New NHS guidelines on IVF treatment to extend age limit up to 42 - what do you think?

[JaneGMumsnet]

Good morning,

New IVF guidelines issued by the National Institute of Health & Clinical Excellence (NICE) say that women aged up to 42 should be allowed one cycle of IVF treatment so long as it is their first attempt. Previously Nice recommended treatment up to the age of 39.

The guidelines also suggest that all couples who are struggling to conceive should get fertility treatment more quickly ? after two years of trying to conceive naturally, rather than three.

We'd love to hear what you think.

Thanks,
MNHQ

I think having a child is not a right - it's a responsibilty. The world would be much better if everyone who had a child (or many children) thought about what benefits they could offer their child rather than the other way round.

Re the raised age limit, imho, it would be better to have a lower age limit but the same rules applied in all areas of the country so that everyone with infertility has the same opportunity to have IVF.

Salbertina, it's outrageous that you (and I believe other's) can suggest that infertility is not an illness. It is also incredibly patronising to state that when women are comparing themselves or the access they have to medical funding in the UK is meaning that they are in anyway suggesting their circumstances are comparable to those living in Africa, of course women here are aware of those issues faced.

Having only skim read the posts from overnight, I'm disappointed to see that there has been a barrage of people continuing to post such insensitive posts. I really would have thought that with the number of couples having infertility issues being at a record high of something like 1 in 9 (or is it even 6) that most people aren't going through life without coming across someone that needs it.

Infertility may not be deemed as 'an illness' by many but how dare people suggest that cancers that have caused it or endometriosis aren't.

Actually, i don't think people are aware. I mentioned Africa as its where i live. From my perspective, ivf shouldn't be prioritized over basic maternity:children's services. Recent reports into nhs children's services found huge failings which have led to many avoidable deaths. Now that is outrageous, not my own opinion to which i have every right..

I had babies at 41 and 42 ( without any treatment or problems conceiving ) . I'm now in my 50 s and I'm fitter and more active than many women half my age,including I suspect , most of those on this thread airily dismissing me as " middle aged" .

Why should couples who are infertile not have the same chances that I have had to have a biological child? It's very selfish to argue that the NHS should prioritise care that I and my family need while not providing services to others. Infertile couples pay their taxes and NI too. I don't see why they are any less " deserving" than eg patient who have breast enlargement for psychological reason ( not after cancer ) , tattoo removal, homeopathy, smoking cessation, treatment for drug addiction,

IMO There is a lot of prejudice on this thread.if anyone posted that black people or Jews were not good parents it would, quite rightly, be removed. But people feel quite happy to say sweepingly that " middle aged" women ( and they do mean women, no one has mentioned older fathers) won't make good parents.

Off for a run now with some other geriatric mums who are training for a marathon < waves goodbye to smug 30 something mums sitting on sofa watching Jeremy Kyle while stuffing their faces with junk food and congratulating themselves on their youth and longevity >

Since you mention homeopathy Kristina - does NHS funding still support homeopathic treatments ? I have a feeling there's an NHS Homeopathic hospital in London - favoured by Prince Charles ? (not sure if that's right ?)

Well if we're looking to make some cuts IMHO they should be a contender !

I'm all for talking treatments, counseling, and holistic approaches, but taking a scientific approach, for me homeopathy is a step too far !

One thing I will say, I have. been dismayed to read the nastiness and insensitivity on this thread.

Everyone has their own view on where the nhs pound should be spent which will, no doubt, be based on something highly emotive in their own family. Being sensitive to that, and wording posts sensitively, would enable everyone to feel free to give their own opinions. No-one should have to give painful details to prevent being flamed for holding their opinion.

MNtowers didn't open this thread for the comments of infertile women (an assumption based on the fact the op did not include that rule) so shouting someone down based on their fertility status is appalling. As it would be the other way round.

Please, everyone posting on here, read your comments before posting them and ask yourself how you would feel if anyone said that to you.

Have just googled and apparently NHS spends £4 million a year on homeopathic treatments and there are 4 NHS homeopathic hospitals, in London, Bristol, Liverpool, and Glasgow.

If they want to turn these into places where simple counseling and a holistic approach are offered then fine, but the treatments don't make any sense IMO !

Sorry for the thread diversion !

@juggling -one example here

www.nhsggc.org.uk/content/default.asp?page=s762&loc_id=2533

Completely agree also. Homeopathy proven not to work, nhs should not fund.

I agree that homeopathy is an area where cuts could be made.

