NHS Funding in Scotland
Scotland currently funds two full cycles of NHS fertility treatment to those eligible, and has standard access criteria for all.
Updated from 1st September 2016 all Health Boards in Scotland must follow the same criteria, as detailed below.
- Eligible patients may be offered up to two cycles of IVF/ICSI where there is a reasonable expectation of a live birth. The definition of infertility for couples is:
- Infertility with an appropriate cause of any duration or
- Unexplained infertility of two years – heterosexual couples
- Unexplained infertility following six to eight cycles of donor insemination – same sex couples
- Fresh cycles of treatment must be initiated by the date of the female partner’s 40th birthday, and all subsequent frozen transfers must be complete before the woman’s 41st birthday.
- One Partner has no biological child.
- Both partners must be non-smoking
- Both partners must abstain from illegal and abusive substances.
- Both partners must be Methadone free for at least one year prior to treatment.
- Neither partner should drink alcohol prior to or during the period of treatment.
- BMI of female partner must be above 18.5 and below 30.
- Neither partner to have undergone voluntary sterilisation, even if sterilisation reversal has been self-funded.
- NHS funding will not be provided to couples where either partner has already received the number of NHS funded IVF treatment cycles supported by NHS Scotland regardless of where in the UK they received treatment.
- No individual (male or female) can access more than the number of NHS funded IVF treatment cycles supported by NHS Scotland under any circumstances, even if they are in a new relationship.
- Couples must have been co-habiting in a stable relationship for a minimum of 2 years.
- NHS funding may be given to those patients who have previously paid for IVF treatment, if in the treating clinician’s view, the individual clinical circumstances warrant further treatment. However if there are any Frozen Embryo’s remaining in the private setting these must be used prior to NHS treatment commencing.
- Patients should not be placed at the end of the waiting list following an unsuccessful treatment cycle.
- Normally, there would be a gap of 6 to 11 months between cycles of IVF, for patients who remain eligible.
- Couples where the woman is aged from the day after her 40th birthday to 42, who meet all other criteria, one full cycle of IVF should be offered if:
- They have never previously had IVF treatment
- There is no evidence of poor ovarian reserve and if, in the treating clinician’s view it is in the patients’ interest
- There has been a discussion of the additional implications of IVF and pregnancy at this age.
- It is essential that patient consent is sought for the freezing of embryos and, if given, couples are informed at the outset that once they have exhausted their NHS quota of IVF, or have a successful live birth, or no longer meet any of the eligibility criteria, self-funding for any future transfers will be required.
- Patients should also be advised at the outset of any constraints to storage time and costs that may apply.
The Scottish Government confirmed it would accept key recommendations from the National Infertility Group report which now has been published. It is hoped a confirmed date for the below will be announced early 2017: The report states:
“From 1 April 2017 introduce a maximum of 3 cycles for all new patients referred from secondary care from this date. The third cycle would not be available retrospectively to those patients in the system, or those who have had treatment at any point in the past”.
Early Referral Pathway
A pathway was developed and sent to all GPs in 2014 outlining where consideration should be given for early referral. The criteria includes
- Previous ectopic pregnancy
- Previous proved PID/STI
- Previous pelvic surgery
- Any significant relevant abnormality on history, examination or investigation
- Previous investigations have revealed a problem
- Abnormal results in semen analysis X 2
(WHO levels to be used)
If you have any queries on NHS funding or any other issues in Scotland, please contact our Scotland Branch Co-ordinator.