Health & Lifestyle

England’s ‘cruel’ IVF postcode lottery MAPPED: How some NHS boards only offer one free cycle, limit treatment to under-35s and deny couples who have kids already

England’s ‘cruel’ IVF postcode lottery is today laid bare by MailOnline’s interactive map.

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.

Yet only three parts of the country abide by this access criteria, developed 10 years ago. 

The majority of health authorities, who are allowed to make their own access rules, offer only one cycle of IVF.

Some deny it to women over 35. Others even refuse to pay for the procedure if they or their partner already have any children.

Charities slammed the ‘arbitrary’ criteria adopted across England, arguing it forces couples desperate for a baby into ‘significant financial hurdles’.

Around a third of IVF cycles among under-35s resulted in a live birth in 2019. Yet this dropped to just 4 per cent in over-44s

Around a third of IVF cycles among under-35s resulted in a live birth in 2019. Yet this dropped to just 4 per cent in over-44s

Private clinics can charge upwards of £10,000 for one cycle of IVF, which has a success rate of just 27 per cent.

But the success rate heavily depends on age. 

Around a third of IVF cycles among under-35s resulted in a live birth in 2019. Yet this dropped to just 4 per cent in over-44s. 

The data crunched by MailOnline was published by the Department of Health, in its attempt to set out how access to NHS-funded IVF varies across the country.

The procedure, first performed in the 1970s, involves removing an egg from a woman’s ovaries and fertilising it with sperm in a laboratory. 

The fertilised egg, called an embryo, is then returned to the woman’s womb to grow and develop. 

Figures show that only women aged 35 and under are eligible for NHS-funded IVF in Hampshire and the Isle of Wight.

This is the most stringent age cut-off of any integrated care boards (ICBs). Some do offer IVF to women aged up to 42.

Women under the jurisdiction of Hampshire and the Isle of Wight ICB must also not have any kids from a current or previous relationship to meet the criteria. 

A spokesperson for Hampshire and Isle of Wight ICB told MailOnline: ‘We understand how important IVF is for couples that need help to conceive, and to ensure our policy is consistent with best clinical practice, national policy and other commissioners of this service, our policy is currently under review.’

However, the same policy is in place at 24 of the 33 ICBs (73 per cent) that provided details of the fertility services to the Department of Health.

This is despite it not being mentioned in guidelines from the National Institute for Health and Care Excellence, which the NHS is urged to follow.

Only eight ICBs provide full cycles.

If a full cycle is not offered, it means any remaining viable embryos are not used. However, couples can choose to freeze them, for a fee, so they can use them in a further transfer privately — which costs around £2,000.

Guidelines from NICE also set out that all IVF should be offered to women under the age of 43 who have been trying to get pregnant through regular unprotected sex for two years.

However, while women aged 40 or under should be offered three IVF cycles, those aged 40 to 42 should only be offered one, the NHS says.

And the final decision about who can have NHS-funded IVF is made by ICBs, whose criteria can be stricter than those recommended by NICE. 

Some ICBs throw up extra hurdles to those seeking to have children.

These include not offering the fertility treatment to those who have paid for even a single cycle of IVF themselves, which costs £7,000 to £8,000 on average in the UK.

Others stipulate that patients must have suffered from unexplained fertility for three years before they can access the treatment.

For female same-sex couples, most ICBs require them 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.

Fresh official figures show that while some parts of the country offer three rounds of the fertility treatment, others provide just one

Fresh official figures show that while some parts of the country offer three rounds of the fertility treatment, others provide just one 

Dr Catherine Hill, interim chief executive of the charity Fertility Network UK, told MailOnline: ‘It’s 45 years since the world’s first IVF baby, Louise Brown, was born in Oldham. 

‘This means England has had longer than any other country to get access to NHS-funded fertility treatment right and yet we are a very long way from this. 

‘It is still the case that if you need medical help to conceive, most people in the UK have to pay privately, and the level of help you get differs depending on where you live.

‘The vast majority of integrated care boards don’t offer three full IVF cycles to women under 40, as recommended by NICE guidelines.

‘Instead ICBs implement their own arbitrary, cruel and often non-clinical criteria to ration access to NHS-funded fertility treatment. 

‘Some bar women over 35 from NHS help, others offer only the absolute bare minimum of just one embryo transfer, and most say if you have a fertility problem but you fell in love with someone who already has children then you can’t have help.’

She added: ‘If you’re a woman in a same-sex relationship, then you’ll face significant financial hurdles before you can have NHS treatment and if you’re single, you’ll either face the same financial barriers or be denied any help.

‘As a society and a healthcare system we are failing fertility patients. 

‘Sadly, the Government’s recently published incomplete data on what ICBs offer does absolutely nothing to change the current appalling picture of NHS fertility provision in England.’

Sarah Norcross, director of Progress Educational Trust, a charity that campaigns to improve choices to those suffering from infertility and genetic conditions, told MailOnline: ‘Almost 20 years after the NICE Guideline for fertility treatment was introduced, it still has not been implemented. 

‘A patient’s ability to access NHS fertility treatment still depends on where they live. This is, and has always been, unacceptable.

‘PET is campaigning to end the postcode lottery, so that all ICBs comply with the NICE Guideline.’

Clare Ettinghausen, director of strategy and corporate affairs for the HFEA, told MailOnline that while fertility treatment ‘helps thousands of people every year start a family’, access varies across the country.

It noted that 17 per cent fewer NHS-funded IVF cycles took place in 2021, compared to 2019 due to Covid-fuelled waiting list backlogs. 

Kayleigh Hartigan, fertility expert and founder of Fertility Mapper, a platform for reviewing clinics, told MailOnline: ‘The data shows significant differences in who has access to fertility treatments, and what and how much treatment they are entitled to across the UK. This is known as the “postcode lottery”.’

She added: ‘Fertility treatment is costly and emotionally and physically draining. 

‘Providing clear and transparent information is critical to support people through this process, putting them back in the driving seat and helping them make informed choices.

‘[It] is a difficult process for everyone — and it’s made even harder by fragmented treatment pathways and a deep lack of transparent information and data. 

‘This makes finding out how to pay for treatment, and choosing the right clinic for your budget and needs both difficult and stressful.’

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