Disgusted with IVF Charging.

[POP2005]

My wife and I have been trying for a baby for around 3 years, at the moment she is taking Clomid to assist with Ovulation.

We are hopeful that the Clomid will be a sucsess, but we have been exploring all avenues. I stumbled across the HFEA website that lists all assisted conception units in the UK and I was shocked to see the NHS charging first time patients for IVF treatments.

Searching for some kind of campaign on the net was fruitless but through search engines I found many discussions on the matter and I was shocked to see the amount of hatred people have been spouting on various discussion boards about the cost of providing free IVF on the NHS for childless couples, they estimate the cost at £400m.

£1,500 seems to be the average cost (not including drugs) and for a childless couple, intially, this is a small price to pay as we are desperate to be parents but where does it stop?

I have even seen adverts from loan shaks offering IVF loans to desperate couples.

We could end up in extreme debt and still have no baby at the end of it.

Yet if I was to drink myself into oblivion and screw up my liver the treatment and operation would be free, hell, if I decided to have my gender "reassigned" I could even get a free sex-swap op on the NHS, smokers are offered free cessation assistance on the NHS and we all know that cancer treatments for smokers are also free.

Infertility in most cases is not self inflicted yet couples are forced into debt to pay for treatments - people who have made themselves ill through stupidity are treated free.

The estimated £400m cost is a small price for the goverment as IVF children grow up to be taxpayers.

Its time to End the postcode lottery now.

hear, hear, aloha.

Message withdrawn

I think everyone deserves a chance to IVF, not only people who can afford it.
What about people who are infertile because of an illness (like cancer)? What about a mother who has lost a child and whose only chance for another child is IVF? What about someone who is severely depressed, whose marriage is cracking under the pressure, and who can't stand to see mothers walking down the street with their children because it reminds them about their longing for a child? Perhaps IVF won't work and they eventually have to realise that they won't have their own child. However, I understand why people want to try all options and I think it is very unfair to just expect them to accept that this is "mother nature" and that they can just adopt a child. Personally I didn't just want a child. I wanted my own child. My husband's child. I think that's the same for most of us.

Twinkie, I just know that many couples who struggle for their own child find it very upsetting always to be told that they can always adopt. And it is very easy to use your Lemon-saying if you are not dealt lemons!

Pie, where on earth did you get "only 1 in 5 couples who seek IVF, private or NHS will have any sucess" from? In the UK the average success rate for each IVF ATTEMPT is 1 in 5. So of course not everyone conceives on their first attempt - but the stats for my local hospital showed that over 50% of couples had a baby after 3 attempts, and looking at the first 6 attempts over 87% of couples had a baby. With any fertility treatment you don't just try for one month. Some women do give up after a number of treatments due to either cost or not being able to cope with the treatment. Also the research that has been done seems to suggest that for most couples the chances of conception remain the same regardless of how many attempts that they have - it remains a 1 in 5 chance each cycle.

The "why don't you adopt?" line is a very difficult one, and I'm not sure that this is a thread for that debate. If nothing else you will not be considered for adoption until you have stopped all fertility treatment - I think my local authority wouldn't even start the home studies etc until you had had no treatment for a year. Once you apply for adoption it will be made very clear to you that this is not just an alternative to normal parenthood - the challenges are quite different. I think that in previous generations these challenges were different ie when you could adopt a baby from birth, but a lot of the children looking for homes have special needs and have quite a lot of history to deal with. This of course doesn't mean that they should have good homes - just that it does mean that they shouldn't automatically be handed to couples who haven't got kids of their own. If anything adoption agencies are desparate for couples who do have some experience in parenting.

With IVF we are looking at a failry successful treatment - bear in mind that the NICE guidance is likely to say that 3 IVF attempts should be offered to all applicable couples where the woman is aged 23-39.

The comparisons to cancer have been unhelpful.

How about using some of the Viagra bill to help fund IVF instead?

150...I got it here and as no one can say how many tries a couple will have whether it be 1 or 20, for whatever reason the statistic relflects National live births total for all ages = 1 in 5 (21%)

Hmmm...not sure I worded that correctly. 21% of IVF treatments in that period resulted in a live birth, irrespective of how many treatments a couple had (including several), 1 in 5 is how it averages out national during that time frame. Your local hospital sounds pretty good given that.

Read this - skimmed most of it, but something stands out to me.

