...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?

@Rixera - why didn’t you give up your baby for adoption and let a couple who wanted a child have them? By keeping the child you are basically negating every word you’re saying. You had your child naturally, so the infertility diagnosis was clearly wrong, but you chose to keep them. You have no right telling another infertile person what to do.

I had IVF and have possibly saved the NHS money. I have a genetic condition - one of a number that they cannot fully diagnose and therefore pre implantation diagnosis was not an option - and the chances of me passing it on were 50/50. Over the years I have had twelve lots of surgery, countless hospital appointments with doctors, physios etc. Goodness knows how much it all cost. I'm walking around with £3k of metal in my face! I didn't want to have a genetic child and for it to face all of that. So we forked out £10 for ivf with a donor egg. We didn't qualify for ivf funding on the NHS. We were very lucky as it worked second time. I think a lot of responses on this thread are quite shocking and until you have walked a mile in someone else's shoes you should not judge them. It's not just infertile people that need ivf.

Rixera it's very easy to say you feel guilty about having a child...when you have a child. A child who I'm guessing you wouldn't change for the world or regret having?

Yes absolutely the NHS should fund IVF, although why eligibility isn’t standardised across the country is beyond me. I work for the NHS and there is money wasted all over the place that puts the amount spent on IVF in the shade. Denying people the opportunity to have children unless they can produce large amounts of money is not the mark of a caring society (actual IVF costs are much less than private clinics charge, so it’s not costing the NHS that much each time). Suggesting infertile couples should just shrug it off and take one for the team with regards to overpopulation is rather arrogant, along with dictating how many children you think people should be allowed to have. These children grow up and the majority with contribute time and taxes to society .... as pp said, it’s the aging population that put a strain on resources. Not that I’m saying we should do anything different there, just that some of the hostility on this thread is directed at the wrong group.

I had one child, followed by two miscarriages ( this is over 25 years ago) I was advised that with two miscarriages followed by other problems that I should not expect to get pregnant again. We began the process to adopt as at that time IVF success rates were very low and I did not want to have DS1's early years adversely affected by the possible emotional turmoil if it was not successful ( and it was not certain it would be possible) At that time you could have an independent social worker do your assessment and we sourced one and arranged a visit, she came to see us once. We would both have been quite happy to take an older child or siblings, we wanted our son to grow up with siblings himself. Much to my surprise I became pregnant again and we had DS2. We did ask if we could continue with the adoption process but apparently even then it was not permitted when you were actively pursuing a baby of your own. As DS2 was a happy surprise I hoped that we could still adopt, but no. Once DS2 had arrived I became pregnant again but sadly miscarried a third time, by then I was over 40 and I felt the prospect of having dependent children post retirement ( which was then 60) meant I should call it a day. Now we are approaching retirement DH and I have again discussed the matter and might apply to foster an older child.

But this 'you can't tell me what to do' attitude and suggestion I should give my child up for adoption is ridiculous. There are so many children already wanting to be adopted! Why on earth would giving my existing child up help the problem of overpopulation?

And if the only people allowed to discuss the issue are infertile couples that seriously limits the amount of people allowed to talk about this uncomfortable but highly impactful topic. Obviously I would never say this to someone in real life but this is a topic specifically devoted to this conversation and it's something I am very worried about for the sake of all the children growing up in the next generation. If it is hard for my generation to get by, how much harder will it be for them? And how can we help if the only people allowed to have an opinion on IVF or reproducing are the people who want to?

I think having IVF on the NHS in a country that is massively overpopulated is bonkers. We should be doing everything to get our population under control. I wouldn't rule out incentivising not having children.

You do know that we're below replacement fertility level? As are half the countries in the world? Which economists describe as a demographic time bomb for an ageing population

I don't deny that global population is a massive issue

But as a country our population is likely to decline based on declining fertility rate and being less than replacement fertility rate

I assume you also advocate for sterilisation so fertile couples can't have more than one child?

That's a lot more children from easily conceived 2nd, 3rd and even more DC, than the number of IVF babies

By definition the couples who can't conceive aren't causing the population issues

@Isittimeforbed out of interest do you know what is the cost of IVF versus the cost of on going counselling and medication for depression that I'm fairly certain I would have needed had we not been successful?

