Government Should Provide Full IVF Funding, Experts Say | HuffPost Life

'Current access to treatment is a postcode lottery.'

Jennifer Cockerell, Press Association Health Correspondent— PA for HuffPost UK

Full Government funding of IVF treatment would lower rates of multiple pregnancies and their associated risks of complications for mothers and babies, health experts have said.

Multiple pregnancy following IVF treatment occurs from the transferral of more than one embryo into the uterus.

It is the most common adverse outcome of IVF treatment and is often performed to reduce costs for patients who pay for their own treatment, the Royal College of Obstetricians and Gynaecologists (RCOG) said.

In 2013 the National Institute for Health and Care Excellence (Nice) recommended Government funding for three full IVF cycles, but funding still varies across the country.

JAMES KING-HOLMES/SCIENCE PHOTO LIBRARY via Getty Images

Six out of 10 IVF cycles in the UK are funded by patients themselves, said the RCOG, which has published a Scientific Impact Paper.

Multiple pregnancies involve substantial health risks for mothers and babies, as well as costs to NHS services.

Mothers may have a higher risk of pregnancy-induced high blood pressure, gestational diabetes, haemorrhage following birth, and postpartum depression and heightened symptoms of anxiety and parenting stress.

There can also be a greater risk of complications for mother and baby, and increased burden on NHS maternity and neonatal services.

Multiple pregnancy is associated with a six-fold increase in the risk of pre-term birth, a leading cause of infant mortality and long-term mental and physical disabilities, including cerebral palsy, learning difficulties and chronic lung disease.

The estimated neonatal cost to the NHS for twins is 16 times higher than for a single baby.

“Current access to treatment is a postcode lottery which is completely unacceptable for couples with infertility problems."”
- RCOG president Professor Lesley Regan

Despite these risks, double embryo transfer (DET) during IVF treatment continues. It is widely believed by patients and health professionals that the success rate of IVF treatment is higher following the transfer of two embryos than with one embryo.

The RCOG said studies have shown that in women with a good prognosis, single embryo transfer is comparable to that of DET and with a significantly lower risk of multiple pregnancy.

The report’s lead author, Tarek El-Toukhy, consultant gynaecologist and specialist in reproductive medicine and surgery, said: “Multiple pregnancy is the greatest avoidable risk of IVF. The health and financial burden it places on women, families and the NHS cannot be overstated.

“To ensure rates of multiple births remain low, there is little doubt that the single most important factor that could enhance the acceptance of single embryo transfer among patients and practitioners is appropriate funding for IVF treatment.

“It is also clear from other European countries, such as Sweden and Belgium, that further reduction in the multiple pregnancy rate to single figures is feasible where generous IVF state funding arrangements have reduced the associated adverse implications of multiple pregnancies for both mother and baby.”

RCOG president Professor Lesley Regan said: “IVF is a cost-effective treatment and should be available on the NHS.

“Yet current access to treatment is a postcode lottery which is completely unacceptable for couples with infertility problems.”

Keith Reed, chief executive of the Twins and Multiple Births Association (Tamba), said: “The Government needs to mandate fair access to fertility treatment across the country.

“For many, taking the affordability question out of the equation will make it less likely they will opt for treatments which increase their chances of having twins.

“However, the majority of UK twins and triplets are conceived without IVF intervention and healthcare organisations need to step up their efforts to address the risks associated with multiple birth pregnancy.

“There is a growing body of evidence that good care and following multiple birth guidance during maternity reduces the poor outcomes and need for neonatal care which put pressure on NHS services.”

A Department of Health and Social Care spokesperson said: “As this report itself highlights, we have made great progress in improving patient safety by lowering the national multiple birth rate in IVF from 24% in 2009 to 11% today.

“We know fertility problems can have a serious and lasting impact on families—and the Government has been clear that the NHS should provide access to IVF for all patients that meet the criteria set out in NICE guidance.”

Before You Go

10 Things You May Not Know About Your Fertility

(01 of10)

1. Your fertility is mostly determined by genetics, which influences how many eggs you are born with. Doctors believe that the number of eggs you have at birth determines the length of time you will remain fertile. At birth, women have about two million eggs in their ovaries. For every egg ovulated during your reproductive life, about 1,000 eggs undergo programmed cell death. Other things, such as smoking cigarettes and certain types of chemotherapy, can accelerate egg cell death and promote an earlier menopause.

(02 of10)

2. Regular menstrual cycles are a sign of regular ovulation.Most women have regular cycles lasting between 24 and 35 days. This is usually a sign of regular, predictable ovulation. Women who do not ovulate regularly have irregular menstrual cycles. Those who do not ovulate at all may have a genetic condition called polycystic ovarian syndrome (PCOS).

(03 of10)

3. Basal temperature charting does not predict ovulation.An older method of tracking ovulation involves taking your oral body temperature each morning before getting out of bed. This is called basal body temperature. This method is used to spot a rise in basal temperature, which is a sign that progesterone is being produced. The main problem with using this method is that your temperature rises after ovulation has already occurred. This makes it more difficult to time intercourse at an optimal time for conception. A better method is to use over-the-counter urine ovulation predictor test kits such as Clearblue Easy. These kits test for the hormone that prompts ovulation, which is called luteinizing hormone (LH).

(04 of10)

4. Most women with blocked fallopian tubes are completely unaware they may have had a prior pelvic infection.About 10 percent of infertility cases are due to tubal disease, either complete blockage or pelvic scarring causing tubal malfunction. One major cause of tubal disease is a prior pelvic infection from a sexually transmitted disease such as chlamydia. These infections can cause so few symptoms that you may be completely unaware your tubes are affected. This is why fertility physicians will order a dye test of the tubes, called a hysterosalpingogram (HSG), if you have been trying and failing to conceive for 6 months or longer.

(05 of10)

5. In most cases, stress does not cause infertility. Except in rare cases of extreme physical or emotional distress, women will keep ovulating regularly. Conceiving while on vacation is likely less about relaxation than about coincidence and good timing of sex.

(06 of10)

6. By age 44, most women are infertile, even if they are still ovulating regularly. Even with significant fertility treatment, rates of conception are very low after age 43. Most women who conceive in their mid-40s with fertility treatment are using donated eggs from younger women.

(07 of10)

7. Having fathered a pregnancy in the past does not guarantee fertility. Sperm counts can change quite a bit with time, so never assume that a prior pregnancy guarantees fertile sperm. Obtaining a semen analysis is the only way to be sure the sperm are still healthy!

(08 of10)

8. For the most part, diet has little or nothing to do with fertility. Despite popular press, there is little scientific data showing that a particular diet or food promotes fertility. One limited study did suggest a Mediterranean diet with olive oil, fish and legumes may help promote fertility.

(09 of10)

9. Vitamin D may improve results of fertility treatments. A recent study from the University of Southern California suggested that women who were undergoing fertility treatments, but had low vitamin D levels, might have lower rates of conception. This vitamin is also essential during pregnancy. At Pacific Fertility Center, we recommend our patients take 2,000-4,000 IU per day.

(10 of10)

10. Being either underweight or overweight is clearly linked with lowered levels of fertility. The evidence in recent years is that obesity is clearly linked with a longer time to conception. Having a body mass index less than 18 or over 32 is associated with problems ovulating and conceiving, as well as problems during pregnancy.

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