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

Adoption isn't always a solution either. You have to wait a year after fertility treatment to apply, and if, as in many cases where IVF is a last resort, you're anywhere near the age of 40, then you won't be able to adopt a baby but will only be "allowed" an older child who has probably already been damaged by the care system and will therefore require a huge amount of attention, understanding and specialist care. (I speak from experience here.) Once I found out that we were too old to adopt a baby, and having close personal experience of how challenging damaged children can be, I knew that adoption was not a path open to us.

I don't agree with extending it, sorry. Like others have said in times when the NHS can't fund life saving cancer treatments I think its a poor choice to fund this over such stuff.

If people have got past their mid/late 30s without trying for a child then they've left it too late through their choice. If they haven't left it too late then they'll have had IVF before the age of 39. If anything I think the age should be lowered. Its not like there's not enough publicity about how hard it can be to get pregnant the longer you leave it.

My ex husbands wife was turned down for IVF. My ex got cancer and froze his sperm before chemo but they won't allow her to have IVF because she is a step mum to three of my children.

I would love to see that change. I do think we are lucky to have IVF on the NHS but I don't think she is less worthy of getting a chance because she has step children.

Tell you one thing. If I'd had children in my "peak" years with the man I was with in my twenties, my children and I would be costing the State a damn site more in benefits than a couple of rounds of IVF in my 30s with my devoted DH.

For those disagreeing with the extended age range (I'm in two minds about this myself) - what about the other new suggestion, that referral for IVF should come after two rather than three years of unsuccessful TTC?

I thnk shorter referral times will have a far greater impact anyway, to be honest. I would have loved to be referred this time last year instead of now.

This is going to get lost.

I'm very torn on this issue i'm afraid and i don't think my response will be popular. I don't want to offend anyone and this is just my own experiences and views.

I know exactly what it's like to go though the absolute pain and dispare of infertility (albeit at the age of 23). I'm luckily now pregnant with our second and last child. I'm so grateful that i found the person that i wanted to have children with at a fairly young age and we made various sacrifices so that we could have them in our 20s as i knew that i didn't want children past 30.

I also know what it's like to have older parents. My mother was in her 40s when she had me (not by IVF), my dad was 7 years older than her. My mum died when i was 13 and i barely remember her and my dad is now 68 and i'm facing the very real possibility that within the next 10 years, i'm probably going to have to take on a major role in looking after him. I'm in my mid 20s, so this is actually quite a scary thought for me. I so so desperately wish that my parents had been younger when they had me, i really do. I also have a friend who's the same age as me who is in a similar situation. He really struggled through university as his father was already retired by that time and couldn't offer any significant financial support.

I'm honestly not sure our parents fully thought this through when they decided to have us and if they did.... well... it was a really half baked idea!

I'm very much an 'each to their own' kind of person and support every woman's decision to be a parent (so in that respect, i think the new NHS guidelines give people a greater chance of achieving this and they are right to do so), but i just think that people shouldn't necessarily take up the offer of IVF at the age of 42 as i'm just not convinced that they fully take into account the true consequences of being an older parent.

I don't agree Enjoy. Many many women like I do support our children entirely alone and cost the state not a penny. Many many women work hard to fund IVF treatment.

Anyway this is all about Cameron having made a huge mess of the female vote and losing it never mind the tiny number of women in cabinet posts. Unless he does a lot more for women (and £1k a year childcare tax relief when childcare costs £25k a year full time is no help) he will not get re-elected.

I think it is astonishing that there is a sense of infinite resources with respect to this issue, yet there is such a firm (mistaken, in my view) general belief that other cuts are necessary.

Housing benefit, DLA, etc - all of these things are for people who struggle to get by without them - children are an enhancement to life. I don't get it, I am very surprised to see this.

I think geographical disparities between treatment available are very unfair, but I struggle to see why this is something that is more deserving of public funds than other things.

I also struggle to see why "medical" childlessness is seen to trump everything else, in some quasi-moral way. I also struggle with the fact that, for women, the having-babies thing occupies such a high ground. There are many sorts of legitimate emotional pain and practical and physical difficulties which people in general can suffer; no one gives a shit if I can't get a decent job or have crippling depression, but when I was struggling physically in pregnancy, strangers moved heaven and earth to help me (bless them). I am so grateful for my children and so grateful for the general public recognition of what a massive thing it is to bear children and look after small children, but you know, if you have had depression, it is not the hardest thing in the world, and I don't get why not-having-them should be seen - for women - as the worst thing in the world.

worldgonecrazy in our area you can adopt a baby up to age 50. I'm not sure adoption is necessarily a solution for people who would like to have a baby. Everyone is different. Just wanted to say about the age thing in case anyone was interested.

I do agree with the waiting time for referral going down from 3 years of ttc to 2 years. If its not happening after 2 years chances are you're going to need help. And by the time you've waited, had tests, etc its probably going to be 3 years!

As was said earlier, curryeater - it is extremely hard to understand if you have not been in the position of trying to conceive whilst being infertile. As mentioned in RedToothBrush's post of the NICE comments on the psychiatric effect of infertility, it is a huge burden to bear. To me, it feels more like intense grief than anything else.

Whether you can understand it or not, it is the case for an enormous number of people. I would not wish it on anyone.

