME as giving birth and your assumption that people do not want to adopt because they 'don't know what the are getting' WTF are you on?

You are urging people just to go for it... go and pick up a child, any child. Don't think about the age or the potential issue the child may have. JUST DO IT.

Yes Johnny, just do it, and sit back as the disruption rates soar to an even higher rate than they are now. That will do the kids so much good.

BasicallySFB Wed 20-Feb-13 22:30:22

So sorry gin - thanks

MrsDeVere Wed 20-Feb-13 22:31:48

And he talks about his grandchildren

So ladies, remember, no kiddies for you unless you adopt them. We need the extra space for Johnny and his brood...

ArielThePiraticalMermaid Wed 20-Feb-13 22:34:51

Message deleted by Mumsnet for breaking our Talk Guidelines. Replies may also be deleted.

ArielThePiraticalMermaid Wed 20-Feb-13 22:35:05

Oops, sorry.

BasicallySFB Wed 20-Feb-13 22:38:30

Tut tut ariel - I was deleted (for the first time ever in 2 years of being here!) for possibly calling someone 'narrow minded'. I'm actually quite embarrassed ... I had a shiny unblemished record.

I should have gone all out... smile

TheDoctrineOfSciAndNatureClub Wed 20-Feb-13 22:38:34

So sorry gin xx

And Sorrel, sorry that the timing of this is crap for you xx

johnnybear71 Wed 20-Feb-13 22:39:32

Message deleted by Mumsnet for breaking our Talk Guidelines. Replies may also be deleted.

ArielThePiraticalMermaid Wed 20-Feb-13 22:39:39

Well if I'm deleted for that, I won't argue with it smile

MrsDeVere Wed 20-Feb-13 22:40:52

Message deleted by Mumsnet for breaking our Talk Guidelines. Replies may also be deleted.

gaelicsheep Wed 20-Feb-13 22:41:52

johnnybear71 - I just don't think you'll make much headway with an argument about world overpopulation when you are talking to women who are personally suffering a great deal. It's just quite irrelevant and cruel. (I am very sorry about the loss of your DC).

DumSpiroSpero Wed 20-Feb-13 22:43:09

42 does not strike me a remotely unreasonable. I know a woman of 49 who gave birth to a gorgeous healthy baby boy last year after conceiving naturally and several woman who have had their first babies over 40 so it makes sense to raise the age limit.

That said, from a personal POV I'm in favour of anything that might give my lovely best friend and her DH more of a chance to conceive after nearly 3 years of trying.

BasicallySFB Wed 20-Feb-13 22:43:27

grin I was a tad surprised...

Erm... It's not your gender that's got people's backs up johnnybear71 - it's you preaching about the worlds finite resources when you have several children yourself. makes your argument kind of ... Hollow.

Oh, that and the sheer offensiveness of some of your other assertions. And the misinformation.

ArielThePiraticalMermaid Wed 20-Feb-13 22:44:36

This is a thread about NICE guidelines.

Overpopulation is valid and massive concern - in fact I was debating on a thread about it the other day. It was in context though. This is not.

TERRICOVERLEYDoSAC Wed 20-Feb-13 22:48:45

Never felt gladder, having read through this, that we have a national body making recommendations on the basis of evidence.

Think there are some pretty arbritray lines being drawn here about what is and isn't 'medically necessary' and about 'personal culpability' for leaving decisions too late, which in real life are a good deal less clear cut.

To illustrate, I've had (self-funded) IVF in my early 40s to treat infertility due to recurrent miscarriage (having suffered 8 miscarriages due to a blood clotting disorder in my 30's). Not where I expected to end up having started trying to conceive at the relatively tender age of 29. This has been the most psychologically debilitating experience of my life. I've had the good fortune to have the resources to pay for treatment - and this has ultimately been successful. Whilst I will never 'get over' the precious pregnancies I've lost, as a result of my treatment, I am no longer defined by loss and have been able to move out of a very dark trough of despair and anguish. It makes me very sad to think that other women trapped in this situation have until now been denied the same chance of treatment, becuse they don't have the ability to pay privately.

Oh, and two of these babies were lost later in pregnancy. The NHS had the decency to provide funeral arrangements (shared with other bereaved parents). Was this strictly medically necessary? No. But do we really want to let go so lightly of what is humane and civilised?

johnnybear71 Wed 20-Feb-13 22:55:32

Message deleted by Mumsnet for breaking our Talk Guidelines. Replies may also be deleted.

LineRunner Wed 20-Feb-13 22:57:58

johnnybear Would you mind awfully considering taking your views onto a thread where they are actually relevant? This thread is about the new NICE guidelines on IVF.

I think there's a thread on badly phrased passive-aggressiveness and theories of millions of years of evolution out there for you somewhere.

MrsDeVere Wed 20-Feb-13 22:59:14

jumped up
some angry woman

I sense isshooos

<sad face>

LineRunner Wed 20-Feb-13 22:59:42

Don't forget to tilt your head MrsDV.

