To be annoyed at IVF comments

@Flashesofrage

I've had 5 miscarriages and then 2 ruptured near fatal ectopics and now have no tubes left which is why we are doing IVF

(And it may also mean they are less of a burden on the state when they get to the age of 80 compared to a couple with no children to look after them.)

If you want to attempt to put a price on it, let's say a 35 year old couple has a successful round of IVF which costs the NHS £5000. The couple have a child and both live until they are 80 years old. They have each gained 45 years of relief from the pain of childlessness, which means it has cost the NHS about £55 per year (or just over £1 per week) for each of them.

The question is how many people successfully have NHS IVF babies and would any negative health outcomes for those people cost more than £68 million in total (ie both in terms of the cost of treating them for any MH issues but also eg lost productivity at work etc).

I don't agree that that is the question though. I don't think you can put a price on giving someone (or most often two people) permanent relief from the torment that is involuntary childlessness.

Someone may live the rest of their life with depression or indeed PTSD as a result of their infertility and not actually cost the NHS very much other than perhaps the odd prescription for prozac. Or someone might kill themselves because they cannot bear it any longer (like the husband of a PP on this thread) and never cost the NHS another penny.

Does that mean that because a round of IVF treatment may (or may not) be more expensive than the impact on two people's mental health and quality of life, it shouldn't be funded?

If you don't think quality of life matters at all, then why give someone a prosthetic leg when they can get around on crutches?

The NHS funds all sorts of things which are aimed at improving people's physical and mental quality if life, and most of them are uncontroversial.

The French healthcare system offers free fanny yoga for all women who have had a vaginal birth which is aimed at restoring pelvic floor function to combat incontinence and improve sexual pleasure. I think we can all agree that this is absolutely not necessary, and yet on Mumsnet there are constantly threads complaining about how women's post-natal health is chronically neglected, and every time this subject comes up you can guarantee that someone will bring up the French fanny yoga and complain that the NHS doesn't do that. Funny how we all tend to believe the health service should fund things we personally want to be able to benefit from.

Incidentally, the French social security system also funds four rounds of IVF.

Given that the "price tag" of a cycle of IVF is a drop in the ocean in terms of the overall NHS budget and that the outcome is completely life changing for those who successfully conceive, I'd say the answer to that question is a blindingly obvious yes.

No. That's not the right analysis IMO. It's not a question of what proportion of the NHS budget is spent on IVF. The question is how many people successfully have NHS IVF babies and would any negative health outcomes for those people cost more than £68 million in total (ie both in terms of the cost of treating them for any MH issues but also eg lost productivity at work etc).

As I say I'm on the fence. I'd normally be inclined to just look at the NICE guidance but if they are considering the benefits to the child who is born as a result of the IVF then that is fundamentally flawed in my view. They do not suffer by never existing.

As mentioned earlier, I think the question that should be asked is "Do the benefits to those who successfully conceive via NHS-funded IVF justify the price tag?"

Given that the "price tag" of a cycle of IVF is a drop in the ocean in terms of the overall NHS budget and that the outcome is completely life changing for those who successfully conceive, I'd say the answer to that question is a blindingly obvious yes.

So if you believe that in the UK in 2020 everyone has the right to medical care, why should that not include IVF?

That's a ridiculous argument. They are lots of things that fall within the definition of medical care that are not provided for free on the NHS.

As mentioned earlier, I think the question that should be asked is "Do the benefits to those who successfully conceive via NHS-funded IVF justify the price tag?" which I think another poster said was £68 million/year. I don't think that the NHS should take into account the life years that will be gained by the child who is the result of the IVF as NICE apparently do - the focus should only be on those who already exist. Perhaps the cost is justified due to MH benefits; I don't know as I don't have the data.

There are other things I'd stop before NHS IVF (right to buy, most cosmetic surgery on the NHS, gender reassignment surgery on the NHS) but I'm still on the fence.

