...to ask why the NHS funds IVF?

[moofeatures]

I promise I'm neither an (intentionally) goady fucker, nor Katie Hopkins.

But.

Following on from a recent thread about there being a perception that public money grows on trees, I'd like to ask your stance on the NHS funding IVF.

Now, before I get flamed for my insensitivity, let me explain that I myself was diagnosed with ovarian failure in my 20s. I am still of an age where I'd meet the criteria for NHS IVF funding, which would be my only way to have a biological child. I initially grieved for this as I always assumed I'd be pregnant one day, but also from day 1 of my diagnosis I've felt that artificial reproductive hormone therapy/IUI/IVF falls outside the remit of what the NHS should provide as it serves no medically therapeutic purpose.

The logical response to my argument is: "if the only option for IVF is to privately fund, then you're depriving less affluent people the chance to become parents", which is both true and a shame... but is it the NHS's problem? Really, it's the infertility which took away that choice - and it is a choice, not a right... at least in my opinion.

Am I alone in feeling this way?

Thanks Apple. One of my friends couldn’t get IVF as her husband had a child from a previous relationship. Just seemed so sad that SHE couldn’t have the opportunity, without saving thousands of pounds, just because HE already was a dad.

I think cancer is bloody awful, don’t get me wrong, but what’s the logic of allowing IVF on the NHS even if the person already has a child? As opposed to someone who is infertile for another reason?

@CoffeeAndCupcakes85 A lot of CCGs fund if there's a child as long as one of the couple is childless, so the man or the woman can have children but not both of them and not to each other

As well as being cruel, the mental health ('you can't have a baby if you want one too much') argument is nonsensical. No one would have known that recurrent miscarriage would send me a bit loopy if I'd conceived and carried to term easily instead - but I'd still be me, and so just a big a 'risk' to my baby. The people smugly saying that they'd have coped much more rationally with infertility than actual infertile people do are talking absolute nonsense - we can all respond perfectly to hypothetical situations, it's the actual things that happen to you that test you.

Coffee, I wish I knew.

For anyone who is interested in helping support funding for IVF, MP Steve McCabe has just had a first reading of a ten minute rule Bill in parliament. Its worth doing some research, and maybe asking your local MP to support the second reading in November.

My local area offers IVF only for former cancer patients. Which I think is pretty disgusting - infertility is infertility regardless of its cause, so it seems to be based on the idea that cancer is 'really sad' but infertility is 'just a bit sad'. Which isn't a medical judgement at all.

Completely agree with you Lisasimpsonsbff. That’s really bad .

There's something horrendously wrong with a system, when it means people with infertility have more chance of having children it they get cancer.

and yet there are lots of people who'll say 'well if they've had cancer, I guess they can have IVF but no one else'.

Many of us will get cancer at some point in our lives. We do need to treat and research it. It's important.

But it can't come at the expense of everything else!

and yet there are lots of people who'll say 'well if they've had cancer, I guess they can have IVF but no one else'.

I actually suspect that that's what the decision is based on - which sort of 'sad face in the local paper' story is likely to get sympathy. Which, again, is not a medical decision based on any kind of objective criteria.

I think that this is actually an excellent thread, and I agree with the PP who said it’s annoying when an OP is called goady for raising a divisive and emotive issue. Having read some of the eloquent and thought provoking arguments in favour, I now absolutely think IVF should be funded on the NHS. And I think it’s great to have somewhere where people can discuss things in a rational manner.

I think that's quite grotesque, to say you can only have IVF on the NHS if you've had cancer. IVF was pioneered to help infertile people, to separate that group into the deserving and undeserving is horrible. However I don't think gay couples should get IVF on the NHS unless there are fertility problems which mean they couldn't get pregnant naturally using a sperm donor. If thete are no such problems it's not really a medical issue.

It is a difficult one over funding as each CCG decides on their own policy and criteria. They also buy in the IVF as separate CCGs.

NICE say three rounds should be offered. My CCG offer 1 if you meet the criteria, some offer 2 or 3, some none and some only if you have had cancer. I feel for those with infertility from cancer, but cancer is not the only horrid illness that causes infertility so it is unfair for it to be singled out (I think it is good they get it but so should the others with infertility).

Most CCGs have the same restrictions, so healthy BMI, no previous children, stable relationship for at least 2 years, non-smokers and a few others but they can set their own criteria.

I read an article by an IVF doctor a while ago (she is part of the Create clinics) that each CCG buys in the treatment so a basic IVF can cost a CCG anywhere from £2k to £11k depending on who they buy it from. That is a ridiculous range and she says that basically the NHS is being ripped off and if NHS as a whole bought the IVF treatment, rather than CCGs individually, they could get a cheaper deal and could offer more cycles/wider criteria for the same overall cost.