Regardless of whether the nhs should pay or not, this thread is now an incredibly difficult read for someone suffering infertility.... actually it's still pretty tough for me even though I've got my daughters. Reading this is like reading that some posters think my children shouldn't exist.

Waves to @bananafish81 - sensible words as always from you

OK, so if we axed all NHS funding for IVF, that would mean more money for cancer treatments, which I think we'd all agree would be Very Good Thing.

Let's take a quick look at cancer spending.

A lot of the most common cancers are caused by being overweight, smoking, drinking and being sedentary

In 2018, the head of the NHS in England said that

"Being overweight is the second biggest cause of cancer, after smoking, and is the major cause of Type 2 diabetes - a disease where the treatment and complications cost 9% of the NHS budget annually.

The chief executive of the NHS said in 2016 (imagine it's more today in 2018), that British taxpayers are spending more on treating obesity-related conditions than on the police or fire service.

"The NHS spends around £16 billion a year on the direct medical costs of diabetes and conditions related to being overweight, compared with the £13.6 billion p.a.spent on the fire and police services."

If IVF is a "lifestyle choice" that doesn't warrant any funding, should the NHS fund treatment for illnesses that result from smoking or obesity - which could, depending on your viewpoint, be considered as "lifestyle" choices? Should people who may well be infertile just because of bad luck be penalised to make way for treatments for people whose illnesses could be argued to be 'self-induced'?

If you want to ration treatment based on 'lifestyle choice', do you think the NHS should fund, say, dialysis for kidney failure through alcohol abuse? Yes, it's a medical need - the person's kidneys are failing - but if you're taking a hard line on NHS funding for 'lifestyle choices', you could argue that the person has 'chosen' to drink themselves to death.

Or lung cancer treatment for a person who's 'chosen' to smoke 40 fags a day since they were 12?

How about accidents resulting from taking part in dangerous sports?
Or how about alcohol related A&E admissions, for all those people who get drunk on a Saturday night and need patching up after they've fallen into a gutter?

How is it ok to blame NHS funding shortages on such a specific section of society? Why should infertile couples simply have to get on with it so that others can receive care for other illnesses related to 'lifestyle choices'?

The NHS is a universal service and it's a very slippery slope to start determining who is and isn't deserving of treatment.
The whole point of the NHS is to provide treatment to all.

Sadly I don't envisage there being any NHS funding for IVF within 5 years time, as so many services will need to be cut to care for an ageing population

But let's not put all the blame for infertile couples, eh?

And posting from earlier in the thread, summarising previous posts:

However let's say IVF funding is axed completely - what kind of dent would that make in the NHS funding gap?

post from PP on the thread:
"It is hard to find precise figures, but as far as I can tell from Googling, the NHS spends around £400m on IVF each year, which given that the budget for England is £122bn, is around 0.3% of the total spend. This seems to be approx. 40% of the IVF cycles done (e.g. the other 60% are privately paid for). I do not think there can possibly be figures on how many UK couples are doing IVF abroad, but given the price differential it's got to be quite a few."
"So the absolute best case scenario of ending IVF today would be saving less than 0.5% of the budget (which would immediately be wiped out by the costs of NHS deliveries of multiples conceived in less regulated private clinics here and abroad)"

I hope that people having their 2nd or 3rd DC are criticised for their use of NHS resources, when the funds for the medical care for their extra children could have paid for lifesaving cancer treatments.

When a fertile couple has their 2nd DC, how often do they hear 'congrats, but think of all the cancer drugs the NHS could have paid for if you'd have stopped at one and adopted instead?'

If I'm entirely honest, I don't think the IVF funds saved should go back into the NHS but into children's services since it was about creating more children and the money is better spent on the ones we already have, so improving things for kids in care.

Again this isn't going to happen so I'm not limiting myself to what's realistic. And my congratulations given to those who have chosen to have more than two is halting anyway. I congratulate anyone who breeds because obviously they are very happy about it but worry desperately for their kid's generation.

And cancer isn't the only illness. Also I think more should be done to address food issues as BED and COED are not recognised adequately and responding to them would have a knock-on effect to obesity health issues.

