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

Is anyone anywhere suggested the NHS should provide IVF for women of 60?

By and large it IS possible to conceive and carry a baby if you WEREN'T a teetotal, celibate 20 year old. I wasn't a teetotal or celibate, and gosh, I got a very good degree at the age of 21 from what I now find out is a Russell Group university!

Yet I still found myself infertile in my early 30s.

What if your perfect man doesn't want children so early in his life? My DH is completely perfect for me in every way, we've been together since we were teenagers, and he is kind, fun, loving, intelligent, and I can't imagine life without him. We started TTC when we were twenty-seven - hardly leaving it too late, but by Xenia's logic I should have ditched him and attempted to get knocked up in my early twenties instead. Of course, given that I'm infertile, that wouldn't really have helped, would it? I'm glad I stayed with the love of my life rather than search for a sperm donor. I'm also glad that DH has input into our choice to start a family - since when was it all about the woman? I don't know about Xenia's marriage, but mine is a partnership, not a dictatorship.

Incidentally, I also have a degree. DH is a well-paid Oxbridge graduate. But that doesn't matter, because I loved him when he only had GCSEs to his name, and in any case we are still infertile - level of education makes bugger all difference.

I don't want to sound unkind, but didn't your husband leave Xenia?

And most 21 year old men knew would have fled for the hills upon finding out I wanted to settle down with them for their sperm.

I'm glad I stayed with the love of my life rather than search for a sperm donor.
^
What evilgiraffe said.

Actually I am a little unsure about how I feel about this and I am not "I'm alright Jack". If anything - if my feelings are influenced by my personal circumstances - it is much more "would that I were alright, Jack". I have written some much more nuanced things on this thread that have been completely ignored.

• Obviously there is nothing wrong with women in their 40s having babies
• except if you are a raving misogynist
• in principle women who want them should be supported to have babies at any age
• but why is there such a priority given to medical barriers to childbirth, so distinguishing very unfairly, between "deserving" and "undeserving" causes of unwilling childlessness?
• this distinction is being reinforced on this thread by people insisting that everything else in their lives was exactly as "they" wanted it to be - married, starting ttc reasonably young, solvent, etc
• and this really rubs me up very seriously the wrong fucking way, because it does nothing to address the very real societal problems that makes having children so fucking hard for so many women. It's about asserting your status as one of the righteous ones, and by implication totally reinforcing that if you have not been able to have children because you did wait till you were 40 to tcc (because you wanted to be able to keep them), or because you have such shaky mental health that you have not tcc (because in this weird society having children places such a huge disproportionate psychic burden on mothers) or because you don't have a husband (because a sexist society demands a huge personal sacrifice from women in traditional relationships) or because - whatever - for whatever reason you have been unable to jump through all the millions of other hoops between women and child-bearing - by buying into this primacy of the medical as the only thing, you are saying "fuck you" to all the other women.

I'm not sure what you mean, curryeater. What societal issue causes infertility? Infertility and childlessness are not the same thing. It is terrible that some people feel unable to have a family - but it is still their choice. It may not feel like one, but there are a lot of people out there in circumstances which they wouldn't describe as favourable, who have children anyway. If you are infertile, it takes away the choice of having or not having birth children - regardless of your personal circumstances.

I am not well today, so apologies if I have mis-read your post or lacked clarity in my own.

I think curryeater raise a good point that it's not only infertility that prevents women from having children. Several of my friends have wanted to be mothers but have not been able to/ felt able to for social reasons.
But I guess infertility is more of an absolute barrier to having a baby unless it can be overcome.
As always my thoughts are with all here x

no, evilgiraffe. no it is not a choice to not have children because circumstances make it too hard for you.
do you believe that mental illness is real, or do you think people should "snap out of it"?
Do you think that poverty and debt are real, or do you think that if people budgeted properly it would all go away?

infertility is not the same thing as childlessness but infertility is only one of the causes of unwilling childlessness and your refusal to see this is exactly the sort of thing I mean.

It is terrible that some people feel unable to have a family - but it is still their choice.

Sometimes it is not a choice. For example google 'tokophobia'. It can be a crippling mental health issue. Support from the medical profession is often needed to overcome the problem - this is not always forthcoming and there is a hell of a lot of ignorance on the subject. Some women with the condition, despite desperately wanting children, terminate pregnancies as a result.

