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 it's really important to try very hard to separate the medical facts behind this debate from the social/political emotive baggage. I'd be interested in responses to these little hypothectical questions:

If women had evolved so that we had no menopause, what age would be considered 'too old' to be a good mother?

If men had a menopause - I mean an absolute cessation of sperm production, rather than the average fertility slump in levels - what would your opinion about fertility treatments for them be like?

(In the latter case, personally, I suspect fertility treatment would be less taboo, better funded, more widely available regardless of age).

I was interested to see that 12ylon you mentioned your fathers age as well as your mothers. It's seems pretty unusual whenever I find this topic being debated. The focus is very much on the age of the mother. I do see your point, and it's a fair one given your experience. However, as life expectancy steadily increases, and better treatments for the medical problems that go along with this improve, it will hopefully become less of an issue.

If IVF for older women is disallowed bcause of clear medical facts around failure of the pregnancy, or health damage to the mother (beyond the usual risks of pregnancy, which, let's face it, is already fraught with peril), then let's assess the argument on that basis.

I do feel though, that so often the argument comes from a place of societal and political prejudice; that a woman can be deemed to be past it, while a man can make babies at any time of life. It's problematic, to say the least, and for me it raises a whole bunch of issues and questions that go well beyond arguments about budgets and health.

I am behind these recommendations. Women are capable of conceiving naturally at this age - it is biologically possible. I also think it should be available sooner, and that postcode lotteries should be erased. There should be better counselling, and perhaps a drive to encourage younger women who know they wish to put energy into their careers first to freeze eggs; to plan their potential motherhood as a carefully considered part of their futures with as much validity and information behind that decision as behind their working life.

Firstly, I think everyone who is a taxpayer has a right to an opinion on what the NHS budget is spent on.

Secondly, however heartbreaking childlessness might be, it is not a life threatening condition, unlike obesity , alcoholism etc.

If the NHS had an infinite budget then fine, but I'd rather see the money go towards better care for Alzheimer's sufferers, for example.

curryeater that wasn't the point I was addressing, but now you mention it the NHS does many things besides trying to cure medical conditions. It helps people to stop smoking, it offers contraception, it provides gluten-free foodstuffs on prescription for children who need it, it provides facilities for childbirth and pregnancy.

The fact remains however that infertility is in the vast majority of cases caused by some sort of medical condition affecting one or both partners. Why shouldn't that be treated? The treatment preferred by the NHS is IVF, because it resolves a multitude of issues. Personally I would have preferred to be properly diagnosed and treated for the specific issue affecting my fertility, rather than dumped in the "unexplained" category and referred for IVF. But that doesn't seem to be considered cost effective because IVF will probably deal with the underlying issue, whatever it may be.

Re gastric band sorry it costs ££££££,is risky and life changing. I think also it could lead to laziness ie patients sitting back and not getting to grips with their weight issue themselves and leaving it to the NHS to make less food end up in their stomachs.

Sheila, but you could argue that conditions like alcoholism and obesity are often self-inflicted. Infertility is not.

Frankelly yes but medical care isn't dependent on whether a condition is self inflicted or not, fortunately.

But infertility if left untreated doesn't cost the Nhs money.

Unfortunately the majority of pct funding decisions are based on whether its value for money.

Gastric bands are 5k private, so will cost the Nhs less I'd imagine. Not sure how much ivf is,......12k a cycle?

You could also argue that since infertility is linked to mental health that it might be life threatening too, in extreme examples.

Viva a privately-funded cycle at my NHS clinic was just over £3k. Of course, the NHS would pay less than that.

Red, yes it might be, but I don't think we should build healthcare around a possibility.

Red, yes it might be, but I don't think we should build healthcare around a possibility

Really??! You don't think it is?! Healthcare is ALL about managing risk!

My fertility clinic charges about £3k per IVF cycle too.

If we're saying that infertility treatment is non-essential, then the same goes for non-reconstructive plastic surgery. If the "damage to self-esteem/mental health" cannot count towards IVF then it shouldn't count for anything else either.

Frankelly yes but medical care isn't dependent on whether a condition is self inflicted or not, fortunately.

No, but it could be made so, if what we are doing is looking to save money. There are all sorts of criteria we could introduce.

I don't think that IVF up to the age of 42 is a particularly good use of public funds tbh

This is what I think. The NHS is short of money already with life saving treatments limited. A line needs to be drawn somewhere and, personally, I think 42 is far too high.

How many years of mental health treatment would you need to clock up £3k?

Viva yes infertility left untreated does cost money-2x treatment for depression,care for the childless elderly,pcos and endo improve hugely with pg,some cancers are higher in childless women.

IVF is 3k and infertility isn't a choice -smoking and most obesity/lack of exercise illnesses are.

Precisely Polka. The short sighteness of people saying "we can't afford it" is annoying. Its not as simple as the obvious price tag.

dragon, success rate for 42 year olds now is the same as it was for under 35 year olds when that criterion was set. What is the difference between giving someone that shot when they are 35 and giving it to them when they are 42?

What is the difference between giving someone that shot when they are 35 and giving it to them when they are 42?

The cost of funding the treatment for more people. That should be obvious.

Heaven forbid that more people should be helped. Let's cancel school hearing tests too. That'll save the cost of a few hearing aids.

So are you ok with the other suggestions here that referral times should be shortened? That would have the same effect of getting people treated before the current age cut off.

Fantastic! A mate of mine has been referred after losing her only child, conceived with fertility treatment, to cancer. She's 39. Hope their next cycle is a success - they are fantastic parents!

Clearly you think the NHS is a bottomless pit of money, Northey.

I'm sure there are plenty of people (including me) who would argue that alcoholism is a disease not a lifestyle choice, and, as I said before, it's life threatening, whereas infertility isn't.

That isn't a reasonable assumption to make, dragon and certainly doesn't work as an answer to anything i have said.