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Free fertility treatment: how to play the NHS lottery

If you need fertility treatment and don't have oodles of cash to spare, it's likely you'll have to face the NHS postcode lottery. We explain why the treatment on offer depends on where you live and exactly what you should expect.

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Fertility treatment funded by the NHS varies across the UK and the waiting lists in some areas can be very long. However, if you're eligible for NHS treatment it could end up saving you thousands of pounds compared to going to private, here's what you need to know.

What fertility treatment is available on the NHS?

If you are having trouble conceiving naturally there are a number of fertility treatments available on the NHS including:

  • Fertility medicines

  • Surgical procedures to improve your fertility

  • Assisted conception methods, including IVF

Your GP will recommend the fertility treatment he or she thinks will be the most effective - not everyone is put forward for IVF right away.

If you're concerned that you may have a fertility problem or you've been trying to conceive without success, the first step is to see your GP for further tests.

Why is NHS fertility treatment a Postcode Lottery?

Eligibility for NHS fertility treatment is loosely based on guidelines published by The National Institute for Health and Clinical Excellence (NICE) in February, 2013.

Unfortunately the NICE guidelines are not universally adopted across the UK.

Instead, the amount of funding set aside for fertility treatment in each area - and ultimately how many people can be helped - is dependent on the regional clinical commissioning groups and other NHS bodies.

The difference from one region to another can be significant and it's this that causes the 'postcode lottery' that dictates the level of financial help for those who are trying to conceive. Broadly speaking the current situation is as follows:

NHS fertility treatment in England

Exact funding levels are set at a local level by Clinical Commissioning Groups (CCGs) and this has resulted in stark differences in the amount of funding for fertility treatment available across England.

Some CCGs follow the NICE guidelines, other set extra eligibility conditions and some don't offer any financial assistance with fertility treatment whatsoever.

So who qualifies for NHS fertility treatment in England?

NICE guidelines set out the following criteria for free NHS fertility treatment:

  • Women aged 23 - 39 years old

  • If you suffer from a recognised cause of infertility, including absence of sperm or blocked fallopian tubes

  • If you have suffered from fertility problems for at least 3 years

Some regional clinical commissioning groups, may also set additional criteria, including:

  • Child based criteria - including no living children from current or previous relationships, or no children under a set age

  • That you stop smoking before being referred for treatment

  • A different age range than recommended by NICE

  • The man's age to be within a set age range

Because the criteria is so different depending on where you live, it's worth speaking with your GP to find out what help is likely to be available.

NHS fertility treatment in Wales

The most recent guidelines for fertility treatment in Wales were published by the Welsh Health Specialised Services Committee in October, 2013, keeping close to NICE guidelines.

All women are now entitled to two full cycles of fertility treatment (some are entitled to 3) on the NHS.

NHS fertility treatment in Scotland

Since the 1st July, 2013 all Health Boards must abide by universal fertility treatment guidelines throughout Scotland.

You can read the guidelines in full on the Infertility Network website, but they essentially set out that everyone who meets certain eligibility criteria will be offered up to two cycles of IV For ICSI (intra-cytoplasmic sperm injections).

Eligibility is broadly infertility with a defined cause or unexplained fertility of two years for heterosexual couples or after six to eight donor insemination cycles for same-sex couples. Further details are on the Infertility Network website.

A consultation will take place next year to judge whether the number of NHS IVF or ICSI cycles you can get on the NHS in Scotland should increase to 3.

NHS fertility treatment in Northern Ireland

Fertility treatment in Northern Ireland follows set criteria across the country, so you avoid a postcode lottery found in other parts of the UK. However, it's only available to those with a medical cause for infertility.

You can read the criteria in more detail on the Infertility Network website.

Can women aged 40+ qualify for free fertility treatment?

Yes, while some CCGs set extra criteria or restrictions on who can qualify for free IVF treatment, others do extend funding for treatment beyond that set out in NICE guidelines.

This means in some areas women aged 40-42 may also qualify for free NHS IVF treatment or other fertility assistance. Where you fall into this age range it's best to check with your regional CCG to find out where you stand.

What are you alternatives to NHS fertility treatment?

If you find you don't qualify for free treatment in your area you can appeal to the NHS directly for funding, especially if the CCG in your area doesn't follow the NICE guidelines.

After this if you're still not successful you can write to your local MP to appeal for funding, there have been cases in the past where they have been able to intervene successfully on behalf of patients.

Another option is to consider moving GP to one that sits under the governance of a different regional CCG. This won't be an option for everyone but if you live near the boundaries of two CCGs then it's worth exploring!

Finally, if none these options work you may need to consider private treatment if you still want to pursue fertility treatment.

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