Thirteen areas of England have restricted or completely halted IVF treatment since the start of the year for women struggling to conceive, with a further eight consulting on taking similar steps.
Data provided by Fertility Network UK showed the scale of local NHS cutbacks in a bid to save money, defying national guidelines and prompting warnings of a postcode lottery for couples trying to have children.
The figures also show that over the past four years the number of clinical commissioning groups (CCGs) in England offering three full cycles of IVF has fallen by 46%, from 50 in 2013 to 27 this year.
NHS group Nice recommends that women aged under 40 should be offered three cycles if they have been trying to conceive for two years, which means cost-cutting CCGs are defying advice set out by the government and the NHS’s own advisers.
Prof Simon Fishel, who was part of a team that pioneered IVF in the UK, said his main concern was the inequality of cuts. Fishel said: “What is the point of having Nice guidelines if they are not adhered to?”
He added: “If the country decides it will not fund IVF then fine, that is a decision that affects everyone … but what I cannot abide is the local variation for something like this, which doesn’t reflect local populations.”
“You have to treat citizens equally and this is a deliberate inequality and obfuscation and allows some areas to say they are offering IVF but when it comes down to the detail, only a tiny fraction of those who need it have access to it.”
NHS providers in Bristol, North Somerset and South Gloucestershire are consulting on restricting fertility treatment in future to women aged 30-35. This would make them the first in the UK to limit services to such a narrow age range.
A spokesperson for the three CCGs said: “We know how hard it can be for couples who are struggling to conceive and will continue to offer fertility treatment to hundreds of people every year. Clinical evidence shows that treatment between the ages of 30-35 offers the highest possible chance of success.”
In Cambridgeshire and Peterborough, a petition signed by 2,088 people is calling for the local CCG to scrap plans to cut funding for IVF treatments. The local CCG said it could save hundreds of thousands of pounds by cutting any specialist fertility services other than in exceptional circumstances.
Stuart Tuckwood of Cambridge Green party, who launched the petition, wrote on the page: “The proposals will save the regional NHS £700,000. A very small amount of money when you compare the figure to the £17.6m the NHS has been forced to spend on private management consultants to draw up new ‘transformation’ plans demanded by the government.”
One person who signed the petition said: “We had IVF on the NHS in Peterborough six years ago, without it we wouldn’t have our daughter. Everyone should be allowed a chance to have a baby.”
Dr Gary Howsam, chair of Cambridgeshire and Peterborough CCG, said: “We are now in the difficult position where we have to evaluate every service we commission.”
“[We have] been consulting on a proposal to stop routinely commissioning any specialist fertility services other than for two specified exceptions. The exceptions are fertility preservation for patients who have a condition requiring treatment that has a significant likelihood of making them infertile, and sperm washing for men who have a chronic viral infection.”
In London, Croydon became the first London borough to stop funding for IVF earlier this year. The decision was made to help save £836,000 annually.
A spokesperson for NHS Croydon CCG said it took the difficult decision amid “severe financial pressures” and that it intended to look again at its ability to fund IVF in a year’s time. “We have a duty to look at the entirety of health needs across the borough and this very difficult decision will help us to prioritise frontline services,” the CCG said.
Others areas that have cut back from three cycles to one cover Swindon, plus most of Cheshire.
Families hoping to conceive are increasingly having to pay privately. Jenny Carrington, from Sandhurst in Berkshire, paid over £12,000 for two cycles of IVF because her county will fund only one cycle. She ended up having to borrow money and use credit cards.
“Further cuts would have possibly meant we couldn’t have had a single funded cycle, which might have meant our daughter wouldn’t have been born. As we now have a child, we would not be able to have another funded cycle, so won’t be able to have another child if IVF is required to conceive again,” Carrington said.
Susan Seenan, the chief executive of Fertility Network UK, said infertility can have a serious and lasting impact and denying people help is “a short-sighted and false economy”.
Seenan said: “The situation in England is in stark contrast to that in Scotland, where all those eligible receive three full cycles of NHS-funded treatment, including couples where one partner has no child. England pioneered IVF approaching 40 years ago, but that achievement literally means nothing if only those who can afford to pay for IVF benefit from it.”
Couples in Wales are eligible for two full cycles of treatment, but in Northern Ireland those hoping to conceive are only eligible for one part-cycle.
Geeta Nargund, a professor and founder of Create Fertility, said she was saddened by the numbers, calling on the health secretary, Jeremy Hunt, to look into it to ensure equal access.
A health department spokesperson said: “The NHS should provide access to services, including IVF, for all patients who meet the criteria set out by independent experts at Nice.”
A spokesperson for NHS England said that these were legally decisions for CCGs, “who are under an obligation to balance the various competing demands on the NHS locally while living within the budget parliament has allocated”.
By: Sarah Marsh, Sunday 6 August 2017 17.27 BST