IVF postcode lottery revealed with BMI and relationship status used to block NHS treatment – iNews

Health officials in England are using relationship status, Body Mass Index (BMI), or the fact that one partner has a child from a previous relationship, to block access to NHS-funded fertility treatment, a charity has revealed.

The British Pregnancy Advisory Service (BPAS) said that its research into the IVF postcode lottery highlighted a systemic problem with the funding of fertility services leaving devastating gaps in NHS-funded IVF care.

Female same-sex couples and single women are disproportionately impacted by policies which require that they self-finance costly, and less effective, artificial insemination, in some cases for at least two years, before becoming eligible for funded IVF, the charity said.

The National Institute for Health and Care Excellence (NICE) recommends that women under 40 should be offered three full cycles of IVF a cost-effective measure and those aged 40-42 should be offered one cycle. However, around 80 per cent of Clinical Commissioning Groups (CCGs) in England, who are responsible for how health care money is spent in their area, do not provide funded fertility treatment in line with these guidelines. This reduces the cost-effectiveness of providing IVF treatment, BPAS said.

Three CCGs do not fund any fertility treatment at all as IVF provision on the NHS England has slowly been eradicated. Scotland offers three cycles of fertility treatment, Wales offers two cycles and Northern Ireland only offers one cycle.Most recent figures show about 54,000 patients had 68,724 fresh and frozen IVF cycles in 2018 with the average age of a patient just over 35.

In its report, BPAS found that 14 CCGs do not offer fertility services to women aged over 35, and a further six CCGs have female age cut-off points between 37 and 39. Data suggests that the trend towards older motherhood is increasing and consequently CCG policies with low age limits are likely to be excluding a large cohort of patients who have not yet started their families and who therefore may need access to fertility services.

The majority of CCGs (54 per cent) do not routinely contribute any funding to patients who must undertake artificial insemination in order to verify their infertility, a policy which will disproportionately affect female same-sex couples and single women, BPAS said. Almost all (96 per cent) of CCGs restrict access to funded treatment on the basis of female BMI, and 24 per cent restrict on the basis of male BMI, the report found.

Marta Jansa Perez, BPAS director of embryology, said: Access to any form of healthcare should be rooted in clinical evidence. Sadly, this report demonstrates that for most patients in need of fertility treatment, this is simply not the case.

It is deeply unfair that systemic problems with funding have effectively created a fertility pot-luck, with devastating consequences for some patients. People living just a few streets apart are facing a gulf between them when it comes to the care they are entitled to and that care could change the course of the rest of their lives.

The Department of Health and NHS England were approached for comment.

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IVF postcode lottery revealed with BMI and relationship status used to block NHS treatment - iNews

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