A minimum age limit for IVF?
Dr. Kirsty Horsey
Progress Educational Trust06 October 2005
Some UK couples seeking help to have children will have to wait until their thirties before they qualify for state-funded IVF treatment on the National Health Service (NHS), according to a report in the Independent on Sunday (IOS) newspaper. While many health authorities set an upper age limit for treatment because the likelihood of success declines with age, many fertility experts think that setting a lower age limit of 30 years or above is 'cruel'.
In February 2004, the National Institute for Health and Clinical Excellence (NICE) issued guidelines stating that three cycles of IVF should be offered to all infertile couples in the UK. NICE had been asked to look at IVF provision because of concerns about the operation of a 'postcode lottery' in which, depending on where in the UK someone lived; they may have better (or worse) access to state-funded fertility treatments. In response, Sir John Reid, the then health secretary, announced that all infertile couples fitting certain criteria should be given one free cycle of IVF by their primary care trusts (PCTs) on the NHS from April 2005, with a view to increasing provision further over time.
One example of the continued operation of a 'postcode lottery' came to light in July 2005, when PCTs in the county of Hampshire were shown to be refusing to fund IVF treatments, despite the Government's promises. They said that, because of limited funding, IVF treatment in the county has to be a low priority.
Now, according to the IOS report, at least 25 PCTs have drawn up minimum age criteria, some as high as 36. But health officials 'have defended the criteria by claiming that younger women have more options available, such as adoption, and more time to try and overcome unexplained fertility problems naturally'. However, experts contend that success rates for fertility treatments are likely to be at their highest when a woman is in her twenties, so this selection process penalises those women most likely to benefit. The IOS report also states that some PCTs have up to three and a half year waiting lists. This leads some, such as Cumbria PCT, to turn away women with children from a previous relationship, or set other criteria.
A spokesperson from the charity Infertility Network UK said that many NHS policies were denying women the chance to have children. 'People have waited, expecting to get treatment, and then are told they are not going to receive it, which is cruel and unfair', she said. And Dr Lawrence Shaw, member of the British Fertility Society, said he was going to leave the NHS because of the way it 'rations' fertility treatment. 'If someone has to wait until 35, then their fertility is not going to be as good as at 30', he said.
Reproduced with permission from BioNews, an email and online sources of news, information and comment on assisted reproduction and genetics.