Refusal of IVF in the UK

In vitro fertilisation is one of several techniques available to help people with fertility problems have a baby. 

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In women, infertility is a result of problems with ovulation in about one in three cases. Some issues prevent women from releasing any eggs, whereas in other cases an egg is only released on monthly cycles.

Ovulation problems can occur as a result of a number of conditions, including polycystic ovary syndrome, thyroid problems or premature ovarian failure, and this is when a woman’s ovaries stop working before the age of 40, the most common age for ovaries to become less active.

However, there are many other conditions that can cause a woman to have problems with fertility. It may be difficult for a woman to become pregnant if the womb or fallopian tubes are damaged.

Another common cause of infertility, which affects around two million women in the UK is endometriosis. This is when small pieces of the womb lining are found outside the womb.

There are numerous reasons as to why people struggle to conceive a child, therefore alternative techniques including IVF can be crucial when helping people with fertility problems.

An investigation carried out by the BBC found that woman over 34 were being automatically refused IVF treatment in certain parts of the UK. Guidelines say IVF should be available to people to the age of 42, however figures in the study show that 80% of areas are failing to provide this service.

Campaign group Fertility Fairness said: “It penalises women who take longer to find a partner.”

As well as this, according to an audit carried out by Fertility Fairness, more than a quarter of fertility clinics use a mans BMI to decipher whether they are eligible for fertility treatment. The campaign group said that a mans age, weight and any other physical criteria should not be used to access NHS services such as IVF. The group also said that clinical commissions groups are rationing access to fertility treatments, therefore making the criteria harder for people to meet, making their experience with trying to get pregnant harder.

Ashley Macdonald, midwife said: “Families can try endlessly to have their own children and with this comes an overwhelming amount of stress and pressure, therefore having the option of IVF makes the process slightly easier in some cases; refusing treatment to eligible people only adds to the original stress.

Couples in both Scotland and Wales are offered IVF until they are 42 as long as certain criteria are met. But in England, seven of 195 Clinical Commissioning Groups have stopped offering IVF on the NHS completely.

One woman told the BBC investigation programme that she was considering moving house, after being told she was too old to qualify for IVF in her hometown of Southhampton.

Macdonald said: “If the couple or family have been assessed to be healthy, responsible and appropriate candidates for parenthood then I don’t think it should matter (what their age is). It’s a known fact that the older a woman gets. the harder it becomes to for her to carry a child, so I do believe once women have reached the age of 40 then access to IVF through the NHS should be limited.”

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Guidelines from the health watchdog Nice recommend that women under 40 would be offered three cycles, and those who are aged 40-42 should be offered one. However, a total of 85 commissioning groups in England – 43 per cent of the total – have cut IVF completely for women over 39.

England’s health secretary Matt Hancock has said that such restrictions are completely ‘unacceptable’.

Funding for fertility treatments varies across the UK as a result of different restrictions and criteria in each individual country. According to the Royal College of Obstetricians and Gynaecologists, six out of ten IVF cycles are funded by patients themselves. In the last two years, 15.3 per cent of Clinical Commissioning groups have slashed NHS fertility services, and one in 10 are currently considering cutting or removing NHS fertility treatment.

Macdonald said: ” It’s a shame that many clinics in England are making it even more difficult for people to have children, restrictions and tough criteria make it seem impossible for people who want to have child later on in their life. We live in a society where women are waiting to have families, so attitudes of CCGs should evolve with society.”

87 per cent of Clinical Commissioning Groups do not provide the recommended three full IVF cycles.

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