20 Feb 2013

Give IVF to women over 40 – Nice

New guidelines published today say that for the first time women up to 42 should be offered IVF on the NHS.

Until now, the official guidance from the National Institute for Health and Clinical Excellence (Nice) has been that fertility treatment should only be available to women of 39 or under, although draft proposals last year suggested change was needed.

The new guidelines, which also break new ground by mentioning same-sex couples, say women who have been unable to conceive after two years of trying should be offered fertility treatment, a year earlier than previously recommended.

They say women aged 40-42, who have not conceived after two years of regular sex or 12 cycles of artificial insemination, should be entitled to one full cycle of IVF, if they have never had it in the past.

Women under 40, who have not conceived after two years or 12 cycles of artificial insemination, should receive three cycles of IVF.

One in seven

Around one in seven heterosexual couples has problems conceiving, which can cause depression and relationship breakdown.

Nice chief executive Sir Andrew Dillon said: “The good news is that, thanks to a number of medical advances over the years, many fertility problems can be treated effectively.

“It is because of these new advances that that we have been able to update our guideline on fertility, ensuring that the right support, care and treatment is available to those who will benefit the most.”

Tim Child, consultant gynaecologist and director of the Oxford Fertility Unit, who helped develop the guidance, said for women of 40-42, “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”.

Same-sex couples

Referring to same-sex couples, a Nice spokeswoman said: “This is the first time same-sex couples have been included in Nice guidance on fertility. In terms of fertility treatment, same-sex couples only account for a small proportion of NHS patients – around 5 per cent.

“However, it is important that we are sure that everyone who has this distressing medical condition has access to the best levels of help.”

A full cycle of fresh IVF can cost the NHS around £3,000.

Not mandatory

There is concern that the new guidelines may not be implemented. The National Infertility Awareness Campaign said they were not mandatory and decisions could still be taken on a local basis – the so-called “postcode lottery“.

Chairwoman Clare Lewis-Jones said: “We know the current system leaves many people unable to access NHS treatment and we need reassurance about the future of NHS fertility treatment as we move towards GP commissioning in 2013.

“The new guideline gives hope to more infertility sufferers, but it is pointless if the recommendations are not put into practice.”

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