Dr. Kirsty Horsey
Progress Educational Trust
15 February 2004
 [BioNews, London]
The UK Government is expected to announce that the provision of in vitro fertilisation (IVF) treatment on the National Health Service (NHS) is to be made uniform across the country, but that only one attempt will be allowed per couple. NHS-funded IVF will also only be available to couples who don't already have children. Sir John Reid, the Health Secretary, is expected to make the announcements later this week, in response to guidelines issued by NICE, the National Institute of Clinical Excellence.
In August 2003, NICE published draft recommendations on the provision of infertility treatment on the NHS, which at present varies across the UK. This has led commentators to suggest there is a 'postcode lottery' for IVF provision. NICE recommended that infertile couples meeting certain criteria should be offered up to three attempts at IVF using fresh embryos, with the possibility of further treatment using frozen embryos. Its draft guidance stated that couples should be offered state-funded infertility treatment if the woman is between 23 and 39 years old, and if there is either a diagnosed cause of infertility, or at least three years of unexplained infertility. IVF could also be offered by the NHS if a couple had 'an unequivocal need' for treatment, such as prior treatment for cancer, very poor semen quality, or Fallopian tube blockage.
The final version of the NICE guidelines, due to be published on Wednesday 25 February, is not expected to differ greatly from the draft. But the government's decision to ration the number of treatment cycles available will be likely to disappoint many couples. At the time the NICE draft guidance was published, it was estimated that it would cost the NHS ?400 million and the fear was that the government would reject the entire proposal because of the projected cost. Instead, it appears that the government will simply limit the availability of treatment, recognising that the postcode lottery needs to be brought to an end, while not being prepared to entail the full financial burden.
Meanwhile, a report issued by a group of MPs suggests that the extra cost of meeting the NICE recommendations would be less than ?50 million. Kevin Barron, chair of the All Parliamentary Report on Infertility said that costs could be saved by streamlining the system to reduce the likelihood of multiple births, rather than limiting the numbers of cycles funded by the NHS to one. He said that he would be 'very disappointed' if the government did not fund the three cycles recommended by NICE, adding 'Scotland already funds three cycles; it would be a great shame if England and Wales did not catch up'.
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Reproduced from BioNews with permission, a web- and email-based source of news, information and comment on assisted reproduction and human genetics, published by Progress Educational Trust.
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