MrsDeVere Wed 20-Feb-13 23:00:13

oopps sorry forgot <head tilt>

MrsDeVere Wed 20-Feb-13 23:00:34

HILARIOUS X post grin

Snazzynewyear Wed 20-Feb-13 23:02:15

When I was younger I would probably have taken the line some posters here have, about how no-one is entitled to have a child, it's a lifestyle choice and so on. Now, being older and having experienced the desire for a child myself (and being lucky enough to have had one after I'd been told it would be difficult) I see it very differently because I have had a partial glimpse of the pain it causes to want a child and then have that denied.

Northey's point some way back about how this is actually about bringing the guidelines into line with current improvements in success rates - they now being for 42 yos what they originally were for 35 yos - is a very good one. Basically the age change is like the Retail Price Index - it's about making sure the goalposts stay in the same place with regard to technical /numerical developments, so your basket of goods costs a comparable amount. confused <getting carried away with metaphor>

I think the most welcome and sensible part of it all is the lowering of the time spent ttc, though. Now I think about it, it has never made sense to insist on 3 years' ttc, thus meaning that 35-6 year olds have to wait till 38-9 for a referral and maybe 39 before treatment which itsel brings the stats down. I would support an 18-month period of ttc (maybe requiring people to 'register' as ttc to verify this?) and then moving to fertility treatment.

RedToothBrush Bosnia-Herzegovina Wed 20-Feb-13 23:05:26

but to have my words twisted to fit some angry womans agenda is beyond the pail hence my "get a grip love" comment...

So, you think its a sexist remark so think its ok to reply with one in response.

It wasn't how I read it. It was about you having 5 children.

And tbh, it is something that IS different for men and women; as I've said upthread a woman's role in society is still very much defined by her status as mother and ability to carry a child. I don't think this should be the case, but it is.

It is far more socially acceptable for a man to be childless - men do not get socially conditioned in the same way, nor do they get questioned/pressured/same level of expectation placed upon them. All the married couples I know, its the woman who always gets asked about when they are having children rather than the man - EVEN if the line of questioning comes from in-laws.

Its not to say men don't have those pressures, but it is to a different extent. Its not to say men can't have an opinion about it, but they should have the good grace and be wise enough to approach with more sensitivity than you have displayed.

I suggest you reflect upon this and your deliberately provokative attitude and how that endears others to your point of view. You can have a discussion, without deliberately attacking and being insensitive and fucking rude beyond belief.

BasicallySFB Wed 20-Feb-13 23:06:32

Maybe next time have a think about the particular thread your posting your opinion on. Yes it's a discussion forum - but most people have enough heart to think before they post insensitive and hurtful opinions on a particularly sensitive thread.

Erm...and can you sense the tiny bit of irony in you arguing that you were shouted down for being A MAN when you then dismiss those of us who disagree as having some sort of 'angry women's agenda'?

LineRunner Wed 20-Feb-13 23:07:44

As TERRI and Snazzy point out, the new guidelines are based on empirical evidence so that treatment is appropriately offered within the 'financial envelope' and there is at last an attemept to spread access fairly across the board.

The whole differential access due to postcode lottery has caused a lot of justifiable resentment.

LineRunner Wed 20-Feb-13 23:08:38

Indeed MrsDV [grin} Great minds...

BasicallySFB Wed 20-Feb-13 23:08:50

For the third time ... Whatredtoothbrush said grin <not stalker ish I promise!>

LineRunner Wed 20-Feb-13 23:09:22

Bollocks [grin failure] grin

MrsDeVere Wed 20-Feb-13 23:10:12

no, no I don't think he will see the irony.
He cant see the irony in lecturing childless people on overpopulation
so...

gaelicsheep Wed 20-Feb-13 23:12:28

I still want to know what was up with OliviaMumsnet and her cough.

BasicallySFB Wed 20-Feb-13 23:12:45

Good point ... I was trying to be diplomatic grin - what I would like to say is eminently delete-able...

RedToothBrush Bosnia-Herzegovina Wed 20-Feb-13 23:13:05

Watching Newsnight atm.

They just had two good points so far.

1) that this will benefit only a very small number of women - hence NICE didn't think there would be a huge additional cost to the NHS
2) there is a danger that some women will perhaps think 'ooo I can wait and leave it even longer now to have children'

LineRunner Wed 20-Feb-13 23:17:06

Mariella's good.

And yes, why shouldn't women benefit from medical science?

BlackSwan Wed 20-Feb-13 23:20:31

The additional cost may not be 'huge', but it will be additional. Not everyone sees the value in spending money on a roll of the fertility dice. While I agree that infertility is a health issue, it doesn't mean an infertile person should be entitled to state funded fertility assistance in their 40's. The NHS budget won't increase... so the money will come from somewhere else, like caring for the children who are already here.

SorrelForbes Wed 20-Feb-13 23:22:29

Thank you TheDoctrineOfSciAndNatureClub

LineRunner Wed 20-Feb-13 23:23:34

I think it's a good use of NHS money.

Northey Wed 20-Feb-13 23:24:11

Hmmm, what do we think about the second point? I am not sure my knowledge of IVF cut off dates had any impact on my choice to start TTC. I, like lots here, started TTC many years below the current cut off age. I eventually reacjed the stage of starting an ivf cycle three months before I would have reached it.

