to be cross with the 32% of the population who think ivf shouldn't be available on the NHS

[tholeon]

I read an article in the paper this morning saying that only 68% of the population think that ivf should be available on the NHS.

I have an ivf DC. He is the best thing that has happened to me. Infertility was the worst. We are lucky in that we could pay for the treatment without bankrupting ourselves. Not lucky in the 'hurrah lets whip £10k out of our back pockets to pay for all these lovely invasive and unpleasent treatments that may not work, while other people just get to have a nice shag' sort of way - but still, relatively so. I know plently people on fertility forums who are unable to afford treatment at all.

Any of the 32% out there? I know money is tight, but infertility is a medical condition, and it causes great heartache and unhappiness in a way that might be hard to understand for those who have not been through it themselves or seen it at first hand. So why do so many people see it as such a low priority?

the not knowing is the hardest part, IME. Until you are fully in menopause, you aren't really going to know if it might still happen or not, even if the odds are getting slimmer and slimmer.

my point is not that I don't think infertile people can live a full life but that I dislike the idea that other people think the way around it is to fill your life with things you may not have wanted to do in the first place. People try to make you feel better by telling you to think of all the time, money and freedom you will have, how you can be the best Aunty ever etc. Some people don't want to be told that this is their alternative to children.

I have no idea what its like to be infertile thank God.

I know a lot about cancer, it fecking sucks.

But I think IVF SHOULD be on the NHS to a certain extent.

It should be far more uniform in its availability though.

I dont know what the rules are now. I think couples should be required to loose weight, stop drinking and smoking etc (not for moral reasons, but to ensure optimum results.)

Loads of things are available on the NHS that not everyone agrees with. There are tens of thousands of people who think blood transfusions shouldnt be allowed. What about weight loss surgery, gender reassignment, life prolonging drugs for people who are only going to live for 2-3 mths anyway?

I dont have problems with any of the above either but lots will.

I dont think anyone has died from cancer because someone else has had 3 rounds of IVF. Its not as simple as that.

Stop all IVF and i really do not think every child who needs one will get a decent wheelchair.

I think the suggestion that couples should only get fertility treatment if they have a certain amount of money is crap. Only the well off should have kids?

I'm in the 32% too. IVF is not a necessity but a want/desire. Plenty of children in care/foster homes for those that want a child so badly.

I'd rather see people like Rivens daughter get a new wheelchair or provide more cancer treatments/search for a cure than pay thousands for something that may not work just because somebody wants something.

No I don't think IVF should be available on the NHS. And I'm saying this as someone who has not yet TTC so for all I know I can't have them naturally. But in some PCTs babies which have been wanted, conceived and carried die because there are not enough doctors/midwives or the resources are not up to scratch. I would rather save those babies than create new ones.

i would still like someone to explain why adults should be discriminated against because a certain type of treatment is seen as unnecessary? my mum's knee replacement isn't necessary, but the nhs will pay, why should one particular type of treatment be singled out, when so much that is unnecessary is already funded?

someone else said they'd be happy for it to be funded if cancer had better survival rates etc, so why aren't other services being cut? why is this ONE type of treatment seen as unnecessary when others aren't? just because it's a relatively new treatment which wasn't funded before, shy shouldn't it be now? there are millions of medicines & treatments which get accepted & funded, so why rule out just one group?

it kind of implies that if you don't think it should be funded, you don't think those people without babies should deserve them.

Edam (because everyone still seems to be ignoring your point!)

If it's right then yes it's an argument for funding. However:

If free IVF is available to everyone who needs it for as long as required then the cost of IVF will increase dramatically and so the argument might not work any more. If IVF is limited, desperate people will still go for an all-or-nothing shot with multiple embryos implanted.

Also, I'm having trouble believing the stats. I assume we're talking about provision to mothers of normal child bearing age (and a lot of private, multiple implantation IVF will be for women over 40 or whatever the arbitrary NHS cutoff is, if only because the chances of success are smaller so they're more likely to take the risk of a multiple birth). The majority of multiple births from IVF will be twins, with some triplets and some greater multiples. Do twins really cost the NHS that much more than single births? Triplets aren't that common (in my experience) with IVF although I have no stats to back that up. I know a lot of IVF babies and only one set of triplets and no twins that I can think of. I also know a set of natural triplets.

I'm suspicious that the study you refer to did not control for the health of the mother in the first place - i.e. would mothers seeking private IVF treatment be more likely to receive additional medical care regardless of the IVF? My argument here is that if a couple don't pass the NHS guidelines for IVF (and I acknowledge that sometimes it's a postcode lottery) then they are a 'worse' case for IVF and more likely to have problems down the line. That's the point of the NHS guidelines, surely.

Haven't seen the study. Quite happy to tear it apart. Just because they're 'health economists' doesn't mean they're right (got it right that time).

I'm still in the 'no' camp (although Edam may be persuading me for purely financial reasons). I don't think I would have gone down the IVF route but can't guarantee it as I wasn't in the situation. My husband felt more strongly about a natural child and might have persuaded me. However, if I had chosen to, I would have expected to pay. Wouldn't have complained if someone had given it to me for free but I wouldn't have complained at having to pay.

Arguing against myself here but

I agree I'd be worried about my ability to support children if my income wasn't high enough to generate a £5k-£15k loan (to pay for up to 3 rounds of treatment). I'm aware plenty of people do though. However, plenty of people could support children very easily but maybe not with that loan hanging over their head. If you use the money for IVF it's not there for the child!

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SassySusan, I have no problem whatsoever with consultants' pay. They are very bright, very hardworking people who deserve every penny imo.