This article from Suzanne Moore on this topic is interesting: "The discussion about at what age IVF becomes pointless is one for the doctors. For me, the much more important one is why do we produce a society that makes it so difficult for women to provide for children when they are most biologically able to have them?"

Warning: I find the comments on CiF often quite woman-bashing so if anyone's sensitive about this issue you might not want to read those as you'll probably get harsher stuff than has been said here.

I've just started a new thread in AIBU on the subject of NHS funding for Homeopathy BTW !

KristinaM as a matter of fact my DH and I were told in no uncertain terms by the local authority with whom we'd applied to adopt to go away 'do IVF' and come back when it had failed and we'd 'grieved the loss of the children we hadn't had biologically' and then they might re-consider us. I didn't even want IVF at that stage! It's also very hard given the way IVF is developing currently to say when it is 'finished'. There is always something else you can try if you can scrape the funds together. Although, I think the NHS ought to be making it easier to access counselling so that individuals/couples can deal with their grief over not conceiving and agree on when it might be time to stop.

blackswan I think there are some points regarding the NHS 'already providing a reasonable amount of IVF'. Firstly, they don't, as it's on a postcode lottery subject to a lot of quite arbitrary rules (like the one about previous children of the partner disqualifying you). Also, as other posters have pointed out, they don't even do it in the most efficient way e.g. not carrying out diagnostic tests that are routinely offered in the private sector first, so that treatment can be appropriate for the individuals concerned and therefore most likely to succeed. There is also a lack of impartial advice in primary care -- the emphasis seems to be on going straight to IVF when healthcare professionals could if they wanted go through the range of options with patients (and some options would cost a great deal less than IVF).

The NICE guidelines have simply changed what is considered 'reasonable' regarding the age cut-off because of increasing success treating older women.

Snazzynewyear, thank you for linking to that Moore article - this is exactly the sort of thing that I mean by saying that there is a weird quasi-moral prioritisation in this conversation of medical issues over other barriers to becoming a parent.

I do however think it is important to note that there is nothing historically weird about people having babies in their 40s. My parents' generation all seem to have more than 10 siblings, the youngest ones born maybe 20 years later than the oldest. (Catholics). It's only in a context of people choosing to stop at some point that it can be portrayed (deliberately, by people with an anti-feminist agenda) as weird for women to have children in their late 30s or 40s, (whether or not these might the only children a woman may have, unlike the great grandmothers I am thinking of who started in their 20s and didn't stop)

There are too many barriers and judginesses about having children altogether.

• having them too late

• having them too soon
• having them single
• having them too poor
• having them without owning a house
• having them to more than one father

If we got rid of some of this misogynist hand wringing, maybe fewer women would need IVF. And then, if cost is the barrier, everyone who wanted it could have it.

This is excellent news! Fertility problems are health problems, no different to any other. I am shocked at people referring to the right to have kids as some sort of luxury or lifestyle choice! 42 these days is a young age, I have women friends that conceived naturally and had healthy pregnancies at that age so I welcome the news.

I am delighted at this news, though I would be happier if the various PCTs would be consistent how they apply guidelines. I have seen too many friends get desperate and end up needing other, more costly medical treatments to combat despair and depression.

My situation: damned lucky. I was married for the first time at 37 and we started ttc 9 mths later when I was 38. I told my GP that we were very 'que sera, sera' about it all, and if it didn't happen, we wouldn't be seeking IVF. I'd had gynae problems since 13 so figured there was a fairly high chance nothing would happen.

6 months later, when 39.4, I got a BFP and after a hellish pregnancy (hyperemesis) my gorgeous DS arrived 4 weeks after I was 40.

If we had been desperate for a child, and one of us had been infertile, we'd have run out of time before the 18mths ttc guideline and I'd have been too old given the current limit. So upping the limit is good in my opinion.

great news. I had no problems conceiving, but had I had problems, would definately have wanted to try IVF. If I then had found out that either postcode, or age, limitations were then in place, I can imagine the utter feeling of helplessness I would have felt.

Allthingspretty why don't you agree with the changes? How does it affect your life?

PHineyJ-if you are seriously interested in pursuing adoption right now ( instead of infertility treatment ) , I would contact your local authority again and ask them to put it in writing. AFAIK that is NOT the official policy of any Uk adoption agency.you could also contact any other local agency and ask them to assess you.

If I was asked for my personal opinion,I would advise that families make sure they have explored ALL the options they feel confortable with BEFORE pursuing adoption. For some that will be less invasive treatments such as ovulation induction, others IVF or AID, or perhaps surrogacy. It's a very personal decision.

