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

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.

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 :)

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!

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.

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

Johnnybear not Johnnycake-damn IPad!

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

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.

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?

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

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

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.

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

Hear, hear, MrsDeV.

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.

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.

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.

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.

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.

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.

Well if you did you would agree.

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.