Northey Wed 20-Feb-13 23:25:15

blackswan, I am just as worthy of help as the children already here. Whatever wouldn't I be?

Northey Wed 20-Feb-13 23:25:35

Whyever. Not whatever.

LineRunner Wed 20-Feb-13 23:26:41

Northey, I thought the woman making the 2nd point was quite weak on that - more of an assertion based on 'women I have met in the big city and then I wrote a book about it' than peer-reviewed research.

TERRICOVERLEYDoSAC Wed 20-Feb-13 23:28:16

''NHS budget won't increase... so the money will come from somewhere else, like caring for the children who are already here''. [Hmm]

Or we could stop giving additional tax breaks to millionaires, or clamp down on tax dodging multinationals...?

gaelicsheep Wed 20-Feb-13 23:28:59

You're right Northey. Hardly anyone, I shouldn't think, starts TTC believing it won't happen. I mean we try so hard NOT to get pregnant you kind of imagine it will just, well, happen.

Perhaps if there wasn't so much holier than thou talk about scrounging parents, people wouldn't feel they have to wait until they can fund every possible financial eventuality before they start TTC.

BlackSwan Wed 20-Feb-13 23:31:45

But where do you draw the line Northey. You can't 'help' everyone. I would prioritise costs of healthcare for children over fertility treatment for those 40+.

Northey Wed 20-Feb-13 23:35:41

A fair amount of this thread has been about just that, blackswan. The NHS chooses to fund all sorts of things which are not purely life-saving treatment only. Your child, for example, could survive perfectly well without an adenectomy or eczema treatment. Why should that be funded over anything else?

Northey Wed 20-Feb-13 23:38:28

And in fact often it chooses not to fund things that it could do that ^are* life saving, because, although the technology exists, the cost is so high that it can't justify it, against all the other things it judges important (such as your child's adenectomy, or eczema treatment).

KristinaM Wed 20-Feb-13 23:39:27

Point of information -contrary to what was posted earlier down the thread, no adoption agencies in the UK " require" applicants for adoption to have had IVF. What they do all require is that you have FINISHED any assisted conception treatment you might be having, you cannot do both concurrently

Many families who adopt are not interfertile. Some who are chose not to have any treatment . Adoption may change your childlessness but its not a cure for infertility.

There are very few if any healthy new Born babies available for adoption in this country. It is stupid and heartless to say to couples who are TTC " well you can always adopt" . It's not the same and it's not that easy.

gaelicsheep Wed 20-Feb-13 23:39:35

OK, well all children regardless of family income get free NHS prescriptions. Is that right? Is it right that, if I was so inclined, I could probably wangle a regular supply of Calpol or eczema cream on the NHS. This argument could go round and round, but it is pointless.

LineRunner Wed 20-Feb-13 23:42:01

There is no reason why IVF shouldn't be prioritised with children's health care, both of which could be prioritised over some of the other things th NHS spends money on. I would suggest having a look at how LAs have recently had to make cuts to management costs, for example, to see where this has worked.

It's about political will, really.

BlackSwan Wed 20-Feb-13 23:44:52

Northey, so your post 40's IVF treatment should come before my child's appendectomy? Not entirely a rational argument now is it?
Infertility is not an illness, it's unfortunate, but it doesn't make you sick and in need of treatment - unlike, for eg, a ruptured appendix.

Northey Wed 20-Feb-13 23:47:31

Adenectomy, dear, not appendectomy.

gaelicsheep Wed 20-Feb-13 23:48:19

How's about children's healthcare, cancer treatments, IVF, etc. ALL get put before scraping drunk twenty somethings up off the street and waging war with the world and his dog?

I've no appetite for this now, sorry. I hope MNTowers have got some useful things out of the thread.

LineRunner Wed 20-Feb-13 23:52:02

I think the best thing here is maybe to accept that healthcare doesn't have to be a competition. The NHS is capable of funding many things for us simultaneously.

And IVF is available on the NHS, these guidelines are based on evidence and designed to be fairer, and the general consensus on MN has been positive.

TheDoctrineOfSciAndNatureClub Wed 20-Feb-13 23:57:03

Gaelic, Olivia does an AHEM when she wants us to settle down and play PARD nicely.

gaelicsheep Thu 21-Feb-13 00:00:57

I see, I was waiting for an announcement of some sort grin

I don't often get involved in bunfights these days. This was nothing. Did you see last nights' AIBU thread (which I was involved in I'm ashamed to say)? That warranted a special link to the Talk Guidelines.

Northey Thu 21-Feb-13 00:13:37

No, what was it about, gaelic?

gaelicsheep Thu 21-Feb-13 00:16:45

1 woman, 11 children and a "mansion".

Northey Thu 21-Feb-13 00:22:15

Ahhh, yes, I can imagine grin

BlackSwan Thu 21-Feb-13 05:47:35

LineRunner - entirely naive to think healthcare funding isn't a competition. The NHS successfully funds several things simultaneously, and already pays for a reasonable amount of IVF - let's not stretch it into middle age.