But if you start adoption and then change your mind about one of the other routes to having a family, there's no going back. Adoption is very very slow and you may have lost your place on the waiting list for IVF etc. You will be older. And if you pull out of the adoption assessment to get treatment you will find it very hard to find anyone else to asses you, unless you are the " right kind " of black family or can parent a child with special needs (normal rules don't apply )

Adoption is a very risky route to having a family. You will not get a newborn baby and there is great competition for healthy toddlers. I've not done both but everyone I know who has says that adoption is much much harder than infertility treatment.which is saying something as many of you know

Sorry,don't mean to hijack IVF thread but so many posters had mentioned adoption I just wanted to clarify

I see it as good news. People say no-one has the right for the nhs to fund IVF for a child but I don't particularly like paying for cancer treatment on the nhs for smokers or for their emphysema treatment. As for the tax on cigarettes it nowhere near covers the nhs costs. Similarly why shouldn't older people be able to have kids? A smoker is easily knocking a minimum of 10 years off their life so maybe they should be banned from having kids due to health issues if older people are refused IVF.

I see the higher age asa cut off point good, I think that it is unfair to judge fertility by age when it is so easy to do a AMH test and see how likely it is for IVF to work.

I don't think the 2 year ttc before having IVF is a good idea. I was ttc for 20 months, I live in a country with a national healthcare system that offers couples 3 fresh and 6 fet cycles (free) me and DP went to the fertility specialist when we had been ttc for a year, she did a sperm analysis and a load of blood tests/ultrasounds for me, they found my DP had not so great sperm (not really bad but not great) I had pcos but I still ovulated and had regular cycles. I am 28 (was 26 at the time) the fertility specialist referred us directly for IVF, I asked about trying other treatments, maybe clomid or iui but she said what is the point just go and have IVF.

We got the drugs, I went for injection training and we were all set for IVF, I just had to wait for my period to come, it never came I was pregnant. We still have thousends of pounds worth of drugs in the fridge.

I feel like we were rushed into trying IVF, bothme and DP had reduced fertility but nothing in our tests showed that we couldn't get pregnant just that it might be a little harder. I feel like if they had made us wait 3 years it would have saved them lots of money and us lots of stress. If they say for an average healthy couple it can take a year 2 years for a couple with reduced fertility would be normal.

Smokers, alcoholics and obese people. All these groups take take take from the NHS. I would prefer my tax money to go to fund healthy prospective older parents receive one chance of hope with IVF.

But really we cant pick and choose who gets help from the NHS. Everyone has their own health problems, but waiting to meet the right person before settling down is a good thing in my opinion. I might be in that boat too if I hadnt met my husband young.

I think it's unfair to use anything other than a complete lack of womb as an arbitrary reason to stop access to ivf. I had a home amh test in 2010 which showed my levels to be really low, and according to the 'statistics' i had a very small chance of having any eggs (at aged 30). The nhs turned us down purely on this basis so we went private and after one cycle on gonal F i'm now due to give birth next month having only used 1 implanted embryo from my 5 eggs. Nothing wrong with me other than not many eggs, the ones I had were perfect, so had i believed the nhs that we had no hope, we'd have ended up with no children. Until more people have access the stats are only based on a few people which isn't an accurate reflection of reality. My gran gave birth to my dad at 42 in 1948 and he was perfectly healthy, all cases should be judged individually.

I used to think it was silly to fund IVF. Now I look at baby DS and it breaks my heart to think anyone would be denied this joy who really wanted it. But on the flip side (having had shitty parents) I don't think anyone has a right to have a baby.

On balance I would come down in favour of funding one round of IVF.

But I do worry that without further funding it will make the postcode lottery situation worse, ie longer waits.

I think it's awful too that individual trust have different rules. Shouldn't there be consistent rules nationwide.

I mean I worry that the changes (42 limit) will make postcode lottery situation worse.

KristinaM thanks that was already the fourth local authority we'd tried (and we spoke to one independent agency as well) so at that point we gave up and decided we'd have to do IVF (privately) which worked for us second time around and we are now proud parents of a baby DD. We were entirely serious about adopting but the process was so byzantine and upsetting that I think we had a lucky escape really. I feel like we might get the thread off topic though so will leave it there although it doesn't take long in any discussion of IVF before someone says you should 'just adopt' instead. AARGH! That word 'just'...there is no 'just' about any of this.

Me too Zara1984