@SirChable👏👏👏
Epic post ❤️

May I just add;
Cost of the NHS per year = £140.4 billion.
Cost of IVF on the NHS per year = £68m...

I'm interested by this comments about how "having a child is not a right". I agree it isn't a right in the sense that nobody can grant everyone legal rights to something which may not be physically possible.

When we talk about rights we might talk about human rights, such as the right to life, the right to a fair trial, the right to a private and family life, the right to freedom to practise your religion etc. We might also mean things like consumer rights or employment rights which are granted to us by law.

Publicly funded IVF isn't about people's rights to have a child, because sometimes with even the best will in the world, excellent medical care and a bottomless pit of money, it just won't be possible.

Publicly funded IVF is about people's rights to medical care. It is medical care that is aimed at treating a medical problem and thereby improving the patient's quality of life. I don't think there is any great distinction to be made between medical care which treats the cause of the problem and medical care which treats the symptoms. If you mend someone's broken leg, you are treating the cause of the problem, and with good medical care and a straightforward recovery you should be as good as new afterwards. If you give someone medication for chronic arthritis or Parkinson's disease, or if you supply an amputee with a prosthetic limb, you aren't treating the cause of the problem but you are treating the symptoms and helping the patients to live a better quality of life. If you allow an infertile couple to access IVF treatment and they successfully have a baby, you aren't treating the cause of the problem but you are treating the symptoms (childlessness). Looked at in that way, IVF is a better return on investment than treatment for many chronic illnesses because if successful it treats the symptoms permanently. The couple will still be infertile but being fertile only matters if you want to have a baby. There is no need for lifelong medical treatment for the post-IVF couple in the way that there is for people with chronic illnesses, whose symptoms may be alleviated somewhat but will still have to live with their illness for the rest of their lives. In that sense, successful IVF treatment is just as good as mending a broken leg. It may be treating the symptoms rather than the cause of the problem, but it does so so successfully that the cause of the problem is no longer relevant.

So back to rights. If funding for IVF is about a right to healthcare rather than a right to a baby, do we consider that we all have a right to healthcare?

Rights are not fixed in stone. Rights are fluid and vary considerably over time and in different countries. In some countries people have no right to healthcare, and it is only available to those who can afford it. In Northern Ireland women don't have the right to an abortion. In Saudi Arabia women have only just gained the right to drive a car or vote.

Rights are man-made (quite literally "man" made, in a lot of cases) and depend entirely on where and when you live.

So if you believe that in the UK in 2020 everyone has the right to medical care, why should that not include IVF?

In the same week I was advised I was not eligible for NHS funding for IVF ( absolutely fine ... I went private and it was successful first cycle )...
My SIL was informed she qualified for a free breast reduction. Same hospital.
She readily admitted herself and to the consultant that it was cosmetic .. ie no pain etc ..
To be fair she was flabbergasted they approved it ...but there you go ..
Different budgets apparently.

Good luck OP

@ivfgottostaypositive

Out of curiosity, what was your reason for needing to do IVF?

It isn't sexist it is the truth. It is different, I am not saying it isn't valid. Read my comment properly, little keyboard warrior. My DH has fertility issues, so I 100% know from experience how disheartening and sad it is for him. A gay man adopting is different to a woman in a heterosexual relationship finding out she is infertile. A gay man cannot naturally conceive with a partner it is impossible, however, a gay man may not be infertile so will not know that feeling. Male infertility is 100% entitled to IVF as is Female infertility. I am saying he knew from an early age he would not biologically be able to father a child, so has had many years to come to terms with this (understandably due to cost does not want to go down the surrogate route) it is different being a mum and growing a baby inside you and delivering that baby in to the world, just like if a woman miscarried. It feels different because they are in us not in our DH's. Doesn't mean they don't want them and love them. I don't need to check myself thanks 🙄 @OneForMeToo

Having a child is not a right but I understand the yearning. People can lose weight, stop smoking or drinking but they can't usually improve their fertility on their own, so I think it is perfectly acceptable to get help from the NHS in this regard. I hope once it starts up again it all works out well for you.

