NHS access to IVF getting worse, study finds

Access to IVF on the NHS is getting worse, according to a report published today.

Eight out of 10 primary care trusts (PCTs) questioned are failing to follow guidelines allowing women three free cycles - despite the fact the rules were introduced in 2004.

Two PCTs have refused women any IVF in the previous two years while one in eight PCTs are failing to comply with guidelines on a woman's age.

This means the same woman can be too old for treatment in one part of the country and too young in another, the report said.

The study, from Tory MP Grant Shapps, was based on an 80% response rate from PCTs in England and found that provision was worse than two years ago.
Overall, 54% of trusts exclude couples from IVF if one partner has a child from a previous relationship.

It also found widespread regional variations.

In the East Midlands, every trust offers one full cycle of treatment but, in the South East, 41% do not offer IVF to any woman aged 23 to 39, as set out in the guidance.

In the East Midlands, no PCT would offer treatment to couples in which one partner already has a child but 70% would in the North East.

Almost half of all trusts said they wanted couples to have been in a relationship for more than three years.

Others said one or two years while some merely asked that the relationship was "stable".

In its 2004 guidance, Nice said the NHS should fund three cycles of IVF for women under 40.

The then-Health Secretary John Reid said couples would be offered one free IVF cycle by April the following year, with a view to three cycles being offered in the future.

But by 2007, this was still not happening. Health minister Dawn Primarolo wrote to PCTs in that year saying they should be looking to fund three cycles.

The letter said: "The Department is looking to PCTs to move towards the provision of three full cycles of IVF, for those who need it, as recommended in the Nice guideline."

Today's evidence shows most PCTs are still failing to offer three cycles.

Experts have warned that the drive to cut the number of multiple births is also being hampered by the lack of access to free IVF.

Couples who have the chance of only one cycle on the NHS may wish to have more than one embryo transferred, they said.

The Nice guidance also said PCTs should allow frozen embryos to be transferred as part of one complete IVF cycle on the NHS.

But very few PCTs offer this.

Mr Shapps said: "IVF remains a postcode lottery in this country."

He added: "Budgets are tight and the NHS must set its priorities, but it is wrong to raise expectations in couples who are desperate to start a family only for them to find out later that they won't get the real help they expected."

Clare Lewis-Jones, chief executive of Infertility Network UK, said: "It is totally unacceptable that patients are denied treatment simply because of where they live or on the basis of their age, or indeed whether or not they fit the various definitions of 'childlessness' adopted by the PCTs."

She urged PCTs to accept recommendations laid down in the document 'Standardising Access Criteria to NHS Fertility Treatment', produced by Infertility Network UK and funded by the Department of Health.

Mr Shapps' report was based on freedom of information requests.

A spokesman for the Department of Health said: "Our survey of every PCT in England shows the NHS is making good progress in implementing Nice guidelines and in providing fair and consistent access to IVF."