NICE hits out at IVF 'postcode lottery' and publishes draft fertility advice

NICE experts have hit out at a postcode lottery in fertility care that 'goes against the fundamental aims of the NHS' in draft guidance urging GPs to refer and support patients struggling to conceive.

Professor Gillian Leng: disappointing that NICE advice not followed (photo: Jason Heath Lancy)
Professor Gillian Leng: disappointing that NICE advice not followed (photo: Jason Heath Lancy)

GP reported earlier this year that GPs had observed an increase in rationing of services.

GPs should refer patients for specialist consultation if they have not conceived after a year of unprotected vaginal intercourse, NICE advises.

They should refer earlier for women over 36 years of age or those with known clinical factors that may limit fertility.

GPs to offer lifestyle advice

GPs should also offer lifestyle advice to patients taking longer than expected to conceive, and access to counselling, the advice says.

The report makes clear that women under 40 who have not conceived after two years should be offered three cycles of IVF treatment.

Women aged 40-42 should be offered one full cycle if they have never previously had IVF, there is no evidence of low ovarian reserve, and the patient has discussed the implications of pregnancy and IVF.

NICE guidance published last year contained similar advice but has not been followed in many areas.

Patients denied treatment

The institute pointed out that Gosport MP Caroline Dinenage had recently told the Commons that women in her area were offered just one cycle of IVF up to the age of 35.

NICE deputy chief executive and director of health and social care Professor Gillian Leng said: ‘Infertility is a recognised medical condition that can affect people of any age and has a potentially devastating effect on people’s lives.
‘Unfortunately, we know that not all areas are following our guidance to the letter. This creates variations in treatment within the NHS, which is disappointing and goes against the fundamental aims of the NHS.’

CCGs have also been warned that patients about to undergo cancer treatment that could damage their fertility should be offered cryopreservation to help them conceive at a later date.

Consultation on the draft advice will run until 12 June.

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