Male GPs Show Reluctance in Referring Patients for IVF, Says Report
IVF.net Newsdesk20 May 2023
Research conducted by the Progress Educational Trust (PET), a fertility charity, has raised concerns about access to NHS-funded IVF treatment. The study suggests that male GPs are less likely to refer eligible patients for IVF, leading to disparity in access to fertility treatments.
GPs play a pivotal role in the fertility treatment journey, as they typically make the initial referral to fertility clinics. PET’s report indicates that there's a significant confusion and lack of understanding among GPs regarding the eligibility criteria for NHS-funded fertility treatment, contributing to the existing IVF 'postcode lottery'.
The study is based on a survey of 200 GPs and commissioners across England, focusing on the knowledge of national fertility guidelines and referral decision criteria. It reveals that GPs’ referral decisions, particularly male GPs, are often influenced by their age and gender.
In cases where infertility is already established—a condition that automatically qualifies for treatment under National Institute for Health and Care Excellence (NICE) guidelines—52% of male GPs versus 73% of female GPs would refer patients for treatment. Similarly, 57% of male GPs would refer patients who had been trying to conceive for a year, compared to 66% of female GPs. Younger and less experienced GPs were found to be more likely to refer patients for IVF treatment.
It's worth noting that NICE's fertility guidelines, which are currently under review, have not been updated for the past 20 years. They recommend that women under 40 should be offered up to three full cycles of IVF on the NHS if they or their partner are infertile. However, the day-to-day decisions of GPs are bound by local criteria set by commissioning groups, and only about 10% of areas meet the NICE guidelines. Many regions offer only one funded IVF cycle.
Another finding from the survey revealed a widespread misunderstanding about the defined endpoint of an IVF cycle. Only 16% of GPs correctly identified that a cycle ends "when all viable embryos are transferred", according to the NICE guideline.
PET's research is a call to arms for the government, NHS England, and commissioning bodies. It stresses that lack of clarity and misunderstanding among GPs regarding the NICE guideline worsen the IVF 'postcode lottery'. Over the past two years, referral criteria have become increasingly restrictive, with 54% of GPs noticing this change.
The study's findings also underscore the emotional toll fertility issues take on patients, with nearly 75% of GPs having received complaints about access to fertility treatment.
The report concludes by emphasizing the need for a nationwide review of IVF referral policies and guidelines to ensure fair access to fertility treatment across the country. The regional variation in eligibility criteria, or the 'postcode lottery', is a stark issue that requires immediate attention.