...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?

MidLife

The implication that couple’s without children are not family is really poor. Everyone creates their own little family unit in their own ways.

I have a great aunt/uncle and a step aunt/uncle who are childless. The former due to a hereditary condition which at the time they’d have been starting a family couldn’t be screened for so they’re childless by choice, even it was a forced one. The latter were unable to have children, for reasons I don’t know and don’t presume to ask.

Both couples are such solid family units and there is a lot about their relationships I would wish to emulate in my own.

I think some of the money going to IVF should be given to research the reasons that IVF appears to be required so much now. Why is infertility so prevalent I mean.

keyboardkate

Prof Simon Fishel, who has been at the forefront of IVF research since working as part of the team who created the first ever IVF baby, has strongly argued that the NHS should support clinical research into infertility, by allowing more access to randomised clinical trials for patients undergoing NHS funded cycles

Realistically this is all academic, as it's unlikely that there will be NHS funding for IVF for much longer, so advancing evidence based medicine will rely on self funded patients. And of course the challenge is that desperate patients are generally reluctant to do so - if you're paying for treatment and you have the opportunity to pay for an untested treatment that offers a sliver of hope that it might improve your chances, most patients would prefer to take their chances and have access to the treatment, rather than risk getting the placebo

The journal article below is worth a read if you're genuinely interested in this subject

https://www.rbmojournal.com/article/S1472-6483(13)00461-6/pdf

I absolutely think we should publicly fund IVF, AND for a second child as well if the parents wish to go through it all again for a sibling. I am sure we have the money, if only it is spent more wisely and we stop funding illegal wars and all that crap.

Someone upthread commented that if they had to choose between extending the life of an old person with cancer, or giving a family IVF, they'd choose the old person. If I was old, and they told me I could accept treatment that would give me six more months (and not a full life at that) or give a couple a real chance at having a child, I like to think I'd believe I'd had a good innings and to let a couple experience parenthood.

Re. research - The NHS hospitals providing IVF and other fertility treatments often carry out research. We took part in two research projects during our one and only NHS ICSI cycle. One was to do with female fertility in relation of thyroid issues, one more to do with the specifics of ICSI.

For those who are interested in the debate over NHS funding for IVF, this exchange from 2003 in the Guardian about NICE recommendations for national IVF funding, still seems relevant. It's a reasoned back and forth debating both sides of the argument

https://www.theguardian.com/society/2003/aug/30/publicfinances.medicineandhealth

"I have no doubt that the NHS will remain imperfect in that it will not be able to fund all levels of treatment (new equipment, new drugs, new surgical procedures etc) required for every existing and emerging condition. I accept that if there is no new or ring-fenced money, there is the risk of robbing Peter to pay Paul.

IVF is highly visible and much debated, but there are other contentious areas. The provisions for A&E, for example, are critical, and yet there are those who as a result of self-affliction cost the NHS millions - through drug addiction, alcohol abuse, dangerous driving etc. I am not arguing against treating such patients, simply recognising the potential for hypocritical reasoning. The argument of efficacy, too, is contentious throughout medicine. Some would argue the same point for certain cancers and the current use of chemo- and radiotherapy.

As already mentioned, infertility/childlessness affects a large part of the population. It is a serious condition, debilitating individuals for life, and is without question a health issue. The opportunity to ameliorate the condition should no longer remain unrecognised by our National Health Service.

I accept that there is indeed a pre-occupation with fertility (more often than not at the subconscious level) but it is not confined to the media. Fertility transcends culture, nationhood, religion. We might overlook the importance and effect on a single infertile couple, but consider the possibility that mankind awoke tomorrow to find not a single fertile individual on the planet. Then where would be the hope, the future, the meaning to life? This sounds dramatic at the global level, but the force of this is felt no less by individual couples."

Some of the previous posts feel directed at me, so I feel like I should respond. I need to make it extremely clear that it is never my intention to make other people feel depressed or to imply how someone must feel.

Everyone's pain and perspective is so individual and completely personal that I could never presume to know someone else's view point. I only wished to raise how I felt in relation to purpose so I apologise if anyone didn't feel like that.