I might be wrong, but I wonder if some people are so against IVF being funded on the NHS because it is statistically more likely to be unsuccessful than it is to lead to a baby being born? Even with 10 cycles (which I’m aware is not available on the NHS) some couples may still not get the outcome they want.

I hope you get your chance when things are running again OP, I really do. Good luck.

Those saying infertility is not a disease, yes it is, categorically. Here's a definition of disease:

"a disorder of structure or function in a human, animal, or plant, especially one that produces specific symptoms or that affects a specific location and is not simply a direct result of physical injury."

Is a function (producing sperm or eggs that can be naturally fertilised) disordered? Yes it is.
Does it produce specific symptoms (yes - the inability to achieve pregnancy) in a specific location (yes, the ovaries or scrotum) which aren't a direct result of physical injury? Yes.

There's so much casual ignorance over infertility. It certainly is the worst disease out there, imo. The most natural human function is to reproduce. That's what all living things are designed to do. Not to fulfill that primary function is the ultimate disease.

There are many areas that the NHS waste money:
Management and bureaucracy
Time wasters
Missed appointments
People who take no care of themselves and expect the NHS to ‘just sort it’ (there are several member of DHs family who have that attitude. I had a boss who was morbidly obese, was told if he lost weight it would sort it, he didn’t want to, just wants a magic pill.

I think in the scheme of things IVF is low down in the costs.

I’m nearly 50. IVF is the only medical treatment I have ever had. Without it I probably would have needed more. I think it was good value.

@ariana1, not necessarily. It's a postcode lottery. I was only entitled to 1, my SIL, who lives in a different city, got 3.

If people are saying this to your face knowing what you are dealing with then it is at best completely insensitive. At worst they are trying to make you feel even worse.

I feel for you immensely and any feelings of disappointment etc that you are having right now are completely valid.

To say that IVF is a waste of public money is a bit of a sweeping statement. There could be a debate around it yes but just to make that comment in a general way shows ignorance. Ignorance to what couples go through ttc. But mainly ignorance as to how the NHS is funded, how that funding is divided up and what proportion goes on fertility treatments.

Personally I don’t think any money spent trying to better someone’s life physically or emotionally is ‘wasted money’ Yes the NHS probably has to look at how things can be streamlined to make savings but cutting entire departments/treatments isn’t the way to do that.

Personally I view IVF as very low down on healthcare priorities. If the NHS is ever scaled back in the future (not impossible based on how this country likes to vote) I think it should be things such as IVF that should be first to go, to keep crucial services still functioning. The priority should be to keep people alive and well.

Male infertility raises different issues - shame, stigma because society (wrongly) conflates fertility with virility, feeling you've let your partner down. With respect to SimonJT I think there is a difference between accepting you won't have a biological child because you're a gay man as in SimonJT's case and actually getting a diagnosis of infertility.

@OneForMeToo yes I agree, found the previous comment a bit precious..

@ivfgottostaypositive yes unfortunately whilst Scotland follows the NICE guidelines other areas don’t- really unfair postcode lottery is the real issue with ivf funding. But yes I do agree it should be limited by age, I was meaning to respond to PPs blaming the infertile for being too old- most who are infertile due to age wont qualify for ivf on the NHS.

Bit sexist to say that as a man it’s different. Considering a previous posters dh killed them selves due to infertility. And yet those saying it shouldn’t be nhs are bad. Check yourself.

I think gastric bands save the NHS more money by not having to treat these people for decades of obesity-related illnesses; usually people that got obese enough for a gastric band are very unlikely to be able to lose that weight on their own. The fact that people who lost 10 stone of their own volition end up in the news at all, shows how rare it is.

I assume those who object to NHS IVF used private maternity hospitals themselves? Surely you didn’t burden NHS maternity services with your ‘lifestyle choice’ to have a child?