It is something that is taboo, and is associated with 'weakness'. There are some pretty nasty views towards it out there. Sometimes people take the attitude that its worth it in the end and if you aren't prepared to go through with birth you 'aren't fit' to be a mother. Whilst some women with fertility problems, take particular personal offensive and take the view that they wish they had that 'choice' and its somehow its desperately insensitive or not realising how lucky you are to have the ability to have children.

The truth is, its medically recognised as a problem, to the extent that NICE guidelines on CS have been changed to accomodate the issue. However, like IVF its a highly politicised debate and many hospitals refuse to follow the guidance.

Choice is something that we are taught to believe in, and think we have. Yet the reality is actually we tend to have far less choice in life than we think or are conditioned to behave in a manner so we don't question our lack of choice or the reasons behind it.

Choice is a word that is particularly used a lot by the NHS. The reality is we have very little. From choosing your GP, to choosing to have IVF earlier; it goes right across the spectrum.

Finding it difficult to read these stories. Lots of this kind of stuff sounds to me like issues I'd be dealing with privately and I can't understand really why so many of you think the NHS has a duty to assist. Sorry.

The UK is bust. We have no money. We have higher debts per capita than the USA, France, Spain and Greece. Why do you think that funds for lifesaving treatment should be spent on IVF treatment?

Tokophobia, oh pleeeeasse. This is the NHS - our tax contributions.

Perhaps I will go back to dealing with this privately and not bother people like you with it.

If your child needed counselling after some kind of awful trauma, I take it you won't be pestering the NHS with it? After all it's not life saving. Perhaps s/he should just deal with it privately.

And I can't understand how people like you can be so lacking in empathy and intelligence, but there you go.

And there we go: "our tax contributions". Bingo.

I refer to the comment I made yesterday evening.

Well actually, yes, if my children needed counselling I would take then privately. First reason, it would probably be more professional and appropriate and secondly I wouldn't actually feel it is something that the NHS should provide for a relatively well off family.

And moreover, do you feel like you should be consulted on every single thing your "tax contributions" are spent on in the NHS? The lady down the road needing the hip replacement? Not life threatening. The chap who can't lift his arm higher than his shoulder because of a sports injury, and who has had to give up his job as an electrician? Not life threatening. The child who's an elective mute because she witnessed her father beating up her mother repeatedly? Not life threatening.

Fuck those people. They don't deserve your tax. Only YOU and YOUR FAMILY do.

The UK is bust, but can afford to write off billions in corporate tax avoidance, give millionnaires a £42000/annum tax cut, pay out for MPs to have a second home in London, a £130/week food budget, transport costs AND a nearly £70k/annum salary for a job that has 12 weeks holiday, billions on wars, billions in oversease aid.

Please, Frogman, find some original twaddle to bring out if you're going to try to argue.

How the blazes do you know how well off or otherwise someone is who is infertile? Oh it should be means tested? I see. This is despite me paying 20% tax since the age of 22 and hardly ever having needed any treatment since, apart from one nasty bout of bronchitis ten years ago.

It seems as though you think that all infertile people are those selfish career people who have just left it too late. No kids, but hey! Loadsa money! They can pay for their mistakes.

It must be nice to be as perfect as you so clearly are.

Frogman Mon 25-Feb-13 13:42:19
Tokophobia, oh pleeeeasse. This is the NHS - our tax contributions.

Yeah OUR tax contributions. As in MINE as well as yours. You don't get the veto on what is 'valid' or what is 'not valid' as a medical issue that tax should be spent on. As far as I'm aware the body which makes such judgements about validity and best practice of medical issues is one by the name of 'NICE'....

Oh...

But thank you on proving my point so very beautifully.

And the other issue that makes me uneasy about the "this is medical, I have to have it" argument, is that the argument doesn't take into account that the new baby is a person. It's all about the needs and wellbeing of the would-be parent, if you take this ultra medical route - "I am not well because I cannot have a baby; in order to be well, I must have a baby" - and that seems inappropriate, no, incomplete, when the individual is arguing that in order to be "whole" they need to make a whole new person. It is eliding things that should be spelt out and considered. There isn't really anything else in the medical world that is like this. This is why I think this is as much as or more a social issue than a medical one. It is about who has children, when, how, why - trying to say that it is equivalent to any other case of treating a patient misses out so much. It's oversimplification and it's being done I suspect for two reasons: 1. because the people who want the treatment honestly feel that they need it as much as treatment to make them well from any other condition, and 2. because it presents the issue as one where it would be heartless and wrong to refuse - patients should be treated, The End.