I've struggled with infertility for years, and as I have mentioned in a previous post I have had times where I have felt like I could be moving on, but then the emptiness (for me) starts to creep in again.

I am extremely grateful for the family and love that I do have, but both my husband and I are so eager for that next stage in life and can't picture a life where we do not have children.

We have both done things to try and find other 'purpose'; retrained in a new career, new degrees, new home projects, new volunteer placements, therapy, etc.

However, we have both acknowledged that we're not ready to move on - as much as we have want too. I genuinely wish I could move on - life would be easier for us to not feel like this. I don't want to feel like I want to be a Mum anymore.

Dun

Your post is horribly ageist. Old people should refuse treatment because it would clear the way for newer life? Nice.

Dun
I think you referred to me.

I didn't talk about an old person and cancer treatment. That's a different debate.

What I said was social care

There is and always be a choice to be made as far as nhs funding, therefore the issue is one that it is important to debate. My view is that with limited resources there are some aspects of the nhs provision that quite simply are not sustainable. Given the money that is spent on pregnancy and subsequent social care I feel that those who undergo such an invasive procedure have a commitment and as a group are likely to be less a burden on the nhs. The difference in the quality of life to those undergoing ivf is in my opinion likely to be considerably more than those undergoing some other procedures. The amount spent on rehabilitation programmes, some counselling and therapy provision, weight loss surgery, some operations for psychological reasons to name a few is in my view less of a priority. However , at the end of the day the choice in terms of allocating spending is just that - there is no right answer.

TacoLover,

I completely understand where you are coming from with your post. When I was struggling with infertility, I was desperate for hope and reassurance. I accessed resources for childless not by choice people and some of what I read was so despairing it made me feel worse.

I needed those words of support to know my life was not meaningless. I appreciate your understanding and support.

I totally get that most people have ivf as they have fertility issues but for some people like us it's the only option to have a healthy baby. That's not eugenics. It's preventing a lifetime of suffering. So as much as research is needed, ivf should still be funded too. Ours wasn't but luckily we begged and borrowed x

I believe PCOS is one of the medical conditions where you can have two rounds of IVF after you have been trying to conceive and been unable. I think it is right for the NHS to fund it. Two rounds is nothing if you may not be ovulating so need help to conceive.

I believe PCOS is one of the medical conditions where you can have two rounds of IVF after you have been trying to conceive and been unable. I think it is right for the NHS to fund it. Two rounds is nothing if you may not be ovulating so need help to conceive.

Nope. Number of cycles is irrespective of the reason for needing IVF. It's purely based on CCG policy

NICE guidance for anovulatory PCOS is ovulation induction with Clomid, if unsuccessful after 6 cycles (or if you're clomid resistant after stepping up to the maximum dose of 150mg) then some trusts will fund ovulation induction with injectables, but most won't. IVF is only tried for PCOS if ovulation induction has been unsuccessful. Some trusts will recommend Laparoscopic ovarian drilling but few do this

And if your trust doesn't fund IVF at all then you're shit outta luck

I drink and I'm overweight. I also pay a lot of tax and don't have children (another barren woman).

I don't actually have any LTC and am pretty fit and healthy, but if I go on to develop diabetes in the future then you can rest assured that my taxes have contributed to you fertile women having your kids and educating them.

Remember that the NHS only funds IVF in certain parts of the country, not the entire UK, and the criteria to meet the NHS funding is quite strict, including BMI of both partners, age, health and lifestyle, previous children on either side etc. How many cycles of IVF is also determined by each area too i.e. someone in Manchester may get 3 cycles, whereas someone else in Staffordshire will only get 1 cycle. Also, not all the IVF medication is NHS funded so you still have to pay for some things. Yes having children is a choice, but that doesn't mean that every woman experiencing infertility will even want to have IVF.

I think funding on the NHS for any treatment should be for those without self inflicted ailments, which infertility is. Smoking is self inflicted and they get NHS treatment, along with those who get lung cancer caused by smoking; again self inflicted (excluding those who never smoked as I know someone who never smoked and died of lung cancer; not self inflicted so should be treated). Those who want a tummy tuck or breast enlargement shouldn't be funded either. If they can get treated on the NHS, then IVF patients should. Those wanting breast reduction is not self inflicted so should be treated; as its not their fault and can actually cause back problems.