I think that this is actually an excellent thread, and I agree with the PP who said it’s annoying when an OP is called goady for raising a divisive and emotive issue. Having read some of the eloquent and thought provoking arguments in favour, I now absolutely think IVF should be funded on the NHS.

I agree that some of the arguments are very rational and eloquent. I'm not sure it's changed my personal opinion, but I can totally see why IVF is funded on the NHS.

I think that, for me, IVF is too much like the thinking that was around as I was growing up in the 60s and 70s - that women's main purpose & value in life was to have children. I rejected that ideology, and it seemed to me during my child-bearing years in the late 70s to end of the 1980s that IVF simply played into that very restrictive view of the value of a woman's life.

@BorchesterTowers that's just not true, as IVF isn't just about the woman, it's also about the man. It's usually a couple who want to have a child together. For those of us who do want children, it's a biological urge that can't be ignored.

If anything, it's more often than not career women who have IVF, because they have put off having babies in order to build up their careers. So IVF is actually empowering for women, because it means they can choose to put off motherhood knowing the option is there.

There's something horrendously wrong with a system, when it means people with infertility have more chance of having children it they get cancer.

Yep. Yet ironically a lot of people who’ve had cancer no longer want it. The prospect you might have a baby you won’t see grow up is not an attractive one.

*BorchesterTowersthat's just not true, as IVF isn't just about the woman, it's also about the man. It's usually a couple who want to have a child together. For those of us who do want children, it's a biological urge that can't be ignored.

If anything, it's more often than not career women who have IVF, because they have put off having babies in order to build up their careers. So IVF is actually empowering for women, because it means they can choose to put off motherhood knowing the option is there.*

That's an extremely rose tinted view of IVF. IVF carries no guarantees and no one should rely on it as a fallback. That said I agree with Borchester Towers, having kids is not the be all and end all and I say that as someone who wanted them enough to try IVF - not on the NHS but was not one of the lucky ones.

I don't think OP is a GF. I don't agree with what she's saying, but I think it's a subject that's worth discussing. I have found her responses to be thoughtful and sympathetic

However this consideration hasn't been shown by many other posters on this thread.

Let's just review some of the comments made (comments from others in bold) shall we:

And if that causes someone to get mentally ill then they should definitely not be having children.

If someones mental health is so precarious then surely that's another reason not to have IVF and bring a child into the mix.

Anyone who's got any mental health issues - no children for you!!

Children are expensive so if you can afford a chid you can afford ivf.

I don't really agree with IVF at all

If you really want children you will find a way to have them

If a couple badly want a child then they would find the means to fund it. If they weren't prepared to do that then obviously the want for a child wasn't that great in the first place.

I believe that’s children are a privilege not a right

If the NHS pays for people who can't have a baby naturally they how long will it be before the NHS has to pay to allow men to have babies. Its essentially a life style treatment

It's a lifestyle choice not essential.

Children are a non essential lifestyle choice, but if you conceive your children naturally it's totally OK to use:

NHS maternity provision
State education
Child benefit and tax credits

There are hundreds of posts on MN every week defending child tax credits, saying that it shouldn't be only the rich who can have children. Posters on low incomes post that they can't afford childcare, new clothes for the kids - all sorts of challenges that come with difficult financial situations.

But can't conceive naturally? Children are a lifestyle choice. If you wanted them enough, you'd be able to afford them.

There's too many people on the planet.

What a total waste of time and money when there are so many children needing adoption.

There is no medical requirement to have a child. We're not underpopulated. You could adopt or foster. Nobody NEEDS a child.

There are so many children in need of homes waiting to be adopted, and the world is over populated already - but if YOUR reproductive organs work OK, then you get a pass, you can carry on populating the world and you can have a birth child instead of providing a home for a child in foster care, and get your maternity care on the NHS.

Is infertility a health care issue? No one dies of infertility

Infertility is not an illness

With alcoholics, obese people and drug addicts, you are treating the medical problem that theirs lifestyle choice has caused. Not having a child in itself is not a medical problem although the cause is

The WHO has defined infertility as a disease, but don't let that bother you. Best our NHS money goes on people with completely self-induced healthcare issues relating to smoking and obesity than on treating those people who through no fault of their own were born with faulty reproductive organs

however ivf doesn’t actually cure infertility the person is still infertile

It's OK to treat COPD and diabetes with medications even though they don't CURE the condition (that might be lifestyle related if you're obese or a smoker). But if your reproductive organs don't work, through no fault of your own, then no treatment for you!

And let's not forget

I worry about the long term implications. Ivf after cancer treatment etc is OK, but for conditions such as poor sperm mobility, what if that is passed on to the next generation? Are we breeding infertility issues that would naturally be curtailed if infertile people didn't have children artificially?

