Figures released by Fertility Network UK show that 13 areas of the UK have cut back IVF funding since the beginning of the year. British Fertility Society Chairperson, Professor Adam Balen said of this news:

“This is ridiculous. In 2013 NICE said that for couples where a woman seeking to get pregnant is under 40, and who meet the criteria of infertility, three full cycles of IVF should be offered. They also laid out a plan to gradually increase funding for IVF across England. Out of over 200 clinical commissioning groups in England only 27 comply with this guidance. It makes a total mockery of NICE and is disadvantaging patients based only on where they happen to live. This is a postcode lottery by any other name and it has to stop. We want to see an independent inquiry into how this has happened.”

NICE, the National Institute for Health and Care Excellence, assesses the cost and benefit of treatment before making recommendations. Professor Balen continued:

“NICE can’t control what the CCGs do and of course it is up to them to decide how money and other resources are used, based on local needs – that was the whole point of establishing CCGs in the first place. But when only 13% are offering the recommended treatment we must ask what has gone wrong. Of course, the simple answer is that there isn’t enough money to go around, but we need to be more subtle than that in our questioning.

“We are somewhat sceptical that these decisions are saving as much money as would have been spent on IVF. The psychosocial impacts of infertility are clear and include grief, anger, depression, anxiety, low self-esteem, and a feeling of being out of control. So by not treating infertility, new health problems are often created. It’s extremely difficult to put numbers on this but we have good evidence that people often go through intense emotional distress when they discover they cannot conceive without medical intervention, and becoming pregnant takes on a whole new pressure and significance for them.”

Last year, the King’s Fund reported on CCGs[1] and found that engagement between the group governing bodies and local GPs was poor. A lack of strong leadership was highlighted and recommendations included greater support from NHS England at the Royal Colleges. Professor Balen commented:

“The report shows worrying problems within CCGs that have the potential to affect decision making. If CCGs aren’t engaged with GPs in their locality and are lacking leadership or the support of national bodies, how can they possibly make good decisions?

“I think IVF is an easy target – most people think it is very expensive, and infertility isn’t considered to be a serious condition. But both of these views are wrong and we believe infertility should be treated just like any other chronic non-life-threatening condition that requires treatment. Most especially, we want to see all patients in the UK treated equally – nobody should be denied treatment based on where they live.”

The cost of IVF to the NHS was estimated by NICE at £107,000 per 100,000 people[2], rising to £129,000 once its 2013 recommendations were implemented. Professor Balen commented:

“IVF treatments are cost-effective and it has been clearly shown that the economic advantage to Society from those conceived by IVF far outweighs the initial costs. We’d expect the total bill across the NHS to be about 77 million pounds a year. Compare that to the estimated cost of alcohol related illness, which is 3.5 billion pounds a year and you get some perspective. The question is why can’t CCGs fund IVF, or why won’t they?

“I can only imagine this situation getting worse. More women are delaying pregnancy into their thirties and will need medical support in order to conceive. We have to get on top of this problem quickly and decide what is best for the whole country. It’s time to stamp out the postcode lottery of IVF!”

[1] https://www.kingsfund.org.uk/sites/files/kf/field/field_publication_file/Clinical_commissioning_web_pdf.pdf

[2] https://www.nice.org.uk/guidance/cg156/resources/costing-report-pdf-188496685

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About the British Fertility Society

British Fertility Society was founded in 1972, by a small group with a common interest in infertility. Since then the burgeoning knowledge in this exciting area of medicine has resulted in the development and introduction of many new reproductive technologies and into clinical practice. The British Fertility Society has grown alongside the development of our speciality and now actively promotes the sharing of knowledge, further education and raising standards of practice.

Today, the Society recognises the multi-disciplinary nature of science and practice of reproductive medicine and welcomes andrologists, counsellors, embryologists, endocrinologists, nurses, and other professional groups working in this field, into its membership.

www.fertility.org.uk