Salbertina Thu 21-Feb-13 08:21:08

I don't think infertility treatment should be a priority esp for older women when the pot is so overstretched anyway. Would rather resources allocated to improved maternity and children's services, for example. Agree with previous poster that infertility is not an illness.

catweasle Thu 21-Feb-13 08:47:31

Words fail me about how disgusting that statement is Salbertina. So because my DH and I are infertile due to his coeliac disease we are second class citizens and not worthy of any NHS help.

Salbertina Thu 21-Feb-13 08:51:11

Not at all disgusting!! Its my view that it should not be a priority over maternity/children's services with a limited pot. Nothing unreasonable about that. I am very sorry to hear about your problems and it is a shame that everything is not affordable on the nhs.

Salbertina Thu 21-Feb-13 08:55:11

And come live in Africa if you seriously feel like a second class citizen!

Jasmo Thu 21-Feb-13 09:00:43

I became unexpectedly pregnant at 42 and found it v hard work and now in mid 50s whilst I adore my youngest I certainly dont get to do what my peer group do because of late motherhood. I dont think being an older parent is great for parent or child. My parents were in their mid 40s when I came along so speak from both sides of the experience. I suggest that if you cant have your own baby and reach 35+ you accept it and get on with something else. Life is not ever perfect and we all carry our own disappointments and sorrows ( I have had a child die aged 19.. makes infertility seem realtively easy to cope with!) so find another path and get on with it. The NHS should be to save life, help with disability and chronic non self inflicted health problems, the reckoning day is very close when it will be unable to provide even basic care for the elderly so why burden it still further!

catweasle Thu 21-Feb-13 09:01:27

I take it you have never been through the horror that is years of infertility or the soul destroying experience is is to have a failed ivf cycle that you have had to pay for as the NHS trust where we live cut of is 38 and there is a 2 year wait. If you had you might have a little bit more sensitivity.

Salbertina Thu 21-Feb-13 09:08:36

Cat- we all have our health issues, should i list all mine? None of which can be treated for free where i am and where infertility treatment is never state funded- too many people dropping dead v young of HIV/TB/malaria/malnutrition. Now they're the second class citizens! I am not insensitive, just realistic about what priorities should be.

catweasle Thu 21-Feb-13 09:09:55

Oh god so that's all I have to do to get over never having a child find another path as its oh so easy cheers for that.

Jasmo Thu 21-Feb-13 09:11:13

I think losing an adult child in tragic circumstances has made me a fairly sensitive person even if I wasnt before! That is a tragedy .......not childlessness which is a lifestyle choice for many and does open other doors in life. Focus on all the things you can do not the one you cant.

Salbertina Thu 21-Feb-13 09:11:48

Sadly we all have stuff to get over. Did you read the poster's story about the death of her 19 yr old dc??? And you say "yhanks for that" hmmbiscuit

Salbertina Thu 21-Feb-13 09:13:01

Jasmo, sorry that was yo Cat. Really sorry to hear about yr dc sad

If you have a baby at 42 your child will be a teenager when you're in your mid 50's. Most people at that age are perfectly active enough to offer everything a teenager needs - mainly providing a taxi service to various social events in my experience ! wink I don't think they're too bothered if you don't go to the disco with them and their friends !
I just think this sort of argument is over-stated.
Sometimes yes illness may affect your family, but this can happen to any of the family at any age and is largely unpredictable.
IMHO 5 or 10 years in the woman's life is really neither here nor there in terms of their ability to form a good bond with their child.

Am so sorry to hear of your loss Jasmo sad

catweasle Thu 21-Feb-13 09:18:05

Sorry no I didn't see that (sad). Having just had a failed ivf cycle I am going to leave as this thread is just to upsetting.

Jasmo Thu 21-Feb-13 09:21:20

All I was saying is that infertility isnt always going to resolved with a pregnancy and what then.. At some point you have to accept the circumstances of your life and do your best to go forward. I have to accept that I lost a much loved child and wont get him back but that life goes on and there is a path for me, DH and other kids in spite of that. My Sister is infertile and I have the greatest empathy with her plight but she is now 74 so never had the chance of IVF..... so please see the joy and beauty in what you have and dont dwell on what is denied to you!

BasicallySFB Thu 21-Feb-13 09:21:33

I'm sorry for your loss jasmo

But childlessness through choice (as a 'lifestyle choice' is really very different from infertility, and the illnesses and conditions which are often associated with infertility.

I'm not sure there are that many women who think 'Ace, I'll delay having a child until I'm 40 then expect the NHS to pick up the tab'. There really aren't.

Salbertina Thu 21-Feb-13 09:21:34

Truly sorry to hear that, Cat sad

Am sorry cat that it's an upsetting thread for you.

Not something people can just discuss dispassionately is it ?

Much love and luck to all here x

catweasle Thu 21-Feb-13 09:33:58

Thanks guys nope not a topic we can just discuss. Jarmo I do get what you are saying DH and I have a plan for when we call it quits probably soon as we won't be doing IVF again due to me not agreeing with the drugs and the horror that I was.

