IVF for the over 40s on the NHS

An expansion of NHS-funded fertility treatment will allow more gay couples and women over 40 to be given fertility treatments on the NHS, despite uncertainties over the funding.

Studies demonstrate that infertility affects one in six couples.

Previous guidelines banned women over 40 from NHS funded fertility treatment, while under the new rules they would be able to apply to a full cycle of IVF between 40 and 42, in case they cannot conceive naturally and have not sought treatment before.

An important element that has been added by the Nice (National Institute for Health and Clinical Excellence) was the time reduction, from three to two years; couples have to wait before the beginning of tests and treatment. Of course, if infertility were a known problem, a couple would be referred to fertility treatment immediately.

New guidelines take also into consideration the issue of multiple births from IVF treatment; they represent one of the biggest risks for both mother and baby as they often lead to premature birth. Only one embryo should be transferred to the womb of younger patients, they prescribe, while a maximum of two for older women. The guidance makes clear that under no circumstances more than two embryos will be transferred. 

According to recent figures around 50,000 women underwent IVF treatment in 2011, with an increase of 4.3 % compared with the previous year. An average of one in five cycles resulted in a baby. 

The director of the Assisted Conception Unit at Guy’s Hospital in London, Prof. Yakoub Khalaf said: “Whether the NHS can afford to extend access to funded treatment is something every primary care organisation will have to decide.” He then added: “We see women aged 40 or 42 day-in and day-out funding their own treatment when their next door neighbour, aged 39, might be having NHS-funded treatment. It is wrong. The chances of success for these women are improving and even if we can offer them a one in five chance of a baby, that is important.”

Professor Khalaf firmly dismissed concerns about NHS funding for same-sex couples mentioning how the law and the whole of society have moved on.

Dr. Jane Stewart, the secretary of the British fertility society, referring to another important problem affecting equality of treatment for women seeking IVF treatment, said: “There is a risk that without central direction from the Department of Health there will continue to be variation according to postcode and that is regrettable.”

Annalisa Ratti