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To ask about your perceptions of access to IVF on the NHS

(59 Posts)
ArgyMargy Thu 06-Nov-14 07:52:12

I am not a journalist but if I'm breaking any MN rules feel free to tell me. I work in the health sector and am interested in health services. Some Clinical Commissioning Groups in our region have got together to produce a new policy for access to IVF (one cycle only) and I have concerns about it. I plan to write to Healthwatch to express these concerns but I would like to know if anyone else shares them. So can I ask you, what sort of things do you think might be in this policy in terms of eligibility? Specifically about age, health status and length of time trying to conceive?

LaurieFairyCake Thu 06-Nov-14 08:01:25

I'd guess you get one go at it, be under 45, and have been trying to conceive for 18months or more.

I heard that it's more difficult to get in some areas but I don't know that

Ohfourfoxache Thu 06-Nov-14 08:03:30

Marking place - worked in reproductive medicine for years, specifically dealing with assisted reproductive technology and (what were) PCT/consortium access policies.

Interested to see people's perceptions of eligibility criteria......

SorrelForbes Thu 06-Nov-14 08:03:45

I think that the policy should NOT exclude people from accessing IVF/ICSI where one partner has children from a previous relationship.

CaptainAnkles Thu 06-Nov-14 08:04:50

Is there a rule about being under a certain BMI?

honeysucklejasmine Thu 06-Nov-14 08:05:24

Absolutely Sorrel, that is very unfair.

FibonacciSeries Thu 06-Nov-14 08:06:42

I'm 40 and my DH has kids from a previous marriage; I wish neither of these two things made me uneligible.

cosysocks Thu 06-Nov-14 08:06:54

I think if one partner has a biological child and the other doesn't this should not be a block to IVF.

aprilanne Thu 06-Nov-14 08:23:10

well in forth valley you can have 3 cycles .but no later than your 40th birthday and no other children from either party or then its just one cycle.which seems fair

Amummyatlast Thu 06-Nov-14 08:28:44

I think it is wrong to limit it to only one cycle, as it's common for the first go to be a trial run, where they work out your reaction to drugs, etc. My PCT has just launched a consultation to reduce the number of cycle from 3, but extend the age range. I personally think that they shouldn't be increasing the age range - if you want a baby you should start to try much earlier than 40. In terms of BMI, what annoys me is that they take no account of what is natural for you. It took me two years of eating as much as possible and drinking build-up drinks to get to their required BMI of 19, and It just wasn't natural for me. (Post baby, even with a baby tummy, I'm still under their ideal weight.)

CrashDiveOnMingoCity Thu 06-Nov-14 08:31:28

I'm torn on the age issue. I'd be interested to see the statistics for IVF success rates for women who are considered too 'old' (not that 40+ is old, of course) to qualify. I shall have a google after work today.

hels71 Thu 06-Nov-14 08:31:53

When I accessed NHS IVF (8 years) it was one cycle, woman had to be under 36 and neither of us could have had children before. Due to support forums i was made aware that other areas had very different rules. Some could have up to three goes. Some had to be under 40, some had upper and lower age limits etc. I was also very lucky in that the waiting list was not very long. I know that in some areas it was huge. (This may have changed I don't know)

I think it is a very emotive issue. Those of us who require IVF see it very differently from those people who believe it is not essential and should not be on the NHS at all.

I think it should be the same across the country whatever that policy is. It is not fair that two couples of the same age etc should have differing access because one lives 5 miles in a different direction.

I guess at least one cycle on the NHS at least gives the clinic information about how people react to the drugs etc, making it possible to adjust these should a second cycle be needed.

CruCru Thu 06-Nov-14 08:40:18

i had IVF privately after speaking with the NHS fertility team. I wasn't eligible (too fat) and in any case, the waiting list was years long.

I know a few people who've had IVF but have never met anyone who managed to get it on the NHS.

Pipbin Thu 06-Nov-14 08:45:14

I have just had my final IVF cycle.
I know that I have been very lucky to have had 3 cycles on the nhs.
I had to lose weight as my BMI was to high and the doctor asked me to get it down before I was referred. I have always struggled with my weight but I think asking it to be below a certain level is ok.

What annoys me is the 'postcode lottery'. If you look on the infertility or conception forums you will find a great difference between the number of cycles people get. I got three, many people would have got just one. In some places, none. It is a national health service and the rules should be the same across the county.
I was listening to Robert Winston talk about this a while ago and he seemed to be of the opinion that many private clinics charge the NHS too much for the procedure.