@bananafish81 - agreed. There is already a huge divide in non-white blood cancer survival rates amongst those who can afford to go back to the country of ethnic origin for treatment and those who can’t. If IVF is prohibited on the NHS too it’ll just underscore existing inequalities rather than make any real difference.

@Rixera - considering you are a supposedly infertile mum who conceived naturally and didn’t adopt but are telling infertile couples to adopt, I think I’m going to take everything you say with a hefty pinch of salt. You’ve lost all credibility to me.

Why?
The doctors made a mistake, the damage to my uterus was not as bad as they thought. I had to have monthly scans throughout pregnancy but there was enough viable tissue that if the egg implanted on one part of my uterus (which it did) it would grow. They were wrong about the infertility and I'm not the first person that's happened to.

Rixera I'm sorry but NHS spending on IVF is not 'highly impactful'. As we've said, the contribution to population is miniscule as is the spending in the grand scheme of NHS funding.

You say that the suggestion you put your child up for adoption is ridiculous. Well so is your suggestion that infertile couple's should take one for the team and not utilise the help offered to have a child.

Or is it that your suggestion doesn't affect you personally so it's easy to dictate to everyone else?

Also saying 'i wouldn't say this in real life...' this is real life. This is some people's actual lives. Real people you're talking to, not robots.

But my opinion cannot possibly enact a change the way I want it to, and this is a conversation about the hypothetical. That's the trouble with this, we all biologically are driven to want children so it becomes emotional.

It is highly impactful because every child brought into the world becomes an adult consumer and has a big impact on our environment. Every child is one more car, one more job, one more school place. Financially it makes up 0.3% of funding or whatever it was, but in a world where money did not exist it would still have a huge impact to create an extra child, particularly when there are children that need adopting.

Again, it does affect me personally. I want more children, virtually everybody does, it's a hormonal drive. I held my friend's new baby at the weekend and that broodiness is like nothing else. But I cannot rationally defend having one. It would be selfish. Living today is a constant struggle for resources, how could I foist another child into that?

Do you go onto the conception threads to tell people how selfish they are to have children when the world is so over populated? Or is it just infertiles?

To the people who don't think IVF should be funded, does that include all fertility treatment or specifically IVF? What if you can get pregnant but not stay pregnant?

I'm not infertile but I've had recurrent miscarriages and am currently the most pregnant I've ever been but only because I'm up to my eyeballs in medication that has kept this one in place. Since we started ttc I've had two ERPCs, two visits to A&E, countless trips to the EPU, many many tests, 3 medicated pregnancies which then still failed and regular appointments with a consultant through an NHS clinic. I've persisted in getting myself pregnant and taking drugs in the hope they'd help but knowing I was still likely to end up having surgery when it went wrong.

I've cost the NHS an awful lot more than a round of IVF so is that okay because I got pregnant without help and they were treating something that was already wrong with me, or is it not okay because I can only stay pregnant with massive intervention and should have stopped trying?

Bananafish no, because they are not asking whether or not they are being reasonable to have a child.

If they were posting on AIBU... yes, probably would. And if a friend were to strike up a conversation about my views on fertility I'd say the same thing, because if they are starting a conversation on people's views I'd assume they want more than an echo chamber of how wonderful reproduction is.

Living today is a constant struggle for resources, how could I foist another child into that?

So why allow each couple (apart from barrens) two children?

no, because they are not asking whether or not they are being reasonable to have a child.

I’m not asking if I’m being reasonable to try and have a child through ivf. How is that different to “normal” conception?

Purpledaisies, because I'm not campaigning for total extinction. Just limits.

we all biologically are driven to want children so it becomes emotional Rubbish. More and more people are choosing not to have children. I am childless through choice. It just wasn't a lifestyle choice that was on my radar. Lots of my friends are childless through choice. It isn't that uncommon anymore.

Why don’t those limits apply to infertile people? Why aren’t I worthy of my two allowed children?

Ok Rixera, there's usually a 'should we have another DC?' AIBU thread fairly regularly - I will look out for your contribution to tell them how selfish they are for contemplating a birth child and that they should adopt instead. They come up fairly frequently, so that's lots of fertile posters to educate.