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NICE tells NHS to offer IVF to over 40s

Women aged 40-42 who are having fertility problems should be offered IVF on the NHS, according to guidelines published today by NICE.

Previously, NICE did not recommend IVF for women older than 39.

The guidelines also recommend IVF treatment for eligible women who have been unable to conceive after two years of regular intercourse - one year earlier than previously recommended.

They also cover women who have been having artificial insemination, which can include same-sex couples. This is the first time these have been officially included in the guidelines, which were originally drawn up in 2004.

The guidelines say women aged 40-42 who have not conceived after two years of regular unprotected intercourse or 12 cycles of artificial insemination should be offered one full cycle of IVF, if they have never previously had IVF treatment.

Where women are under 40, and have not conceived after two years of regular intercourse or 12 cycles of artificial insemination, three cycles of IVF should be offered.

NICE chief executive Sir Andrew Dillon said: “Infertility affects more people than you might think; around one in seven heterosexual couples in the UK.

“We know fertility problems can have a potentially devastating effect on people’s lives, causing significant distress, depression and possibly leading to the breakdown of relationships.

“The good news is that, thanks to a number of medical advances over the years, many fertility problems can be treated effectively.

“It is because of these new advances that that we have been able to update our guideline on fertility, ensuring that the right support, care and treatment is available to those who will benefit the most.”

Tim Child, consultant gynaecologist and director of the Oxford Fertility Unit, who helped develop the guideline, said: “Many women do conceive naturally in the 40-42 year age group, but for those who can’t, and who have been diagnosed with the medical condition of infertility, then improvement in IVF success rates over the last decade mean that we are now able to offer cost effective treatment with a single IVF cycle. This decision was taken after considerable discussion and close analysis of the available evidence.”

On same-sex couples, a spokeswoman for NICE said: “With the advancement of medical technology and techniques such as donor insemination, same-sex couples are now able to become parents.

“Infertility is a medical condition that can be caused by a past illness or underlying medical condition and can affect anyone, regardless of sexual orientation. Infertility can also cause real suffering and can lead to depression and the break-down of relationships.

“This is the first time same-sex couples have been included in NICE guidance on fertility. In terms of fertility treatment, same-sex couples only account for a small proportion of NHS patients - around 5%.

“However, it is important that we are sure that everyone who has this distressing medical condition has access to the best levels of help.”

A full cycle of fresh IVF can cost the NHS around £3,000.

The National Infertility Awareness Campaign (NIAC) warned that as NICE guidelines are not mandatory, fears still remained over local implementation.

Chairwoman Clare Lewis-Jones said: “By updating the fertility guideline and extending the range of people it is recommending receive treatment, NICE clearly understands the impact which infertility has on people. And we must be clear that infertility is a medical condition that causes significant distress for those trying to have a baby and has a devastating impact on people’s lives.

“We know infertility can be treated effectively and thousands of people have become parents after fertility treatment.

“The current ‘postcode lottery’ approach to the treatment of infertility here has gone on for far too long and it is vital that the Government supports the measures in the updated guideline and communicates the need to implement them to those who commission fertility services in the NHS.

“We know the current system leaves many people unable to access NHS treatment and we need reassurance about the future of NHS fertility treatment as we move towards GP commissioning in 2013.

“The new guideline gives hope to more infertility sufferers - but it is pointless if the recommendations are not put into practice. People are suffering every day because some PCTs have continually flouted the NICE guideline.

“Infertility requires specialist knowledge and GPs are, by their very definition, generalists.

“Over 50% of respondents to our patient survey last year found their GP lacked sufficient knowledge on infertility and this worries us.

“NIAC is willing and able to work with the Government to close this knowledge gap so that access to fertility treatment is improved in the new NHS.”

Readers' comments (3)

  • If a woman makes a choice to delay having a child over her career sadly she should face the consequences or use the finances accrued over her working life to pay for this treatment herself. (Partner included obviously)
    There are enough demands on the NHS as it is.

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  • I agree with the above, but why should any iVF be paid for by tax payers when the NHS is already struggling to cope with the more basic and urgent demands required of it.

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  • I wrote the first comment. I do have sympathy with those who are unable to conceive and I can understand why some IVF treatment should be available on the NHS.
    Infertility is a medical problem and being unable to have children can cause mental health issues.
    Choosing to delay parenthood putting your career first should be an automatic exclusion from NHS treatment though. I know that sounds harsh but the NHS has more important priorities.

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