Sunday, 17 February 2013
More IVF for lesbian couples and women over 40
More lesbian couples to get IVF on the NHS under new plan. Under an expansion of NHS-funded fertility treatment, the National Institute for Health and Clinical Excellence (Nice) will recommend that lesbian couples be offered six cycles of artificial insemination and, if that fails, IVF.
Most lesbian couples trying for a child are forced to go private because state provision is patchy. One cycle of IVF can cost them £8,000.
The NHS is having to find £20 billion of efficiency savings over four years because flat-rate budget increases are not enough to cope with increasing demand. Campaigners said local clinical commissioning groups, which make the final decision on fertility provision in hospitals, will be unable to afford the extra treatment without making drastic cuts to other services.
However, Nice does not have to consider budgets when setting its guidelines. It is updating its 2004 fertility advice to take medical advances and changes in society into account.
Infertility is thought to affect one in six couples. There were just over 1,000 cycles of insemination performed for women in same-sex relationships in 2010, resulting in 152 babies. The number of cycles of IVF for this group rose from under 100 in 2009 to 561 in 2010, resulting in 215 babies. Most couples paid for treatment privately.
Current guidelines bar women aged over 40 from NHS-funded fertility treatment. Under the new guidance, they would be offered one full cycle of IVF between the ages of 40 and 42 if they have not previously had treatment and cannot conceive naturally.
The guidelines also reduce the length of time couples need to try naturally for a baby before tests and treatment can begin, from three years to two. In cases where the fertility problem is known, couples can be referred immediately.
In an effort to reduce the number of multiple births from IVF treatment — the biggest risk to mother and babies because of the increased chance of premature birth — the guidance also stipulates when one embryo should be transferred to the womb, and restricts two embryos to older women. Under no circumstances should more than two embryos be transferred, the guidance is expected to say.
Almost 50,000 women received IVF treatment in 2011, a 4.3 per cent increase on the previous year, with around one in four cycles resulting in a baby.
Prof Yakoub Khalaf, the director of the Assisted Conception Unit at Guy’s Hospital in London, said the guidelines were common sense. “Whether the NHS can afford to extend access to funded treatment is something every primary care organisation will have to decide,” he said. “After the 2004 guidance we had some PCTs providing all three cycles and others providing none. I cannot imagine the situation will have changed much.”
He 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.”
He dismissed concerns about NHS funding for same-sex couples, saying “the law and the whole of society has moved on” and he did not think a significant number would seek treatment.
The guidance also states that insemination should be offered to disabled people who cannot have sex naturally.
Dr Jane Stewart, the secretary of the British Fertility Society, said: “Fertility problems are a bona fide health issue and should be funded as such. However 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.”
Josephine Quintavalle, of the campaign group Comment on Reproductive Ethics, said: “Women in lesbian relationships may or may not have fertility problems, but if not then it is difficult to understand how they qualify for fertility treatment in the first place.”
Anthony Ozimic, from the Society For the Protection of Unborn Children, added: “The guidelines ignore biology in the name of politically correct social engineering. In the case of IVF for same-sex couples, children are being abused by being deliberately deprived of either a father or a mother. And in the case of IVF for women over 40, technology is being abused, by extending childbearing beyond the limit set by Mother Nature.”
Article: 16th February 2013 www.telegraph.co.uk
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