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NHS told to end IVF ‘postcode lottery’

NICE publishes 10 standards to end inequality of access to fertility treatment

Mark Gould

Thursday, 15 May 2014

The National Institute for Health and Care Excellence (NICE) says that the NHS is denying too many couples access to a full range of fertility treatments. It has today published a new set of draft standards which it hopes will help the NHS eliminate a “postcode lottery” of treatment and support for people with fertility problems.

NICE published updated guidance for the NHS last year on the diagnosis, treatment and care of people with fertility problems. This included offering 3 full cycles of IVF treatment to women under 40 who have failed to get pregnant after 2 years of trying or 12 cycles of artificial insemination. It also recommended that women aged 40-42 should receive 1 full cycle if certain criteria were met.

However, not all areas offer the full number of cycles. Gosport MP Caroline Dinenage told the Commons last week that women in her area are only being offered 1 cycle of IVF treatment up to the age of 35.

NICE says the draft quality standard highlights key areas of care where improvements are most needed. This standard has been published for consultation and supports the need to offer the full number of recommended IVF cycles. The final standard is expected to be published in October.

NICE also recommends GPs refer people for specialist consultation if they have not conceived after 1 year of unprotected vaginal intercourse, or earlier if there is a known clinical cause, a history of predisposing factors for infertility or the woman is at least 36-years-old.

They should also offer counselling to people before, during and after investigations and treatment for fertility problems, irrespective of the outcome.

And women having IVF should have the appropriate number of embryos transferred according to the age of the woman whose eggs are used, the cycle number and quality of embryo.

The draft quality standard also says that Clinical Commissioning Groups (CCGs) should offer cryopreservation to people of reproductive age who are preparing to have treatment for cancer that is likely to give them fertility problems. Earlier this month, a judge criticised Thanet CCG for refusing to fund this procedure for a woman about to undergo chemotherapy for a severe form of Crohn's disease, simply because the CCG disagreed with NICE guidance.

Professor Gillian Leng, Deputy Chief Executive and Director of Health and Social Care at NICE, said:

“Our updated guidance which published last year provides clear recommendations on the most clinically and cost effective way to treat people with fertility problems. Unfortunately, we know that not all areas are following our guidance to the letter. This creates variations in treatment within the NHS, which is disappointing and goes against the fundamental aims of the NHS.

”The quality standard that we are currently developing should help healthcare services to focus on the key areas of care that need to be addressed most urgently and ensure that the right support and treatment is available to those who need it.”

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