Scotland shining exemplar of fertility treatment
Scotland is to expand access to NHS-funded fertility treatment: providing access to 3 NHS-funded IVF cycles and enabling access for couples with children from previous relationships.
Responding to this news, Susan Seenan, chief executive of Infertility Network UK and co-chair of campaign group Fertility Fairness said: ‘Scotland continues to lead the way in providing equitable fertility treatment. The Scottish government brought in equity of provision in 2013 and is now committing to delivering the full clinically recommended 3 IVF cycles (for eligible women aged 40 and under). In addition, it is relaxing current access criteria and will offer fertility treatment to couples where one partner has no biological child. This increase in access to medical treatment is fantastic news for people in Scotland affected by fertility problems and we commend the Scottish Government for both recognising the importance of treating this medical condition and backing it up with action.’
Sarah Norcross, co-chair of Fertility Fairness added: ‘Fertility Fairness urges the rest of the UK to follow the Scottish Government’s lead and to take immediate action to stop the rationing of fertility treatment. Scotland now stands head and shoulders above the rest of the UK in terms of IVF provision. While Scotland will provide three funded IVF cycles for all eligible couples, in England both access criteria and provision of treatment are determined by postcode: less than 2 per cent of England’s clinical commissioning groups offer three full cycles of NHS-funded IVF to eligible couples and allow access to treatment if there is a child from a previous relationship. ’
‘In Wales and Northern Ireland, while there is equity of provision in terms of the number of cycles offered and the access criteria around children from previous relationships, nobody with fertility problems can access three funded IVF cycles. In Wales, affected individuals are offered two funded cycles of fertility; in Northern Ireland, couples can only access one partial IVF cycle (one fresh cycle and just one frozen embryo transfer).’
NICE guidance recommends three cycles of IVF for women under 40 years and one cycle for some women aged 40-42. The latest data from Fertility Fairness shows that in England less than one in five (17 per cent) of clinical commissioning groups offer three full cycles of NHS-funded IVF to eligible couples, as recommended by the National Institute for Health and Care Excellence 2004 guideline (this represents a drop of 7 per cent since 2013).
Just four clinical commissioning groups in England offer 3 funded IVF cycles and allow couples with a child from a previous relationship to access NHS-funded IVF: these clinical commissioning groups are Bury, Heywood, Middleton and Rochdale, Oldham and Tameside and Glossop.
| England | 0 Cycle Providers | 1 Cycle Providers | 2 Cycle Providers | 3 Cycle Providers |
| 2015 | 1% | 59% | 23% | 17% |
| 2014 | 1% | 52% | 29% | 18% |
| 2013 | 3% | 49% | 24% | 24% |
In Scotland, all health boards are now committed to funding 3 cycles for women under 40; in Wales, women under 40 are entitled to two cycles and in Northern Ireland women under 40 are offered one cycle.
In Scotland access criteria around children from previous relationships will now be equitable and access will be enabled. In England, access criteria around children from previous relationships are deeply inequitable and vary dependent on postcode. The majority of clinical commissioning groups (82%) specify that if either of the individuals in a couple have any living children from previous relationships then neither of the couple are eligible to access NHS-funded fertility treatment.
In Wales and Northern Ireland access criteria around children from previous relationships is equitable. In Wales, IVF on the NHS is available for couples who do not have any living children (biological or adopted), or where one of the partners does not have any living children (biological or adopted). For single women/men – the criteria states that the woman/man does not have any living children (biological or adopted).
In Northern Ireland, couples with children can access treatment. A previous restriction on those with dependent children was removed in 2006 and couples who have children living with them (in any capacity) have equitable access to services.