NHS shortcomings driving fertility treatment abroad

Pressure on the NHS budgets and shortages of donors along with high costs are encouraging British patients to seek infertility treatment abroad.

In the UK, infertile couples can access free IVF treatment on the National Health Service (NHS). However, pressure on NHS budgets, shortages of donor eggs and sperm and high costs of private IVF treatment in the UK are encouraging Brits to travel abroad for infertility treatment.

Treatment under the NHS

Within the NHS, the local Clinical Commissioning Groups (CCGs), allocate funding for IVF, and follow guidelines on funding which are set by the National Institute for Health and Care Excellence (NICE).

A woman can benefit from up to three IVF cycles for free on the NHS, provided that:

• The woman is aged between 23 and 39 at the time of treatment, and:
• one or both of the couple have been diagnosed with a fertility problem, or:
• the woman has been infertile for more than three years.

Women aged 40-42 are subject to additional considerations:

If a woman aged 40-42 has not conceived after two years of regular, unprotected sex or after 12 cycles of artificial insemination, she should be offered one IVF cycle if the following criteria are met:

• They’ve never previously had IVF treatment.
• There’s no evidence of fertility problems due to a low amount of eggs (low ovarian reserve).
• There’s been a discussion of the risks of IVF and pregnancy at this age

The NICE guidelines are only guidance and are not mandatory. Some CCGs apply additional criteria that can restrict access:

• The woman must be a healthy weight (BMI range 19-30).
• The woman must not be a smoker.
• The woman must not have children from the current or a previous relationships.
• The woman must be within a specific age range. Some CCGS will only fund women under 35 years old.

Waiting lists for IVF in the UK

So… the rules that are applied by Clinical Commissioning Groups vary from one area of the UK to another, and waiting lists for treatment vary significantly. According to analysis by Fertility Fairness, of the CCGs offering IVF to patients, 125 fund one cycle of treatment, 46 fund two cycles of treatment and only 34 CCGs fund three cycles. Four CCGs do not fund any treatment whatsoever. Download their 2016 Audit of Specialist Fertility Services.

Nurture Fertility, a clinic in Nottinghamshire says childless couples are having to wait too long – typically six to nine months – for IVF treatment because of a chronic shortage of egg donors. The clinic treats around 60 patients a year with donated eggs, but says there may be three times as many who need egg donation.

At the recent European Society of Human Reproduction and Embryology (ESHRE) conference in in Geneva, the charity, Fertility Network UK, said UK couples were being failed by “substantial cuts to services”.

Private treatment for IVF in the UK

The 2014 HFEA report, “Fertility Treatment in 2014 – Trends and Figures” stated that:

• 52,288 women had a total of 67,708 cycles of IVF (5% year-on-year growth in the number of IVF cycles.
• 2,511 women had a total of 4,675 cycles of donor insemination (a 1% increase on the previous year.)
• 59% of IVF cycles in the UK were funded by individuals through private treatment.
• 85% of egg donation treatment was funded by individuals through private treatment.

One cycle of IVF in a UK private clinic can cost up to £6,000, with a median cost of around £3,500 according to Private Healthcare UK.

Growth in fertility tourism

Restrictions on NHS treatment, the high cost of private treatment and the shortage of donors are the main drivers encouraging UK couples to seek IVF treatment abroad.

• A research study by Fertility Clinics Abroad on 241 British couples suffering fertility problems found that the vast majority – 93% – were considering treatment abroad to overcome the shortcomings of the UK’s NHS.
• Intuition’s web portal, Fertility Treatment Abroad, is seeing a surge in UK women exploring the overseas option; enquiries about IVF abroad have rocketed up by 345%, year on year.
• Spain, Greece, Cyprus and the Czech Republic are the countries that first come to mind for the infertile couple in the UK.

There’s no doubt that fertility tourism is here to stay. It’s one of the most robust and sustainable segments of the medical tourism market; fertility clinics across Europe can expect their international business to show continued growth as state funded provision of IVF comes under pressure from reduced funding.