All of this is just my opinion.

In addition to my above post, alcoholism is also treated on the NHS which again is self inflicted.

If IVF shouldn't be funded as it's a lifestyle choice, neither should antenatal care, the same lifestyle choice, but I bet most of the people saying IVF shouldn't be provided didn't go private to have their children. And no I've not needed IVF thankfully.

Whenever there’s an ‘IVF shouldn’t be funded on the NHS’ discussion, you can absolutely guarantee that you’ll get comments arguing that the NHS shouldn’t be funding people to have biological children when there are already so many children waiting to be adopted.

Sorry, let me correct that.

The NHS shouldn’t be funding treatment for infertile people to have biological children, when there are already so many children waiting to be adopted.

It’s totally OK for NHS funds to be used for fertile people to have biological children (even though there are so many children waiting to be adopted).

How often do parents who have easily conceived their children get told that that they should have adopted a ‘poor child in care’ instead?

I know lots of couples with two or three birth children — should we limit fertile parents from expanding their family until they adopt?

How often are couples who easily conceived their children told that NHS funds spent on the maternity care for each child would have been better spent on the existing children already in care?

(See also the ‘IVF money could be spent on lifesaving cancer treatment argument. Would you say ‘Oh, you’re having your second/third child? Have you not thought about the cancer budget?’)

The cost to the NHS for just the pregnancies and births of those extra children is pretty hefty — and that’s before you get on to all the healthcare and schooling they’ll need.

Given there’s so many children needing homes, why don’t we say that any couple can only have a birth child once they’ve already adopted, and there are no more children left in the care system?

Plus — think of the valuable NHS resources on maternity care that could be used to fund lifesaving cancer drugs instead (given there’s so many children waiting to be adopted)?

No? Thought not

(let me be clear that I don't advocate for this line of thinking, it's purely for the purposes of a debating point!)

@bananafish I do actually think people should adopt if they want a big family, whether they can have kids or not. If you have two, that's enough to replace yourselves, no further resources being taken up. There are parents wanting children and children wanting parents yet the children are left unloved in care while the parents make more children in a country with a lack of adequate jobs & housing & school places.

It's mad.

I was diagnosed as infertile and found out that was untrue when pregnant. I don't want to produce another child, though, and feel somewhat guilty for bringing one into such a strained, stressful world when there are so many others that need love. But, I'm aiming to adopt or foster in a couple of decades when more financially stable.

Congratulations on your DC Rixera and also massive props for considering adoption to expand your family. Adoption is about finding homes for children, not children for infertile couples - fertile couples can adopt too!

(I'm infertile, no DC, all my IVF was self funded - and just a bit raw after the weekend's headlines about how IVF has caused a collapse in adoption rates, blaming selfish infertile couples for not adopting - when the same charge isn't levelled at fertile couples! I wrote a blog post about this, which the metro have asked to republish - so it's quite top of mind at the moment)

Thanks for such a refreshing POV on this subject 

Not all infertility is due to medical issues.I had free nhs procedures and test for infertility which showed no cause or problems,nor with partner.
We live in an area which offers no free cycles and luckily could afford to pay and we were successful.
If there had been non correctable medical issues I may well just have accepted being childless.We agreed to have only 1 cycle as I have seen a lot of failed marriages and heartbreak when couples have cycle after cycle,my marriage was about us as a couple not for children.
I was resigned to not having children and did not expect the ivf to work,we had plans which in the event we had to change.
I do feel sorry fir those who ache to be mothers,I didn't have that.I have enough seeing the things I had got rather than what I hadn't.

as a tax payer I would rather my money was spent on IVF rather than gastric band surgery

I couldn't have children. I still don't think that IVF should be done through the NHS. (my husband has a child so we weren't entitled to it anyway).

I heard a couple in the Doctors waiting room the other day talking about how she was pregnant with twins after NHS IVF. She was rough as arseholes, swearing, aggressive and popping out to SMOKE!!!
These people would never have been cleared to adopt yet were funded for IVF. Strange world.