I am a nurse in the NHS so know how much money there isn't but these are only guidelines and most NHS trusts don't follow the current ones so its not like its going to cost anymore. Anyhow it's fine and sunny here in Scotland probably the only one we will have so am off out to enjoy it.

HellesBelles396 Thu 21-Feb-13 09:38:17

I think having a child is not a right - it's a responsibilty. The world would be much better if everyone who had a child (or many children) thought about what benefits they could offer their child rather than the other way round.

Re the raised age limit, imho, it would be better to have a lower age limit but the same rules applied in all areas of the country so that everyone with infertility has the same opportunity to have IVF.

HappyJoyful Thu 21-Feb-13 09:53:26

Salbertina, it's outrageous that you (and I believe other's) can suggest that infertility is not an illness. It is also incredibly patronising to state that when women are comparing themselves or the access they have to medical funding in the UK is meaning that they are in anyway suggesting their circumstances are comparable to those living in Africa, of course women here are aware of those issues faced.

Having only skim read the posts from overnight, I'm disappointed to see that there has been a barrage of people continuing to post such insensitive posts. I really would have thought that with the number of couples having infertility issues being at a record high of something like 1 in 9 (or is it even 6) that most people aren't going through life without coming across someone that needs it.

Infertility may not be deemed as 'an illness' by many but how dare people suggest that cancers that have caused it or endometriosis aren't.

Salbertina Thu 21-Feb-13 10:00:08

Actually, i don't think people are aware. I mentioned Africa as its where i live. From my perspective, ivf shouldn't be prioritized over basic maternity:children's services. Recent reports into nhs children's services found huge failings which have led to many avoidable deaths. Now that is outrageous, not my own opinion to which i have every right..

KristinaM Thu 21-Feb-13 10:06:57

I had babies at 41 and 42 ( without any treatment or problems conceiving ) . I'm now in my 50 s and I'm fitter and more active than many women half my age,including I suspect , most of those on this thread airily dismissing me as " middle aged" .

Why should couples who are infertile not have the same chances that I have had to have a biological child? It's very selfish to argue that the NHS should prioritise care that I and my family need while not providing services to others. Infertile couples pay their taxes and NI too. I don't see why they are any less " deserving" than eg patient who have breast enlargement for psychological reason ( not after cancer ) , tattoo removal, homeopathy, smoking cessation, treatment for drug addiction,

IMO There is a lot of prejudice on this thread.if anyone posted that black people or Jews were not good parents it would, quite rightly, be removed. But people feel quite happy to say sweepingly that " middle aged" women ( and they do mean women, no one has mentioned older fathers) won't make good parents.

Off for a run now with some other geriatric mums who are training for a marathon < waves goodbye to smug 30 something mums sitting on sofa watching Jeremy Kyle while stuffing their faces with junk food and congratulating themselves on their youth and longevity > wink

Since you mention homeopathy Kristina - does NHS funding still support homeopathic treatments ? I have a feeling there's an NHS Homeopathic hospital in London - favoured by Prince Charles ? (not sure if that's right ?)

Well if we're looking to make some cuts IMHO they should be a contender !

I'm all for talking treatments, counseling, and holistic approaches, but taking a scientific approach, for me homeopathy is a step too far !

HellesBelles396 Thu 21-Feb-13 10:16:21

One thing I will say, I have. been dismayed to read the nastiness and insensitivity on this thread.

Everyone has their own view on where the nhs pound should be spent which will, no doubt, be based on something highly emotive in their own family. Being sensitive to that, and wording posts sensitively, would enable everyone to feel free to give their own opinions. No-one should have to give painful details to prevent being flamed for holding their opinion.

MNtowers didn't open this thread for the comments of infertile women (an assumption based on the fact the op did not include that rule) so shouting someone down based on their fertility status is appalling. As it would be the other way round.

Please, everyone posting on here, read your comments before posting them and ask yourself how you would feel if anyone said that to you.

Have just googled and apparently NHS spends £4 million a year on homeopathic treatments and there are 4 NHS homeopathic hospitals, in London, Bristol, Liverpool, and Glasgow.

If they want to turn these into places where simple counseling and a holistic approach are offered then fine, but the treatments don't make any sense IMO !

Sorry for the thread diversion !

KristinaM Thu 21-Feb-13 10:22:48
Salbertina Thu 21-Feb-13 10:25:55

Completely agree also. Homeopathy proven not to work, nhs should not fund.

Snazzynewyear Thu 21-Feb-13 10:38:25

I agree that homeopathy is an area where cuts could be made.

This article from Suzanne Moore on this topic is interesting: "The discussion about at what age IVF becomes pointless is one for the doctors. For me, the much more important one is why do we produce a society that makes it so difficult for women to provide for children when they are most biologically able to have them?"

Warning: I find the comments on CiF often quite woman-bashing so if anyone's sensitive about this issue you might not want to read those as you'll probably get harsher stuff than has been said here.

I've just started a new thread in AIBU on the subject of NHS funding for Homeopathy BTW !

