Should IVF be available to lesbians?

[TooBigForMyBoots]

And single women? Or should assisted conception only be for infertile women in heterosexual relationships?

Absolutely! Please do come back to me with the stats - I'd be really interested.

Yes, but the NHS has not paid for the treatment for the woman to become pregnant in those cases. A 20% chance of a live birth as a result of IVF is a very low success rate.

But this is correlated with age, I thought? IVF is skewed (for obvious reasons) towards older women. If I've misunderstood, I do apologise! But, I must say, even if IVF only results in 1 in 5 live births, it is still not a very poor outcome, is it?

20% of IVF pregnancies result in a live birth according to another poster.

Sorry! 20% of women who have IVF have a live birth, not 20% of those who manage to become pregnant through IVF.

That’s from one round? That is better than I thought. My friends’ disappointments coloured my view.

Oh, sorry, I wasn't clear - I meant, what other non-life-saving treatments are we comparing with? Eg., my mother recently had treatment on her knee that her doctor said had about a 1 in 10 chance of bringing any improvement; it was worth doing because at the moment she can only walk about 4-6 miles and she gets tired. She's 70, and the way they put it to her was: you could do this and be much healthier. You could not do it, and gradually degenerate. There was a small chance the surgery would fail and she'd be permanently unable to walk. It was a really hard decision. But there was no pressure put on her during the process, and I thought that was really impressive.

So what about lesbians who also have fertility problems? You know that lesbians can also have endo, PCOS, cancer that effects fertility, etc etc?

We have a very different view of what constitutes a very poor outcome. Aside from the cost, what is the psychiatric impact on women going through the process often more than once with such a low chance of success? Obvs they are warned of the risk etc but what is the impact of providing this service when it is not capable of providing the desired outcome to 80% of the women who go through it? And that 80% are those who meet the criteria for treatment, so a lot of people who sadly have fertility problems that don’t even meet the criteria have already been filtered out. The cohort who have the treatment are those who have the best chances of success.

Doing the resigned hand clap here.

I am so tired of the assumption we're all super fertile and can just go risk getting raped by some randomer on a one night stand. No, actually, some of us are as boringly infertile as straight people!

Any woman with a medical problem causing infertility is entitled to treatment. The difficulty there arises in where the sperm comes from.

Why can't lesbians and single women access the same services and assistance as heterosexual couples wrt fertilisation and implantation?

Are you saying a woman married to an infertile man just needs to make agreements with members of the opposite sex and do it DIY too?

I don't think we have a different view - I'm not even sure what my own view is (and of course, it would be private). I'm just pointing out that, medically, it is not actually a poor outcome, is it?

Of course clinics do have to discuss the psychological impact of IVF. It's well known that it is very stressful.

But, you are thinking about straight women. The statistics we have, concerning IVF, apply to women in heterosexual relationships. They can't not: until very recently, women who were single by choice or in lesbian relationships, could not access treatment. Even now, they access treatment in very small numbers.

Now, think about it: if (say) 75% of your patients are women in heterosexual relationships who struggled to get pregnant and are now in their mid or late 30s, how will your IVF success stats work out?

If you reduce that pool to your lesbians, does it change? At the moment, my understanding is that we honestly don't know - we still don't have enough data. But, many lesbians (and some single women) are likely to buck the stats with IVF, simply because IVF success stats are mostly based on straight women having what ought to be reproductively successful sex.

It is most unlikely that the cohort who currently have IVF treatment are those who have the greatest chance of success.

I agree with this too.

I'm not sure about this. I thought that a couple had to have been trying to have a baby for a length of time before they could qualify for medical intervention on the NHS.

If neither party has a medical issue / fertility problems then it shouldn't be available on the NHS.

Unfortunately sex between two women or two men is never going to create a baby. You need both.

Debatable ....Your definition of very poor outcome probably is not the same as mine.

Ivf babies are generally born healthy but evidence demonstrates the risks of heart defects, musculoskeletal and central nervous system malformations, preterm birth, and low birth weight are increased in children conceived by vitro fertilization. The risks seem to be based on maternal and paternal factors, but also on IVF itself.

They can access the same treatments for their infertility.

Umm...in a heterosexual couple, it is an infertility issue. In a same sex couple, it is the biological equipment issue. Obtaining a sperm donor for lesbians is fine, but it's not an infertility issue. Clarity matters.

But these are very, very tiny variations, and we don't yet know whether the issue is IVF itself, or not. The vast majority of IVF babies are born to straight couples, and (sadly) it is perfectly possible that, in those cases, there is some biological reason for those issues. That might well not hold true for lesbian couples.

Obfuscation is important for some though…

Personal question @SarahAndQuack
Can't find the post now but you mentioned earlier that biological ties wasn't important to you. So why did you not adopt?

If the heterosexual couple doesn’t have any usable, small, mobile gametes, then yes - gotta get them from somewhere!

DIY artificial insemination is better for the woman’s health and having just now looked at the evidence, better for the health of any resulting baby too (I’m surprised at the many health risks for babies born via assisted reproduction- not a subject I’ve noticed being discussed before now?

‘It is most unlikely that the cohort who currently have IVF treatment are those who have the greatest chance of success.’ A lot of assumptions there. The biggest of which is that the issue with the low success rate for IVF is the infertility issue a heterosexual couple may have, not that the process itself is not capable of delivering a better result than those observed currently. Those women who have IVF now are those with the greatest chance of success, at least through the NHS. You also forget that many of the heterosexual couples will be people with unexplained infertility - where there is no reason medically why the couple have not conceived naturally. Barring age - and again you assume that a lot of lesbians and single women in their 20s would be the ones wanting to have this treatment. Certainly in terms of single women that would seem unlikely, most single women seeking IVF do so because they have not met a partner and so are likely to be older.

It will be true for lesbians as well. Ivf bypasses natural mechanisms of conceiving and therefore more genetic mutations slip through the net.

Good argument for collecting data separately although presumably the categories should be social/medical rather than homo/hetero (as some lesbians will have medical infertility and single women of any sexual orientation could be using assisted conception for solely social reasons. Straight couples using donor sperm for male infertility reasons would also need to be classified differently if the female partner had no diagnosable medical issues)