Disgusted with IVF Charging.

Fair dos, thanks for pointing out!! Bit new to this online dialogue stuff. My bad.

This is a tricky one but, as a broad principle, I err towards the belief that no elective procedures should be funded on the NHS, without very strong clinical rationale underpinning them. And I also appreciate the argument regarding medical treatment being offered free to those who blatantly abuse their bodies - but admit that policing any control around that issue would be extremely hard & liable to slip into judgementality, based on 'in vogue' political correctness. Regarding IVF & other fertility treatments specifically, I fully appreciate that there are huge biological, emotional, social & other impetus to have children. But we also have to accept that the world is becoming grossly overpopulated & this has serious negative impacts on the planet, on natural resources, on social intrastructures etc. Difficult to achieve a balance here but I think we need to shift society away from the perception that having children is a 'right' and move to a position where it is viewed as a privilege. And, yes, I do realise that I am about to get swamped in a mass of diatribes, as this is a highly emotive issue. Yikes!!

I wouldn't trust the NHS . We were on a waiting list for 18 months to have IVF and one day we got a letter to say that they had put us on the wrong list. We are now waiting on a private list for donor ivf and the list is 20 months as there is a lack of donors. Have you thought about a egg share programe? they do this at the Lister hospital in London.

Good point bran I mean don't know what happened there.

I must go to bed.....

Good point really-0 and ties in with my experience. Complex case? NHS? forget it - whatever it is.

I think that besides the monetary cost issue of IVF there is also a health cost. Regardless of whether it was free or not I wouldn't consider having IVF on the NHS because their success rates are generally very low and it's not worth the risk to my health for such a low chance of success. In a big organisation like that it's very process focussed rather than individual focussed, which works well for things like broken legs which are generally very similar to each other, but not necessarily for fertility treatment where there are so many different causes of infertility and you can have such diverse reactions to the drugs used.

In some clinics the success rate for IVF per cycle is one in three! Mind you, some clinics don't take people they think it won't work for easily (eg those in late 30s plus) so as to boost their published success rate. High success rates don't always mean better treatment, just as the success rates of top selective schools reflects as much on the intake as the teaching. Mind you, IVF is getting much more successful and the techniques are being refined the whole time.

In some clinics the success rate for IVF per cycle is one in three! Mind you, some clinics don't take people they think it won't work for easily (eg those in late 30s plus) so as to boost their published success rate. High success rates don't always mean better treatment, just as the success rates of top selective schools reflects as much on the intake as the teaching. Mind you, IVF is getting much more successful and the techniques are being refined the whole time.

I agree with your point - IVF does not work for everyone. But what I found so frustrating during my own fertility journey was the number of well meaning people telling me that IVF was so unlikely to work that I just should give up and accept not being able to have children when it was just that the statistics weren't being fully understood. I also resent the time I spent under a NHS hospital spending months on treatments with lower success rates (ie 10-15%) because IVF was a scarce treatment with a long waiting list - a waste of my time and NHS money, but until I did a lot of research I knew no better.

150...I think that the success rates of IVF probably do have a lot to do with funding. Its is costly non life saving treatment that has no guarantees. And I'm not making any judgements on whether it should be free or not (or how devastating it is for people), but with a finite amount of resources life saving treatment with higher success rates (sometimes guaranteed success) will get prioritised.

As to the postcode lottery, this isn't exclusive to IVF, as I'm sure you know, prominent cases include MS drugs as well as newer Cancer drugs.

One of the things that was bugging me about this debate was the seeming resoluteness that IVF would work, for sure. That if only the funding were availabe couples would have babies. 38% after 3 attempts is still a third (and thank you for the explanation, I was getting quite confused!) and that is still a significant number who would then have to find their own funding according to the NICE guidelines, and so may not go any further. I just think that there is a real danger of people really expecting science to cure everything.

Jimjams - I agree that the NHS isn't at its best with chronic conditions.

My frustation with the postcode lottery for IVF isn't whether people pay per se, but the different success rates at different hospitals. I am frustrated that there are couples having NHS funded IVF at units with a less than 10% per cycle success rates whilst other units enjoy up to 40+% rates - provided you pay for it. I do wonder whether the fact that the majority of UK IVF is still in the private sector means that research, best practice etc is not shared equally as of course the private units would prefer to have a "competitive edge". (I've no evidence that this is the case BTW - just wondering!).

I have to say on the issue of IVF funding, I'm afraid this is one area where given a limited pot, I would prefer for money to be spent on research whilst most couples paid or subsidised their treatment. Childfree couples tend to have more disposible income, and should be in a position to afford at least to contribute towards the treatment. Perhaps I just spend too much on childcare and stuff for the kids, but they certainly cost me more than the £2-6k that say 1-2 IVF treatments might cost per annum. More tricky once you have a child - I went back to work for a while to pay for #2. And as for #3: if we were fertile then it would be a possibility, but I'm not sure it is fair on the other 2 for me to go back to work and go through several treatments hoping to be successful again.

In terms of diverting money from other areas of the NHS towards IVF, I simply don't have the sort of info or background to make an honest decision. Should cancer treament be cut - no. The viagra bill - maybe? Do I want to pay more in taxes specifically towards IVF - if I'm honest I can think of more deserving causes...