Phineyj Thu 21-Feb-13 10:55:17

KristinaM as a matter of fact my DH and I were told in no uncertain terms by the local authority with whom we'd applied to adopt to go away 'do IVF' and come back when it had failed and we'd 'grieved the loss of the children we hadn't had biologically' and then they might re-consider us. I didn't even want IVF at that stage! It's also very hard given the way IVF is developing currently to say when it is 'finished'. There is always something else you can try if you can scrape the funds together. Although, I think the NHS ought to be making it easier to access counselling so that individuals/couples can deal with their grief over not conceiving and agree on when it might be time to stop.

blackswan I think there are some points regarding the NHS 'already providing a reasonable amount of IVF'. Firstly, they don't, as it's on a postcode lottery subject to a lot of quite arbitrary rules (like the one about previous children of the partner disqualifying you). Also, as other posters have pointed out, they don't even do it in the most efficient way e.g. not carrying out diagnostic tests that are routinely offered in the private sector first, so that treatment can be appropriate for the individuals concerned and therefore most likely to succeed. There is also a lack of impartial advice in primary care -- the emphasis seems to be on going straight to IVF when healthcare professionals could if they wanted go through the range of options with patients (and some options would cost a great deal less than IVF).

The NICE guidelines have simply changed what is considered 'reasonable' regarding the age cut-off because of increasing success treating older women.

curryeater Thu 21-Feb-13 11:05:53

Snazzynewyear, thank you for linking to that Moore article - this is exactly the sort of thing that I mean by saying that there is a weird quasi-moral prioritisation in this conversation of medical issues over other barriers to becoming a parent.

I do however think it is important to note that there is nothing historically weird about people having babies in their 40s. My parents' generation all seem to have more than 10 siblings, the youngest ones born maybe 20 years later than the oldest. (Catholics). It's only in a context of people choosing to stop at some point that it can be portrayed (deliberately, by people with an anti-feminist agenda) as weird for women to have children in their late 30s or 40s, (whether or not these might the only children a woman may have, unlike the great grandmothers I am thinking of who started in their 20s and didn't stop)

There are too many barriers and judginesses about having children altogether.

- having them too late
- having them too soon
- having them single
- having them too poor
- having them without owning a house
- having them to more than one father

If we got rid of some of this misogynist hand wringing, maybe fewer women would need IVF. And then, if cost is the barrier, everyone who wanted it could have it.

DeeBeee Thu 21-Feb-13 11:19:31

This is excellent news! Fertility problems are health problems, no different to any other. I am shocked at people referring to the right to have kids as some sort of luxury or lifestyle choice! 42 these days is a young age, I have women friends that conceived naturally and had healthy pregnancies at that age so I welcome the news.

moonbells Thu 21-Feb-13 11:46:24

I am delighted at this news, though I would be happier if the various PCTs would be consistent how they apply guidelines. I have seen too many friends get desperate and end up needing other, more costly medical treatments to combat despair and depression.

My situation: damned lucky. I was married for the first time at 37 and we started ttc 9 mths later when I was 38. I told my GP that we were very 'que sera, sera' about it all, and if it didn't happen, we wouldn't be seeking IVF. I'd had gynae problems since 13 so figured there was a fairly high chance nothing would happen.

6 months later, when 39.4, I got a BFP and after a hellish pregnancy (hyperemesis) my gorgeous DS arrived 4 weeks after I was 40.

If we had been desperate for a child, and one of us had been infertile, we'd have run out of time before the 18mths ttc guideline and I'd have been too old given the current limit. So upping the limit is good in my opinion.

VeganCow Thu 21-Feb-13 12:35:29

great news. I had no problems conceiving, but had I had problems, would definately have wanted to try IVF. If I then had found out that either postcode, or age, limitations were then in place, I can imagine the utter feeling of helplessness I would have felt.

Allthingspretty why don't you agree with the changes? How does it affect your life?

KristinaM Thu 21-Feb-13 13:26:47

PHineyJ-if you are seriously interested in pursuing adoption right now ( instead of infertility treatment ) , I would contact your local authority again and ask them to put it in writing. AFAIK that is NOT the official policy of any Uk adoption agency.you could also contact any other local agency and ask them to assess you.

If I was asked for my personal opinion,I would advise that families make sure they have explored ALL the options they feel confortable with BEFORE pursuing adoption. For some that will be less invasive treatments such as ovulation induction, others IVF or AID, or perhaps surrogacy. It's a very personal decision.

But if you start adoption and then change your mind about one of the other routes to having a family, there's no going back. Adoption is very very slow and you may have lost your place on the waiting list for IVF etc. You will be older. And if you pull out of the adoption assessment to get treatment you will find it very hard to find anyone else to asses you, unless you are the " right kind " of black family or can parent a child with special needs (normal rules don't apply )

Adoption is a very risky route to having a family. You will not get a newborn baby and there is great competition for healthy toddlers. I've not done both but everyone I know who has says that adoption is much much harder than infertility treatment.which is saying something as many of you know sad

Sorry,don't mean to hijack IVF thread but so many posters had mentioned adoption I just wanted to clarify

rollerskaterabbit Thu 21-Feb-13 16:50:50

I see it as good news. People say no-one has the right for the nhs to fund IVF for a child but I don't particularly like paying for cancer treatment on the nhs for smokers or for their emphysema treatment. As for the tax on cigarettes it nowhere near covers the nhs costs. Similarly why shouldn't older people be able to have kids? A smoker is easily knocking a minimum of 10 years off their life so maybe they should be banned from having kids due to health issues if older people are refused IVF.

honeytea Thu 21-Feb-13 17:10:55

I see the higher age asa cut off point good, I think that it is unfair to judge fertility by age when it is so easy to do a AMH test and see how likely it is for IVF to work.

