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NICE aims to end fertility 'postcode lottery'

NICE aims to end fertility 'postcode lottery'


Draft guidance on treatment and support for people with fertility problems has been released by the National Institute for Health and Care Excellence (NICE) to combat the 'postcode lottery' of treatment. 

Earlier this month, Thanet clinical commissioning group (CCG) was criticised by a judge for failing to fund cryopreservation for a woman about to undergo chemotherapy for a severe form of Crohn's disease. 

The CCG disagreed with current NICE guidance.

A draft quality standard has called on CCGs to offer the treatment to people of reproductive age who are preparing to have cancer treatment that is likely to give them fertility problems. 

Updated fertility guidance published last year on the diagnosis, treatment and care of people with fertility problems recommended offering three full cycles of IVF treatment to women aged under 40 who have failed to get pregnant after two years of trying or 12 cycles of artificial insemination. 

It also recommended that women aged 40-42 should receive one full cycle if certain criteria was met. 

The ten statements are part of a draft ‘quality standard’ which highlights key areas of care where improvements are most needed. This standard has been published for consultation and supports the need to offer the full number of recommended IVF cycles. 

Professor Gillian Leng, deputy chief executive at NICE, said: “Unfortunately, we know that not all areas are following our guidance to the letter. This creates variations in treatment within the NHS, which is disappointing and goes against the fundamental aims of the NHS.

”The quality standard that we are currently developing should help healthcare services to focus on the key areas of care that need to be addressed most urgently and ensure that the right support and treatment is available to those who need it.”

The full, draft quality standard is available to view on the NICE website, but includes other statements such as:

 - GPs referring people for specialist consultation if they have not conceived after 1 year of unprotected vaginal intercourse, or earlier if there is a known clinical cause, a history of predisposing factors for infertility or the woman is at least 36-years-old.

 - Offering counselling to people before, during and after investigations and treatment for fertility problems, irrespective of the outcome.

 - Women having IVF should have the appropriate number of embryos transferred according to the age of the woman whose eggs are used, the cycle number and quality of embryo.

Professor Leng continued: “We now want to hear what organisations think about this draft quality standard. By getting involved with this consultation they will be helping us to develop it further, making sure we address the most important issues that will drive up standards of care for patients.

“When published, this standard will complement our guidance on the treatment and support of people with fertility problems, creating a comprehensive guide to help the NHS provide and maintain consistent and high-quality care for all.”

The final standard is expected to be published in October 2014.



The real lottery here is the difference in success rates. Better two attempts at one of the better units than 5 at one of the poorer

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