If all else fails, why don't we infertiles just DIE OUT, and save all the bother, don't risk passing our barren genes on. Natural selection, let the defective ones die out.

It's not rose tinted. It didn't work for me, as I had no eggs. It was a really traumatic experience, especially the egg collection when the surgeon searched for one hour and could only collect one immature egg. We adopted our DDs in the end. But I know people for whom it has worked and I'm pleased for them.

when i went through ivf, part of the discussions had with the doctors were the increased chance of genetic or birth defects by essentially forcing conception between cells which under normal circumstances wouldn't be good enough to work on their own.
i don't see how the thought process of it possibly being better not to pass on those kind of problems isnt one to consider seriously, rather than just shutting down the pp who said that.

Are we breeding infertility issues that would naturally be curtailed if infertile people didn't have children artificially?

Fertility issues are rarely inherited ones for reasons obvious to anyone who isn’t daft.

Infertility is a health issue. It also has a huge impact on mental health etc.

I think that’s a perfectly reasonable use of NHS resources. If the NHS didn’t do it, what good would that do? Wanting a child, and not being able to have one, must be horrendous. I count myself lucky that we had no trouble conceiving. I wouldn’t be surprised if providing IVF actually saved money on mental health treatment.

when i went through ivf, part of the discussions had with the doctors were the increased chance of genetic or birth defects by essentially forcing conception between cells which under normal circumstances wouldn't be good enough to work on their own.
i don't see how the thought process of it possibly being better not to pass on those kind of problems isnt one to consider seriously, rather than just shutting down the pp who said that.

There is a small likelihood of sperm motility issues being inherited, which is discussed as part of ICSI consents

What genetic defects were discussed as a result of IVF in your consults?

I had 4 cycles and have also been through genetic counselling for pre implantation genetic screening - apart from the ICSI implications in the event that the male partner has male factor infertility, I don't recall increased chance of genetic defects being a result of assisted conception. Could you point me in the direction of what these might be?

Do we suggest that people with ASD don't reproduce because of the likelihood that it may be inherited?

What about people who have IVF for PGD specifically to avoid passing on genetic diseases?

when i went through ivf, part of the discussions had with the doctors were the increased chance of genetic or birth defects by essentially forcing conception between cells which under normal circumstances wouldn't be good enough to work on their own.

See the last paragraph. This was all covered in my ICSI consents (we had standard IVF but obvs you have to consent to ICSI if needed on the day) as part of informed consent

If we're going to go down the lines of anyone with any kind of genetic related health issue not procreating, then that's a different debate.

Male infertility is known to be associated (in some cases) with chromosomal and other genetic anomalies. There is known to be an increase in gross chromosomal abnormalities such as balanced translocations in men with very low sperm counts. Also, about 5% of men with very low sperm counts have small areas of missing DNA on their Y chromosome. This is referred to as a "Y micro-deletion". The technology to test for Y micro-deletions is now available.

Chromosomal testing (karyotype) of the male can also be done, to evaluate the normality of the male’s chromosomes. If you are interested in having any of this testing performed, be sure to ask about it before the female partner begins medications for treatment – results may not be available for several weeks.

There are some other specific genetic disorders that have been identified as causes of defective sperm production and male infertility. It is certain that there will be additional hidden or recessive genetic disorders that will be discovered in the future that are the cause of some other cases of male factor infertility. Techniques such as ICSI will, in some cases, lead to transmission of genetic problems that might cause infertility in male offspring, or could possibly be associated with other (at this time unknown) medical problems in the child. In some cases, these disorders probably would not be transmitted without ICSI - particularly if the couple remains childless.

There have now been many thousands of babies born after IVF with ICSI with follow-up after birth. Thus far, there has not been demonstrated to be any clear increased risk for birth defects as compared to IVF with conventional insemination.

I think that’s a perfectly reasonable use of NHS resources. If the NHS didn’t do it, what good would that do? Wanting a child, and not being able to have one, must be horrendous.*
It is, but it is also something people can and do get over and move on from. I speak as one who had no choice but to do so.

Some people would rather see the MHS funding IVF and cutting funding for type 2 diabetes. Some people would prefer everything to be poured into cancer treatment, other heart disease.....for every single person there is an argument for why the NHS should fund what they want.

We feel that way because it is ours - we pay for it, therefore we have a say in it. We all want the NHS to help us at some point. And yet we vote in a government that wants to destroy and privatise it.

How about this. We have enough money in this country to fund IVF, cancer drugs, diabetes treatment and everything else. Yet the NHS is being starved of money because this government chooses to spend it elsewhere. So maybe, instead of bickering over what treatment we want to stop, we should be making sure we have a government that funds the service we need?