I don't think the 2 year ttc before having IVF is a good idea. I was ttc for 20 months, I live in a country with a national healthcare system that offers couples 3 fresh and 6 fet cycles (free) me and DP went to the fertility specialist when we had been ttc for a year, she did a sperm analysis and a load of blood tests/ultrasounds for me, they found my DP had not so great sperm (not really bad but not great) I had pcos but I still ovulated and had regular cycles. I am 28 (was 26 at the time) the fertility specialist referred us directly for IVF, I asked about trying other treatments, maybe clomid or iui but she said what is the point just go and have IVF.

We got the drugs, I went for injection training and we were all set for IVF, I just had to wait for my period to come, it never came I was pregnant. We still have thousends of pounds worth of drugs in the fridge.

I feel like we were rushed into trying IVF, bothme and DP had reduced fertility but nothing in our tests showed that we couldn't get pregnant just that it might be a little harder. I feel like if they had made us wait 3 years it would have saved them lots of money and us lots of stress. If they say for an average healthy couple it can take a year 2 years for a couple with reduced fertility would be normal.

BalmainMummy Thu 21-Feb-13 17:20:29

Smokers, alcoholics and obese people. All these groups take take take from the NHS. I would prefer my tax money to go to fund healthy prospective older parents receive one chance of hope with IVF.

But really we cant pick and choose who gets help from the NHS. Everyone has their own health problems, but waiting to meet the right person before settling down is a good thing in my opinion. I might be in that boat too if I hadnt met my husband young.

leniwhite Thu 21-Feb-13 17:24:27

I think it's unfair to use anything other than a complete lack of womb as an arbitrary reason to stop access to ivf. I had a home amh test in 2010 which showed my levels to be really low, and according to the 'statistics' i had a very small chance of having any eggs (at aged 30). The nhs turned us down purely on this basis so we went private and after one cycle on gonal F i'm now due to give birth next month having only used 1 implanted embryo from my 5 eggs. Nothing wrong with me other than not many eggs, the ones I had were perfect, so had i believed the nhs that we had no hope, we'd have ended up with no children. Until more people have access the stats are only based on a few people which isn't an accurate reflection of reality. My gran gave birth to my dad at 42 in 1948 and he was perfectly healthy, all cases should be judged individually.

Zara1984 Thu 21-Feb-13 18:07:36

I used to think it was silly to fund IVF. Now I look at baby DS and it breaks my heart to think anyone would be denied this joy who really wanted it. But on the flip side (having had shitty parents) I don't think anyone has a right to have a baby.

On balance I would come down in favour of funding one round of IVF.

But I do worry that without further funding it will make the postcode lottery situation worse, ie longer waits.

I think it's awful too that individual trust have different rules. Shouldn't there be consistent rules nationwide.

Zara1984 Thu 21-Feb-13 18:08:21

I mean I worry that the changes (42 limit) will make postcode lottery situation worse.

Phineyj Thu 21-Feb-13 18:57:51

KristinaM thanks -- that was already the fourth local authority we'd tried (and we spoke to one independent agency as well) so at that point we gave up and decided we'd have to do IVF (privately) which worked for us second time around and we are now proud parents of a baby DD. We were entirely serious about adopting but the process was so byzantine and upsetting that I think we had a lucky escape really. I feel like we might get the thread off topic though so will leave it there -- although it doesn't take long in any discussion of IVF before someone says you should 'just adopt' instead. AARGH! That word 'just'...there is no 'just' about any of this.

Phineyj Thu 21-Feb-13 18:58:47

Me too Zara1984

Igmum Thu 21-Feb-13 21:02:00

Wonderful news. I was lucky enough to have been able to pay for IVF myself and had DD after the first cycle. Cannot begin to describe the joy after trying so desperately. Good luck to everyone trying now

Onsera3 Thu 21-Feb-13 23:04:50

I'm going to be selfish and say no, it shouldn't be extended. Instead I think younger people with fertility issues like myself should get more rounds of IVF.

I have endo and polycystic ovaries so was unable to conceive. I had IVF on the NHS at 31 and it was successful.

I'd love a sibling for my little one but I'm not entitled to anymore free treatment.

After studying the stats during my treatment I learnt how it is much less successful for older parents and the overweight and obese. Trying to get pregnant when you're older or overweight means that you have made some choices or lifestyle decisions that have inhibited your chances if having a baby. (Like smokers etc that others have mentioned who need help from the NHS)

If there was enough money sure. But IVF for someone old or fat is still much less likely to work for someone younger and slim like me so it seems kind of wasteful.