I think anyone who has tried to use the NHS for anything other than an acute condiiton will have discovered that it is quite frankly crap. It is so bad that it effectively doesn't function. Nice idea but it doesn't work. You've all heard me moaning on enough about the total lack of SALT my son has recieved0- despite still being non-verbal at the age of 4 and a hlaf. Actually the ironic thing is if he could speak then he would more than likely get SALT. It's becuase he's "too difficult" to treat that they don't bother, and we have to pay for weekly provate SALT. If we were on wefare in the States I believe he would have recieved SALT at least twice a week for last couple of years (JJ? is this right??) If you are difficult to treat, whatever it is that you may need, you will not get the service you require on the NHS. I would imagine infertility hits this problem- it's hard to treat.

As someone who has spent the last 2 and a half years battling with the HA, and got absolutely nowhere, so instead has gone private (what are credit cards for after all?) I say scrap it and start again with a sensible system which provides good free care to those who can't afford to pay for it, and provides good cheap care to those who can afford to contribute some or all of the cost.

These figures are per treatment cycle started (ie each attempt not complete course of attempts), pie and are for all ages. Agree that this sheet doesn't show the cumulative figures. The NICE site does though as do some others. The point is that the clinical recommendation is not to have just one attempt, but will be to have 3 attempts (equally couples without fertility problems shouldn't have sex only once if they want to conceive).

IVF really is fairly successful these days - though still not for everyone sadly, but it is currently geared to ability to pay...

ER...but the figures below are for ALL IVF treatment.

sorry pie- saw more info at the bottom of the page you linked to. This indicated about 6,300 births for 23,700 patients that year, so better than a 1 in 4 chance. But again this is just the info for one year. As a complete cycle takes almost 3 months not many people can fit in more than 2 or 3 in a year.

Some hospitals are better than others, but a 1 in 5 stat per treatment isn't far off the "normal" chaqnces of conceiving - ie you are putting these couples back in the place where they would have been - some couples conceive the first month they try, the majority will ahve conceived by the 6th month or so..

Ok, I know I sound thick, but the site tells you how to read the statistics...it says:

Other results from all IVF treatments
Number of single, twin and triplet live births from treatment. These figures include still births and neonatal deaths.

Patients: Number of patients who received IVF treatment (some patients will have had more than once treatment cycle).

so how would the cumulative figures change how the national average works out when they are included?

can I just correxct my post. HAving read misdees post I should say that NHS care for acute coniditons is also bad.

I do think that unless you have tried to use the NHS frequently in recent years you don't really get an idea of how bad it is. It is dreadful pretty much across the board. I have had some successes with the NHS in recent years (such as the time my son got eczema herpeticum) but the dreafulness of the bad times doesn't make up for the few good appointements.

I don't really see the point in saying condition X is worse than condition Y, or Z's condition is self inflicted so they don't deserve to be treated. At the moment the NHS will be failing X, Y and Z. It needs to be scrapped.

Ok 1 in 4 on the later statistics, but that still means that IVF isn't a cureall surely?

150...I thought that 80% of couples conceived in the first year, how can IVF be putting them back where they would have been anyway then?

Pie that is for 1 YEAR! 23,737 patients had 25,273 cycles, so most patients only had one cycle that year - say at best 1,600 had 2. Many of the remainder who weren't pg would have had further attempts the next year, and the next year and the next year - until they run out of money or can't face the disppointment any more. That is why IVF funding and acute cancer funding are different. Many couples can battle for 15 or more years in order to conceive. People with acute conditions can't wait, and hence the comparison is a poor one. which is why I chose Viagra as an alternative comparison. Like infertilty, impotence won't kill you....

maybe IVF should be free until a successful delivery - then you pay for the baby according to how many attempts it took.

Yeah but 150percent the fact that couples may take 15 years to conceive means that the NHS will never be able to cope with fertilty treatment properly. My son needs 15 + years of speech therapy. He hasn't had any yet. If he needed 6 weeks worth he would have received it. The NHS just is totally unable to cope with chronic conditions.

Because IVF cycles do not equate to months in terms of time, just in terms of bringing about the same conditions (sperm meets egg, gets it together and travels to womb for a chance to settle down)...

Each month a couple has a 1 in 5 or so chance of conceiving - just as each IVF cycle a couple has a similar chance of conceiving. You don't just give up after one month or one attempt. You spend time getting over it and preparing for the next attempt...

I was using the comparison to indicate that IVF couples will have a baby at the end of the process, not specifically the time-line: it takes much longer, but it is defintiely worth the wait when it happens!

Ok, I see that. But IVF can't overcome EVERY cause of infertility can it, so in that respect its never going to give an infertile couple the same chances as a couple without fertility problems is it? Sometimes, no matter how many attempts it doesn't work, right?

actually fairymum, the thought of adopting or fostering a child in a few years is something that has been in my mind a lot lately, but only if(!!) the health of my family is ok.
i had my kids young, i'm glad i did, as i dont know what the future holds, no-one does. i'm lucky, but the nhs is overstratched (have i said that enough yet), if they cant provide SALT for kids, take months for people to have MRI's, send kids home having asthma attacks cos they dont have enuff beds, until that is sorted out and everyone gets equal treatment regardless of where they live, i'm afraid there is no hope.