Just to be clear I want everyone who wants babies to have them, in case that is not clear already from my post. I wish those on this thread who are going through this all the best.

And the other issue that makes me uneasy about the "this is medical, I have to have it" argument, is that the argument doesn't take into account that the new baby is a person. It's all about the needs and wellbeing of the would-be parent, if you take this ultra medical route - "I am not well because I cannot have a baby; in order to be well, I must have a baby" - and that seems inappropriate, no, incomplete, when the individual is arguing that in order to be "whole" they need to make a whole new person. It is eliding things that should be spelt out and considered. There isn't really anything else in the medical world that is like this.

Is there proper support and proper help out there to support people to make a decision one way or another; which perhaps includes NOT having fertility treatment? I do not believe there is.

I posted a looonnnggg way upthread about the differences between counselling actually available and what is in the NICE guidance.

Is it valid to have NHS treatment to counsel infertility just as much as extend IVF to 42?

Not to mention the attitudes in society are still generally about expecting you to have children and viewing women who don't as somehow 'less than' in terms of social status and understanding still remain. Until people universality ask "Are you having children?" rather than "When are you having children?" there will always be this problem that someone is not 'right' both physically and mentally.

And one of the things that stops people talking about some of these decisions are the taboos and the attitudes that have come up in the course of this thread about 'validity'.

You can not just sweep a problem under the carpet and expect it to go away.

I've always thought that one of the purposes of the NHS and medical treatment was to level the playing field, to try and help those disadvantaged in some way to tackle life in the same way as those born luckier. Therefore the child who can't see properly gets glasses, the schizophrenic gets treated with anti psychotics, the person born with the dodgy heart gets a heart op, the person who's infertile gets fertility treatment. And so on.

Ariel it should be. It should be.

"I am not well because I cannot have a baby; in order to be well, I must have a baby" - and that seems inappropriate, no, incomplete, when the individual is arguing that in order to be "whole" they need to make a whole new person.

No. IVF is about being able to try. I am fully prepared for IVF failing, but it is the only way that DH and I have a chance of succeeding in TTC. This isn't about me, or him, but about someone who doesn't exist. We want to be able to try to bring that person into existence. How is that different from anyone else who is TTC?

Regarding mental health issues - surely they are also a medical barrier to having children? I imagine they're a good deal more difficult to treat than physical issues.

Again, I'm really not at all well today, so apologies if I'm misunderstanding posts. I still don't understand curryeater's earlier point regarding societal causes of childlessness and how that relates to IVF - rather than making assumptions about me, why not try explaining what you mean again? It may be that we agree with each other.

Indeed, Ariel. It's about levelling the playing field.

evil,giraffe I haven't made any assumptions about you (if you meant me?) and if it looks as if I have, it's because I phrased something badly.

Firstly, I don't think we need to get all either / or about anything. As it stands, some people who don't have children, and would like to, would benefit from IVF; some people who don't have children, and would like to, would benefit from a higher minimum wage or better mental health care. I don't think we need to pick one group at the expense of another - certainly not in theory, in principle, chatting all this through on a messageboard.

However: as Ariel points out in this very thread, more and more (in general, not just about the NHS) we are hearing lots of invidious stuff that is opposed to sharing; opposed to supporting other members of society; highly individualist rhetoric that carries with it a moral tone that strongly suggests that people who need help, almost by definition, don't deserve it. I HATE this sort of crap.

And I feel as if there is a different sort of version of it apparent when people are very very keen to point out that their need for IVF is a bone fide medical issue just like having a broken leg through no fault of one's own and certainly not self-inflicted like obesity related diabetes or smoking related disease. It feels like this is buying into, and supporting, the deserving v undeserving dichotomy which I oppose as absolutely wrong and unconstructive.

and it individualises a lot of issues which would be more constructively addressed on a societal level, because individualising everything is just a way of weakening us and making us more easily fucked over.