ArielThePiraticalMermaid Thu 21-Feb-13 23:58:37

Like it having taken taken four years before you've got anywhere. Like only meeting fuckwit men. Like the NHS having fucked you around.

Those sorts of lifestyle choices.

But hey, you deserve two children.

midastouch Fri 22-Feb-13 00:24:59

I didnt realise if one person had a DC and the other didnt you werent eligible, i think thats awful! I also didnt realise waiting times were so long. I do however still think that younger people with fertility problems should be a priority, as everyone knows your fertility declines with age, there are far more concerns with older parents both during pregnancy and as your child grows up. Surely its much harder on you as you get older dealing with lack of sleep, tornado toddlers etc.. Just my opinion though

scarlettsmummy2 Fri 22-Feb-13 00:33:22

And the prize for most tactful post goes to onesera! And I am going to be even more selfish and say I don't give a toss what age you are or how slim and lovely you are, but you shouldn't get to have TWO babies funded by the NHS. There are better uses of the money, and if you want a second save up for your own IVF.

anonymosity Fri 22-Feb-13 02:37:34

You can't look at it in isolation though, can you - you can't just say "everyone has the right to fertility treatment" if you don't look at all the other issues.

There has been recent press suggesting a) we're creating a generation of infertile people (the babies born to those who have had IVF) b) that we're creating a generation of people with increased illnesses / allergies and disabilities.

I don't know if its true, its just what has been reported in the press as a suggestion.

But also what is happening on the adoption front - thousands of small children are not being adopted, in favor of searching for your own offspring. And they continue to be left in foster care or homes and that can also create a bigger underclass.

I am not passing judgement I am just saying it cannot be seen / viewed and decided without these factors having some impact.

FrankellyMyDearIDontGiveADamn Fri 22-Feb-13 07:15:23

I've seen no evidence to suggest that children born via IVF are infertile. Didn't the first ever IVF baby recently have her own child, conceived naturally.

It's been said a million several times already, adoption is not a substitute for having your own child. You need to be in a whole other place mentally to be able to handle the complex adoption process. Plus, again as has been said, children being adopted deserve to go to homes that truly want them, not see them as second-best.

Perhaps people who are able to have children naturally should be limited to one child and then adopt if they want more [sarcasm]

As the very eloquent MrsDeVere said earlier in the thread, why are women with infertility problems being blamed for the adoption problems in this country? Surely it is everyone's responsibility to look at this avenue?

triplets Fri 22-Feb-13 08:07:16

onsera what is your definition of old and fat please? This is a difficult subject, we each are entitled to our own opinion and to express it, but please word it carefully because you can hurt peoples feelings. This is my life experience.........my life.
I married in 1978 and just a year later gave birth to Matthew.
For the following 14 years we tried to have another baby, it just didn`t happen.
On June 2nd 1994 my beautiful child died in my garden, totally unexplained.
After 2 years of utter raw grief we decided to try ivf.
After three attempts all funded by ourselves and using donor eggs it worked.
At the age of 46 I gave birth to Thomas, Rebecca and James, all healthy beautiful babies.
When they were nine their father was diagnosed with stage 4 cancer, he is currently in remission.
Life is hard living with three teens at our age.
But I know parents with twins/triplets and young children of different ages who can`t cope and they are years younger.
We all are here only once, some for a very short time.
IVF I believe should be offered to older women also if they desperately want a child, they should be offered the chance, even if its only offered once. Why don`t they offer partial funding?
It is difficult but we each have our own reasons.
As for being "old and fat" ...........hmm .....I suppose onsera I now fall into that categorie being a size 16/18........but I did have triplets at 46 and I have lots of much younger friends who are very much overweight and look the same age as me! Please be kinder smile

DomesticCEO Fri 22-Feb-13 08:13:17

I was 33 when I needed IVF but had to self fund cos I was told I was too young!

I don't have any problem with this age extension but its a nonsense when the PCTs just ignore it.

Oh and passing on IF to our IVF babies is clearly bollocks - I had blocked Fallopian tubes, I don't think either of my sons could inherit that hmm.

13Iggis Fri 22-Feb-13 10:11:13

Triplets your story demonstrates how we can never know what is ahead (good or bad) and that it is all to easy to write someone off as being less than ideal candidates for ivf. Surely the same could be said for any medical treatment, if your are older or obese or very underweight, you are less likely to benefit from it, so let's just have a cut-off and say no-one over ten stone or over 55 gets any medical treatment at all.
Anyone seen Logan's Run?

honeytea Fri 22-Feb-13 10:33:21

Anoymosity would you suggest that anyone with health issues that could possibly genetic should refrain from having children? Anyone with a family history of asthma, depression, diabetes, dyslexia, should choose not to have children so as not to risk them developing that problem?

My ds might have inherited my dp's rubbish sperm, if we had a dd she might inherit my pcos but I am personally a lot more worried about them inheriting my dyslexia or my mil's depression or my brother's asthma.

From tge research I read there are studies tgat show a higher rate of birth defects with icsi but no correlation has been found between "traditional" IVF and birth defects.