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

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

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?

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

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

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.

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.

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.

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.

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.

redtoothbrush - you talk so much sense :)

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.

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.

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?

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.

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?

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

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.

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.

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.

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.

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.

Psychological effect, not psychiatric, my apologies.

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.

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.

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!

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.