ArgyMargy Thu 06-Nov-14 08:47:03

My major concern is that women will not know what they don't know, and this ignorance may mean they become ineligible. Just putting the policy on a website isn't the answer. There is such a range of policies out there; who would think of checking in advance, esp if you had no idea there might be a problem with conceiving?

Fourarmsv2 Thu 06-Nov-14 08:47:44

My sister had IVF to eliminate a genetic condition. She struggled to get approved due to being too young. Surely age shouldn't be a criteria in these situations?

CrashDiveOnMingoCity Thu 06-Nov-14 08:52:09

Four I guess it depends on the success rates of IVF in certain age groups. I know it declines with age but I'm not sure of the exact figures. Being 'too young' sounds bonkers, unless they were concerned for her about managing the impact of PGD?

babykonitsway Thu 06-Nov-14 08:54:19

I've had two rounds of NHS IVF and I think it should be funded but with strict criteria.

For example I had to be:

under 39
bmi less than 30
non smoker - breathalyser proof
teetotal or close too - impossible to monitor
no previous children for me or hubby
diagnosed infertility reason or 3 years unexplained infertility

I don think this is strict enough.

All couples must fill out really detailed HFEA forms to ensure welfare of child, part of this I believe should include income, family unit, criminal record etc.

I will get shot down for this but why should the NHS pay for all the investigations required at £x cost and then £5k a round of treatment if you or your partner don't work and put nothing back into the system, fertility treatment after all isn't life saving. It is absolutely soul destroying and heartbreaking but it is not like cancer, stroke etc treatment.

tiggytape Thu 06-Nov-14 08:54:20

My perception is that IVF is expensive and therefore conflict exists between what might be the optimum course of treatment (maybe 3 cycles at the earliest age possible) and what people will actually get.

To make the money go further my perception is that some areas restrict treatment for couples where one or other already has a child and some counties possibly don't offer as many cycles as would be ideal.

IVF doesn't have a great success rate even in young and fit patients so, to make sure the money goes on those whose chances are higher, age, weight and lifestyle limits are set eg women in their 40's, very obese patients and those who smoke or even have significant health problems may not qualify for NHS treatment.

My other perception is that it can depend on where you live as to whether you qualify.
No idea how much of that is actually the case.

Hotbot Thu 06-Nov-14 08:59:55

Not sure about all the rules but I think it should be the same no matter where you live in the uk as should criteria for boob jobs etc on the nhs. Disparity across th U.K. Is very unfair in these things

Pipbin Thu 06-Nov-14 09:02:10

I personally think that all the NHS should follow the NICE guidelines, not just if they fancy it.

Why should I get 3 shots at ivf but someone in York get none? Am I more deserving?

SorrelForbes Thu 06-Nov-14 09:07:29

honeysucklejasmine Isn't it? DH and I applied for IVF when I was 39 (we were unable to apply prior to that due to on-going treatment I was receiving for an un-related medical issue). DH has two teenage/adult children from a previous marriage so were were immedicately precluded from continuing with our application.

if you want a baby you should start to try much earlier than 40. In an ideal world yes but in real life, not always possible.

SorrelForbes Thu 06-Nov-14 09:08:22

Sorry, I meant to add that my biggest grips is with the postcode lottery/disparity across the UK.

tiggytape Thu 06-Nov-14 09:19:12

I was always under the impression that the limits they set on age and weight weren't a moral judgement about people's lifestyle choices - I cannot imagine they would be. Surely is just a medical decision. If there is only so much money in the pot, then it gets concentrated on people who have a 30% chance of success rather than a 2% chance.

It is a bit like when the NHS refuse to pay £thousands for a drug that can extend life by 3 or 4 months. For the people who want the drug, those 3 months might mean one more Christmas with their family but, if the NHS fund that then they don't also have the money to pay for other cases and other drugs which prolong life by so much more or save lives and have "better" outcomes in terms of using that money to best effect.

rattling Thu 06-Nov-14 09:22:16

When I had IVF 6 years ago you could have 3 rounds if you were under 38 with neither partner already having children. That was under 38 at the time of each attempt, with a 3 year wait once you were on the list and it taking about 2 years to be referred to the infertility clinic. So my decision to start trying for a family at 35 meant we left it too late for funding. However we were able to self fund our NHS treatment which had a much shorter wait and fixed, quite reasonable price (about £3000 for ICSI?) which I haven't heard much of elsewhere.

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