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NICE: ‘Limiting IVF access is unacceptable’


30 October 2014

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Clinical commissioning groups (CCGs) deciding to limit access to IVF should "rethink their approach", the National Institute for Health and Care Excellence (NICE) has warned. 
NICE guidelines recommend three full cycles of IVF for women aged under 40, and one full cycle for some women aged 40-42. 
Some parts of England are providing good fertility services, but other areas are deciding not to fund the full number of IVF cycles. 

Clinical commissioning groups (CCGs) deciding to limit access to IVF should "rethink their approach", the National Institute for Health and Care Excellence (NICE) has warned. 
NICE guidelines recommend three full cycles of IVF for women aged under 40, and one full cycle for some women aged 40-42. 
Some parts of England are providing good fertility services, but other areas are deciding not to fund the full number of IVF cycles. 
However, fewer than one in five CCGs offer the full number of NICE-recommended cycles, according to recent research. 
More than half (52%) only offer one cycle to eligible couples while people with fertility problems in the Vale of York are refused IVF treatment altogether.
Last month, Mid Essex CCG confirmed it would no longer provide any specialist fertility services except in “exceptional clinical cases”.
NICE acknowledged that there are current financial restraints but emphasised that fertility is a "core NHS service". 
Professor Gillian Leng, deputy chief executive and director of health and social care at NICE, said: “Infertility is a recognised medical condition. People affected, which includes one in seven heterosexual couples, should be able to receive treatment as a core NHS service. Infertility can have a potentially devastating effect on people’s lives: it can cause significant distress, depression and possibly lead to the breakdown of relationships. 
"It is unacceptable that parts of England are choosing to ignore NICE recommendations for treating infertility. This perpetuates a postcode lottery and creates inequalities in healthcare across the country.”
NICE has created a new quality standard to supplement the existing guidance. The document calls for: 
 – Nurses and GPs to give people written and verbal advice about lifestyle factors that may affect fertility, if they are worried that it is taking longer than expected to fall pregnant.
 – Counselling to be offered to people who are having problems conceiving before, during and after investigation and treatment for their fertility problems.
 – People who are preparing to have treatment for cancer that is likely to result in fertility problems, giving them the option of freezing their embryos or sperm ahead of treatment (cryopreservation).
Anna Bradley, chair of Healthwatch England, said: "Fertility issues are a particularly emotive subject and it should be a basic right of couples from Bradford to Bedfordshire, or wherever they live, to be able to access the same level of care and support on the NHS.
"Sadly, the so called 'postcode lotteries' created by the inconsistent decisions at local level is causing widespread inequality, resulting in unnecessary confusion and frustration for patients and their loved ones. Ultimately, this raises some very serious questions about whether NICE treatments should indeed be made mandatory.  
"We therefore fully support this move by NICE, and would urge anyone who is being denied access to a NICE recommended treatment to get in touch with their local Healthwatch for help in challenging the decision.”

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