The nhs isnt for people who left it too late imho

If people have got past their mid/late 30s without trying for a child then they've left it too late through their choice

There are anecdotes on this thread where people have started trying for children well inside what is considered to be "too late", but due to waiting lists and incompetence, have not been able to complete the treatment before the present cut off.

I started TTC at 34, and if I was still listening to my GP, I would only now be starting the referral process, a month before my 38th birthday, so much did she try and convince me that things were "probably fine" (granted I could have sought help earlier)

Also, it's frequently not about leaving it "too late" and when you see friends around you conceiving their first child in their mid 30s quite easily, it's very easy to think that you are fine. By the time you realise no it isn't fine, you are one of those selfish career women who deserve no sympathy or funding because you left it too late, despite having paid tax since your early 20s.

Psychological effect, not psychiatric, my apologies.

I have never experienced fertility problems but I support these changes to the guidelines, both raising the age to 42 and shortening the referral time. It gives greater parity.

Xenia, were your births on the NHS? How much do you think 5 of those cost? Did you think about the implications for NHS finances before you conceived? I do however agree that there should be no postcode lottery for health services. The disparity is ridiculous.

Viva you said "If people have got past their mid/late 30s without trying for a child then they've left it too late through their choice." Have you not read the thread? There are loads of posts about how long it takes to get through the system. I very much doubt that anyone gets to 42 and thinks "ooo, I'd quite like a baby now" and starts hammering on the door of the IVF clinic. I can think of one woman from the conception boards who was trying for 10 years, adopted a child and recently became pregnant at 40 from (private) IVF. It's hardly like it suddenly occurred to her that she might like a child.

curryeater I agree with evilgiraffe. Infertility is like an all-consuming kind of grief. It is without a doubt the hardest thing I have gone through, and both my parents have had cancer, and I have watched them go through horrific treatments and awful times. I'm not at all surprised by the long quoted passage a couple of pages back about the psychological effects of infertiltiy.

I'm not qualified to argue about what is an appropriate age limit, or how many cycles should be funded, or if the NHS should be involved at all. Our ddtwins were unplanned, the direct result of a monumental piss-up contraception failure. The issue to me is that it all depends on which health authority area you're in. I know 'postcode lottery' affects quite a few common medical conditions, but IVF does seem to be one where the differences are particularly glaring. Just knowing that whether you're in Brighton, Bournemouth or Blackpool, you'll get the same help, would be wonderful. Even if it was no help at all, at least everyone would know where they stood.

I appreciate the postcode lottery and the ethics of what the NHS should even fund in the first place are not what are up for discussion here.

Xenia whilst I'm always interested and comforted by your work own financial capability, can I just say that I self funded 6 rounds of IVF. So i know exactly the cost. would you like to see the invoices? Also I work now to support the resulting DS.

I would prefer to see something that would ensure universal treatment offered across the country than a raising of the age in guidelines which may or may not be followed.

I do not doubt or question the all-consuming grief of infertility. But is grief a medical issue?

Curry no, but neither is gastric band surgery. There's probably far fewer of these than IVF treatments to be fair, but there's a lot of non-essential costs in the NHS. Why should it be fertility treatments that get the push when a person could just go on a diet?

I would prefer to see something that would ensure universal treatment offered across the country than a raising of the age in guidelines which may or may not be followed

Thats not NICE's remit though. NICE's remit is merely to recommend best practice. It would take government policy to change the enforcement of such recommendations. Personally I am of the opinion that what is actually is the point of NICE if it can just be ignored whenever it takes the political whim of whichever PCT is ignoring it. It is one of the biggest failings of the NHS and not one of the major three parties is doing anything to address this.

Recent research has found that a diagnosis of infertility is as hard on a person as the diagnosis of a terminal illness or the death of a loved one. The pain it causes is not to be belittled.

As someone once said to me, if you had diabetes you would seek help from a Dr; if you were short-sighted you would get glasses to correct the problem. Infertility is not a self-inflicted problem, so why is it that couples should not seek help for it?

Gastric band surgery actually can very much be deemed a medical issue. It's cheaper for the Nhs to give someone with significant writ issues a gastric band than it is to deal with all obesity related complications such as diabetes further down the line. So gastric bands save the Nhs money.

redtoothbrush - you talk so much sense :)

And frankelly - that's so true. It's far beyond a minor upset - it can be (for some) absolutely soul destroying. In part confounded by the societal expectations as addressed above, and the sheer unfairness of the treatment incoherence depending on PCT.

Yet again adoption is being bandied about like it's the solution to everything. Not everyone is suitable to adopt (regardless of age). Surely these children deserve parents who actually want to adopt them, not those whose default position is adoption when they can't have their own biological children. Of course there are couples who are infertile and are well suited to be adoptive parents, but it shouldn't be the get out clause for infertility.

As for the extension on age limit, I agree with it. Take for example our situation. We married when I was 30 and tried to conceive unassisted for 3 years. We then sought help and had the initial investigations carried out on the NHS. That took around 1 year. Then we started our first cycle (self funded), when I was nearly 35, the next when I was 36 and the final, successful cycle at 37. DS1 was born a few months before I turned 38. If we had waited for NHS funding, it would be likely I would have been close to 40 before our 3rd attempt.