I agree with you about the centralisation of specialist services though.

"or whatever the arbitrary NHS cutoff is"

it's around 38 on average

also the majority of IVF births are not miultiples AFAIR.

"25% of deliveries after IVF were twins and 1.7% were triplets." from 2002 HFEA patients guide.

"It is important to note that in the United Kingdom, the maximum number of embryos to be replaced per cycle is three. In order to reduce the risk of multiple pregnancy, the HFEA in the United Kingdom (August 2001) has decided to reduce the number of embryos to be transferred from three to two. In exceptional circumstances a three eggs or embryos transfer may be performed. This will be case specific and indications might include clinical and laboratory criteria. Countries have different regulations and restrictions with regard to the number of embryos to be transferred"

risks and complications of IVF treatment

EmmaKate..... I mean when my mother comes home she has to pay for her own GP appointment and full fees for prescriptions...ie £30.

for those arguing for centralised services, have you ever had to use centralised services yourselves?

I'm currently travelling 125miles round trip (which has been a weekly trip for post-op follow up for the past 7 weeks, and I'm not done yet) to see an eye specialist, as my local hospital doesn't have a specialist who could carry out the surgery I needed. It takes over 3 hours each way on the train/bus. (Can't drive as they dilate my pupils, but driving would still be 1.5hrs+ each way) I'm young (ish ) fit & healthly other than a dodgy eye & it's still a drag & DH has to take a day off work each time to look after our two preschool children. I can't help but think how elderly/disabled people would cope if they had to do this journey (and a very high proportion who need the op I had are 60+)

Yes things can be centralised to a certain degree, but they still need to be accessible to everyone, particularly given that the elderly & disabled usually need to access then more than your average Jo Bloggs. It's much easier to do this for those that live in a big city with multiple hospitals, than for those that live a lot further from major hospitals.

Posie - how long has your mum been out of the country? If she was resident for a 10year (continuous) period and has been non-resident for less than five years she's entitled to free NHS care. Whether or not she deems it acceptable to accept it is different.

Mumblechum

I actually think consultants and doctors in general are overpaid. Yes they work very long hours and have to be quite bright. However there are many many bright people who don't get medical school places who would be perfectly capable of becoming doctors and consultants. You could pay doctors quite a lot less and have plenty of people still wanting to do it. There's this general misconception that you have to be brain of Britain to be a doctor. You don't, you just need to quite bright with a strong work ethic.

That's not to say they 'deserve' less. That's to say that without the unions they could be paid less. There are plenty of people on front-line services who 'deserve 'to be paid more and aren't.

Thanks DF. That is a much higher twin and triplet rate than normal but I'm not convinced it's high enough for the extra medical care needed to outweigh the costs of the IVF treatment.

With the exception of GPs - who work basically part time and do no out of ours cover and are very overpaid, doctors are absolutely NOT overpaid. Hospital consultants don't make 100k plus until they have been a consultant for more than 20 years! Eg - not until they are about the most senior doctors in a the whole hospital.
Junior doctors start on 23k, with an additional banding supplement if they work very long antisocial hours, or do a particular difficult responsible job (e.g. junior doctors doing surgical jobs in big hospitals are paid more than those doing 4 days a week in a GP practice from 10am to 4pm).
This is NOT overpaid for the level of training, working hours, and responsibility that a doctor has.

2002 guide is a little out of date. HFEA now recommends single embryo transfer (and maximum two) but in order to give people the same chance of a successful pregnancy, they advise using all suitable fresh and frozen embryos from one cycle before starting another.

If anyone is interested here is the actual NHS payscale.
As you will see, the suggestion that GP's earning £100k per year are "poor compared to consultants" is simply not true - vast majority of consultants are on less than £100k.
www.nhsemployers.org/Aboutus/Publications/PayCirculars/Documents/Pay%20Circular_MD_1_10.pdf
I think there is a mistaken public perception that doctors are a paid a lot more than they actually are.

If anyone wants to find out more about HFEA policies, think they are available on their website, and there's a patient charity that's been involved in the guidelines but I cannot recall who they are. Will have to go and interrogate my files!

I think most consultants earn every penny TBH, having seen how hard my friend has worked for the past 20+ years & the responsibilities she has now (she's a consultant in paediatric anaesthetics, she works in paediatric intensive care). She works long hours (and you can't "just" leave at 5pm ever) + on call on top + the studying/reading necessary to keep up to date as well, they earn every penny...

Right, very quick look at my files and (miraculously given the state of my filing!) I've found something useful. The Expert Group on Multiple Births After IVF produced a report in 2006 called 'One child at a time'. Led by Professor Peter Braude. At that point (Oct 2006) it said one in four IVF pregnancies resulted in twins.

Not sure if it's publicly available but you could try googling. Or go and look at Infertility Network UK or the Multiple Births Foundation, who were part of the expert group (alongside a lot of obs and gynae consultants and commissioners and so on). Or the East of England Strategic Health Authority - they were the first to try to put the NICE guidelines into place. Or go to www.nice.org.uk and see the guidelines.

Things may have moved on since I was vaguely involved in this last year, of course.

Betsy - I agree.
Unless you have actually been a doctor you can't even begin to imagine what's involved. A bad day at work as a doctor makes a bad day at work in almost any other job look like a walk in the park.

proseccogirl - my consultant friend actually worked out a couple of years ago that she earns about £15/hr, ie about the same rate as an EO in the civil service...

This was in response to another "friend" having a go about how much she earned, said friend happened to be an EO in the civil service, who takes full advantage of her flexi-time etc, my consultant friend offered to swap jobs