IVF should be given sooner and to older women, says NICE

IVF Nearly 14,000 women in the UK became pregnant through IVF in 2011

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Couples struggling to have a baby should get fertility treatment more quickly and older women should gain access to IVF, new NHS guidelines say.

IVF should be offered after two years of failed attempts, not the current three, says the National Institute for Health and Clinical Excellence.

And the upper age limit should rise from 39 to 42 in England and Wales.

Some fertility experts fear the guidelines may not lead to changes because they are not binding.

In the past, NHS trusts have struggled to find the money to meet the IVF recommendations.

A report in 2011, showed one in four NHS trusts offered the full three cycles. Each round costs £3,000.

Around one in every seven heterosexual couples in the UK who are trying for a baby experience problems conceiving a child.

The Oxford Fertility Unit's Tim Child said it would give hope to many couples.

In 2011, nearly 14,000 women became pregnant through IVF.

The new guidelines, which apply to England and Wales only, state that women aged between 40 and 42 should be offered one cycle of IVF as long as it is their first time and they have enough eggs.

Graph showing IVF success rates by age

The age limit for NHS-funded fertility treatment is 38 in Scotland and 39 in Northern Ireland, according to the Human Fertilisation and Embryology Authority.

Tim Child, who helped devise the guidelines and is the director of the Oxford Fertility Unit, said the decision was not taken lightly.

"When a woman reaches her mid-30s her fertility begins to decline, even more so from her late 30s.

"However, many women do conceive naturally in the 40 to 42 year age group. But for those who can't, and who have been diagnosed with the medical condition of infertility, then improvement in IVF success rates over the last decade mean that we are now able to offer cost-effective treatment with a single IVF cycle."

Medical advances mean this age group has similar success rates to that of younger women when the original guidelines were introduced in 2004.

The update still recommends women under 40 are offered three cycles of IVF.

Some fertility experts raised concerns that the expanded recommendations may not happen in reality.

Dr Sue Avery, a spokesperson for the British Fertility Society and from Birmingham Women's Fertility Centre, told the BBC: "It's good that there's the possibility there, but the funding does not match.

"I can't see any prospect of it happening immediately. Our biggest concern is hanging on to the funding we've got."

The guidelines also introduced rules designed to significantly reduce the number of twins and triplets being born.

'Increased risks'

Multiple births, a consequence of implanting more than one embryo to increase the odds of success, are one of the biggest risks associated with IVF for both mother and child.

Twins tend to be born smaller and earlier - triplets even more so.

Women under the age of 37 should have only one embryo transferred in their first cycle.

Caroline Wood: "We were fortunate, we could afford the treatment"

Subsequent cycles, and cycles in older women, can consider implanting two embryos.

Most couples should no longer be offered intrauterine insemination on the NHS, as its results are no better than sex.

However, when there is not an option - such as same sex couples and patients with certain disabilities - it would still be an option.

Dr Tony Falconer, president of the Royal College of Obstetricians and Gynaecologists, said fertility problems could have a devastating effect on couples.

He welcomed the guidelines, but warned there were risks attached.

"The recommendation that IVF treatment be made available up to the age of 42 provides more choice for women, but they should still be aware of the increased risks associated with pregnancy at advanced maternal age," he said.


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  • rate this

    Comment number 86.

    We need to start thinking about reducing the population not constantly finding ways to keep increasing it.

  • rate this

    Comment number 85.

    Having a baby at 42 is a risky affair. It is higher risk for both mother and baby. Just because you can have a baby at 42 does not mean you should. Some girls begin ovulating before they are 10 and I think we all agree that they shouldn't have a baby just because they physically can. And to expect that tax payer to fund it! IVF is not a basic human right.

  • rate this

    Comment number 84.

    A very tricky subject.

    Women are starting families much later now than ever before, so extending the age limit could be said to reflect current society.

    It must be dreadful to be unable to have children without help, but at the same time, having them should not be regarded as a "right".

    There are many children desperate for adoptive parents - is that not a more sensible route?

  • rate this

    Comment number 83.

    re 62
    Quite an eyeopener isn't it? 30% of the population pay for themselves as well as the other 70%. There is such as thing as a free lunch "for the many not the few" and this extension of the IVF age range is the latest evidence, not least because according to the graph, the success rate is only about 20%.