Pie - agreed that IVF will not work for every couple - that is why the NICE guidelines suggest 3 attempts and only for those under 40. However it will work for the majority of couples, which is why NICE (National Institute for Clinical Excellence) are recommending it! There are a minority of couples whose fertility problems are not yet soluble, but research continues. Certainly for someone like Astrogirl suffering from PCOS generally a number of IVF attempts will result in a child - it is simply a matter of time and funding.... The NICE website goes through all the economics including average cost per live delivery etc...

And looking at the detail of the report NICE are not simply suggesting that every couple go straight to IVF - there will still be the usual processes of tests and alternative (cheaper and less evasive) treatment such as Clomid.

And consultants are not stupid - they know if there is no point in recommending IVF, and certainly in my experience (4 consultants to date) have been able to give an indication of what my odds are. I just get frustrated when the odds per cycle are quoted as if to prove that it can't work for 75-80% of couples. Out of 100 couples if 25 have a baby the first time, and the other 75 go on to a second attempt, then 19 more have a baby leaving 56 facing a 3rd attempt with 14 more having a baby - it still means that 38% will be disappointed and decide whether to call it a day or not. But it does mean that over 60% of the couples have a baby (or 2) - it will have taken most of them longer than a year to achieve it though...

Not sure that this answers the funding question though, or are you suggesting that there is a minimum success threshold before a treatment is funded?

Jimjams - I agree that the NHS isn't at its best with chronic conditions.

My frustation with the postcode lottery for IVF isn't whether people pay per se, but the different success rates at different hospitals. I am frustrated that there are couples having NHS funded IVF at units with a less than 10% per cycle success rates whilst other units enjoy up to 40+% rates - provided you pay for it. I do wonder whether the fact that the majority of UK IVF is still in the private sector means that research, best practice etc is not shared equally as of course the private units would prefer to have a "competitive edge". (I've no evidence that this is the case BTW - just wondering!).

I have to say on the issue of IVF funding, I'm afraid this is one area where given a limited pot, I would prefer for money to be spent on research whilst most couples paid or subsidised their treatment. Childfree couples tend to have more disposible income, and should be in a position to afford at least to contribute towards the treatment. Perhaps I just spend too much on childcare and stuff for the kids, but they certainly cost me more than the £2-6k that say 1-2 IVF treatments might cost per annum. More tricky once you have a child - I went back to work for a while to pay for #2. And as for #3: if we were fertile then it would be a possibility, but I'm not sure it is fair on the other 2 for me to go back to work and go through several treatments hoping to be successful again.

In terms of diverting money from other areas of the NHS towards IVF, I simply don't have the sort of info or background to make an honest decision. Should cancer treament be cut - no. The viagra bill - maybe? Do I want to pay more in taxes specifically towards IVF - if I'm honest I can think of more deserving causes...

(Ducking as will now have offended everyone on the thread somehow!)

150...I think that the success rates of IVF probably do have a lot to do with funding. Its is costly non life saving treatment that has no guarantees. And I'm not making any judgements on whether it should be free or not (or how devastating it is for people), but with a finite amount of resources life saving treatment with higher success rates (sometimes guaranteed success) will get prioritised.

As to the postcode lottery, this isn't exclusive to IVF, as I'm sure you know, prominent cases include MS drugs as well as newer Cancer drugs.

One of the things that was bugging me about this debate was the seeming resoluteness that IVF would work, for sure. That if only the funding were availabe couples would have babies. 38% after 3 attempts is still a third (and thank you for the explanation, I was getting quite confused!) and that is still a significant number who would then have to find their own funding according to the NICE guidelines, and so may not go any further. I just think that there is a real danger of people really expecting science to cure everything.

I agree with your point - IVF does not work for everyone. But what I found so frustrating during my own fertility journey was the number of well meaning people telling me that IVF was so unlikely to work that I just should give up and accept not being able to have children when it was just that the statistics weren't being fully understood. I also resent the time I spent under a NHS hospital spending months on treatments with lower success rates (ie 10-15%) because IVF was a scarce treatment with a long waiting list - a waste of my time and NHS money, but until I did a lot of research I knew no better.

In some clinics the success rate for IVF per cycle is one in three! Mind you, some clinics don't take people they think it won't work for easily (eg those in late 30s plus) so as to boost their published success rate. High success rates don't always mean better treatment, just as the success rates of top selective schools reflects as much on the intake as the teaching. Mind you, IVF is getting much more successful and the techniques are being refined the whole time.