The average cost of bringing up a child in the UK is now more than £150,000 - but for some, the cost of trying to conceive a child is even greater. According to stats, one in every 50 babies born in the UK is the result of IVF treatment with 63% of those paying for the treatment privately, skipping the long NHS waiting lists and the postcode lottery of fertility options. However, with the average costs for one cycle ranging between £4,000 and £7,000 (excluding medications), or more than £15,000 for a top London clinic, for many, self-funding fertility treatment is simply out of the question.
So, how exactly does the IVF NHS eligibility work? Under current official guidelines, women under the age of 40 struggling to have a child should get three cycles of the fertility treatment on the NHS. However, these guidelines were developed over 10 years ago and now, with the NHS on its knees with cut-backs and waiting times, the majority of health authorities have created their own access rules – and in doing so, have created what's been dubbed ‘The IVF NHS postcode lottery' - ie. what you get for free totally depends on where you live.
Patients are also often given a generic plan. But with artificial intelligence, treatment could become more personalised.
The Daily Mail have dubbed this process ‘cruel’ crunching the data published by the Department of Health and revealing the parts of the country where some women are completely disadvantaged in their fertility options, with some only eligible for one round of NHS-funded IVF treatment (eg. Hertfordshire and West Essex) while others are able to have three rounds (Sussex).
The data, which GLAMOUR has illustrated below in a searchable table, shows how some UK health authorities have created other criteria such as not offering NHS-funded treatment to women over 35 (Isle of Wight and Hampshire) or some who refuse to offer treatment whatsoever to anyone who has received NHS-funded IVF treatment before (Coventry and Warwickshire).
“I’ve had numerous women tell me they’ve been either sidelined or sacked.”
Others stipulate that patients must have suffered from unexplained fertility for three years before they can access the treatment. It's even worse for female same-sex couples, which most health authorities state need to have paid for three to 12 rounds of artificial insemination — when sperm is injected directly into the womb — before they can access IVF on the NHS.
Dr. Amit Shah, leading gynaecologist and co-founder of Fertility Plus, told GLAMOUR: “Access to NHS-funded IVF via the postcode lottery has been an ongoing issue for decades.”
Dr. Shah added: "While the National Institute for Health and Care Excellence (NICE) is responsible for recommending who should have access to IVF treatment on the NHS in England and Wales, final decisions come down individual NHS Integrated Care Boards (ICBs), regarding who will have access to NHS-funded IVF in their local area. As each ICB has autonomy, this can make for the unfortunate discrepancies we are witnessing across the UK, when it comes to NHS-funded IVF for women.
"When it comes to how bad it really is with the postcode lottery, this ultimately comes down to the geographical location. The volume of resources allocated to IVF depends on the priorities of each ICB. These priorities are determined by where they can best fund that specific population’s needs— for example, if an area is predominantly dealing with cardiovascular issues, resources will be allocated to that health issue over IVF. Each ICB has its own individual budget, and they must determine where it goes. This is why IVF can often come lower down on the priority list, and why it can be harder to access NHS support in certain areas.
“When it comes to the age debacle, it’s important to note that NHS funding happens at a population level versus at an individual level. This is why so many women can feel frustrated if they find themselves in a geographical location where IVF isn’t being prioritised. Above all, cost-effectiveness is at the top of the NHS’ priorities— for example, from, their perspective if every woman under 35 was given 3 IVF cycles, there would be a huge volume of treatments to supply. As we know, each ICB can decide their own criteria. Taking these facts into account explains why despite current guidelines stating women under 40 can have 3 cycles of treatment, we’re not necessarily seeing this all over the UK. Ultimately, without surplus NHS budget, these discrepancies are sadly inevitable.”
The National Institute for Health and Care Excellence (NICE) said in a statement to GLAMOUR: "Our fertility guidelines includes recommendations to reduce variation in practice and improve the way fertility problems are investigated and managed to help get the best care to those who need it. The full access criteria, including age, for referral for IVF can be found on page 53 of the guideline.
“The guideline is not mandatory and nor is NICE responsible for how or, indeed, whether it is implemented. It is for local commissioners and providers to use when making decisions in consultation with people and their families and carers or guardian, and in the context of local and national services.”