  • rate this

    Comment number 82.

    67. "We need a kid tax not a carbon tax"
    Great idea, and then we can look forward to finding unwanted babies at the bottom of lakes.

    By all means stop giving public money to people when they've had a certain number of children (treating twins/triplets etc. of the last birth as one child) but taking their money off of them is a completely different kettle of fish.

  • rate this

    Comment number 81.

    Unbelievable. IVF is an obscene waste of NHS money that could be MUCH better spent. As for raising the age - don't we already have a population problem? Soon there won't be enough resources to support the natural poluation, without introducing more by circumventing nature.

  • rate this

    Comment number 80.

    When the NHS cannot afford to save lives, can it really afford to treat issues such as infertility?

    Yes, some people might like to be able to conceive naturally but they cannot. My parents couldn't so they adopted. I didn't think I was going to until after over 12 years of happily married life when I got a little surprise...

    The NHS should have other priorities.

  • rate this

    Comment number 79.

    I know three parents with IVF kids, including my sister & husband. None were told that there may be issues with IVF kids. My nephew has sight issues, my niece has attention and reasoning problems. We are not gods, using a vacuum to manipulate eggs and sperm in petri dishes is harsh compared to gentle cillia wafting eggs in fallopian tubes. Harsh handling causes damage and issues with the kids.

  • rate this

    Comment number 78.

    There should be no IVF available (privately or NHS funded) until there are no children who need adopting.

    Let's try caring for the kids that are alive first rather than wasting money & resources on bringing new ones into the world.

  • rate this

    Comment number 77.

    I disagree with this not because of tax-payers money being spent on it, but because of the orphans that will not get a loving home because of an age limit raise.

  • rate this

    Comment number 76.

    Don't we have a problem with too many kids needing adoption, wouldn't it make more sense to encourage adoptions, or is that less of a moneyspinner?

  • rate this

    Comment number 75.

    I haven't seen any comment yet on same-sex couples getting NHS fertility treatment: so here goes.
    Why on earth should they? A baby is the result of male/female mating.

  • rate this

    Comment number 74.

    So much for priorities in the cash strapped NHS.More fertilty treatment or more and better cancer care?I need to think about this but can some one start by telling me how many folk have died or suffered harm because of infertility?

  • rate this

    Comment number 73.

    OK Tim Childs. I'm a reasonably clean and tidy, educated, intelligent and articulate lay person, who believes that while infertility may be a dysfunction of the body, childlessness is not an illness and in almost every case infertility per se has no other health consequences. IMO having children IS a lifestyle choice. I'll take up your offer - prove these pts 'suffering' needs IVF not counselling.

  • rate this

    Comment number 72.

    68. sparrow wagpie. Could not agree more with your comment and wish I could vote it up x 100! Well said

  • rate this

    Comment number 71.

    This is rediculous, all the arguments against are based on money and unfairness in other subjects (yes there are many) - but these are not the fault of the honest hard working person. Take money out of your thinking for a moment... should hard working people be able to benefit from modern advances in science? of coarse they should!

  • rate this

    Comment number 70.

    Apparently it all comes down to money, that is what most posters seem to be saying. However no one seems to want to volunteer to forgo any treatment, opt out of local GP services, turn down a life enhancing operation or start to take responsibility for there own health. Anyone willing to give up something for someone else or is it all about what you personally feel entitled to ? IVF is justified

  • rate this

    Comment number 69.

    On another note, helping these people who cannot concieve naturally only worsens the problem by producing more people with the faulty genes.
    If you want to be rid of the problem, stop helping them have children and breed it out.

  • rate this

    Comment number 68.

    We're overpopulated, and the NHS is struggling. This, therefore, is a stupid idea. As for 'craving' children, want doesn't always get, and it's about time people started to accept that.

  • rate this

    Comment number 67.

    IVF on the NHS – no probs. At least these parents will care for their kids. The problem is people have kids just because they can and the state underwrites some and in other cases all the costs through tax breaks and benefits. The world is too overpopulated, it is the root cause of global warming and scarcity of resources. We need a kid tax not a carbon tax, use some to pay for IVF on the NHS.


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