(Ducking as will now have offended everyone on the thread somehow!)

Pie - agreed that IVF will not work for every couple - that is why the NICE guidelines suggest 3 attempts and only for those under 40. However it will work for the majority of couples, which is why NICE (National Institute for Clinical Excellence) are recommending it! There are a minority of couples whose fertility problems are not yet soluble, but research continues. Certainly for someone like Astrogirl suffering from PCOS generally a number of IVF attempts will result in a child - it is simply a matter of time and funding.... The NICE website goes through all the economics including average cost per live delivery etc...

And looking at the detail of the report NICE are not simply suggesting that every couple go straight to IVF - there will still be the usual processes of tests and alternative (cheaper and less evasive) treatment such as Clomid.

And consultants are not stupid - they know if there is no point in recommending IVF, and certainly in my experience (4 consultants to date) have been able to give an indication of what my odds are. I just get frustrated when the odds per cycle are quoted as if to prove that it can't work for 75-80% of couples. Out of 100 couples if 25 have a baby the first time, and the other 75 go on to a second attempt, then 19 more have a baby leaving 56 facing a 3rd attempt with 14 more having a baby - it still means that 38% will be disappointed and decide whether to call it a day or not. But it does mean that over 60% of the couples have a baby (or 2) - it will have taken most of them longer than a year to achieve it though...

Not sure that this answers the funding question though, or are you suggesting that there is a minimum success threshold before a treatment is funded?

actually fairymum, the thought of adopting or fostering a child in a few years is something that has been in my mind a lot lately, but only if(!!) the health of my family is ok.
i had my kids young, i'm glad i did, as i dont know what the future holds, no-one does. i'm lucky, but the nhs is overstratched (have i said that enough yet), if they cant provide SALT for kids, take months for people to have MRI's, send kids home having asthma attacks cos they dont have enuff beds, until that is sorted out and everyone gets equal treatment regardless of where they live, i'm afraid there is no hope.

Ok, I see that. But IVF can't overcome EVERY cause of infertility can it, so in that respect its never going to give an infertile couple the same chances as a couple without fertility problems is it? Sometimes, no matter how many attempts it doesn't work, right?

Because IVF cycles do not equate to months in terms of time, just in terms of bringing about the same conditions (sperm meets egg, gets it together and travels to womb for a chance to settle down)...

Each month a couple has a 1 in 5 or so chance of conceiving - just as each IVF cycle a couple has a similar chance of conceiving. You don't just give up after one month or one attempt. You spend time getting over it and preparing for the next attempt...

I was using the comparison to indicate that IVF couples will have a baby at the end of the process, not specifically the time-line: it takes much longer, but it is defintiely worth the wait when it happens!

Yeah but 150percent the fact that couples may take 15 years to conceive means that the NHS will never be able to cope with fertilty treatment properly. My son needs 15 + years of speech therapy. He hasn't had any yet. If he needed 6 weeks worth he would have received it. The NHS just is totally unable to cope with chronic conditions.

maybe IVF should be free until a successful delivery - then you pay for the baby according to how many attempts it took.

Pie that is for 1 YEAR! 23,737 patients had 25,273 cycles, so most patients only had one cycle that year - say at best 1,600 had 2. Many of the remainder who weren't pg would have had further attempts the next year, and the next year and the next year - until they run out of money or can't face the disppointment any more. That is why IVF funding and acute cancer funding are different. Many couples can battle for 15 or more years in order to conceive. People with acute conditions can't wait, and hence the comparison is a poor one. which is why I chose Viagra as an alternative comparison. Like infertilty, impotence won't kill you....

150...I thought that 80% of couples conceived in the first year, how can IVF be putting them back where they would have been anyway then?

Ok 1 in 4 on the later statistics, but that still means that IVF isn't a cureall surely?

can I just correxct my post. HAving read misdees post I should say that NHS care for acute coniditons is also bad.

I do think that unless you have tried to use the NHS frequently in recent years you don't really get an idea of how bad it is. It is dreadful pretty much across the board. I have had some successes with the NHS in recent years (such as the time my son got eczema herpeticum) but the dreafulness of the bad times doesn't make up for the few good appointements.

I don't really see the point in saying condition X is worse than condition Y, or Z's condition is self inflicted so they don't deserve to be treated. At the moment the NHS will be failing X, Y and Z. It needs to be scrapped.

Ok, I know I sound thick, but the site tells you how to read the statistics...it says:

Other results from all IVF treatments
Number of single, twin and triplet live births from treatment. These figures include still births and neonatal deaths.

Patients: Number of patients who received IVF treatment (some patients will have had more than once treatment cycle).

so how would the cumulative figures change how the national average works out when they are included?

sorry pie- saw more info at the bottom of the page you linked to. This indicated about 6,300 births for 23,700 patients that year, so better than a 1 in 4 chance. But again this is just the info for one year. As a complete cycle takes almost 3 months not many people can fit in more than 2 or 3 in a year.

Some hospitals are better than others, but a 1 in 5 stat per treatment isn't far off the "normal" chaqnces of conceiving - ie you are putting these couples back in the place where they would have been - some couples conceive the first month they try, the majority will ahve conceived by the 6th month or so..