British Fertility Society response to the updated NICE guidance on fertility

The British Fertility Society (BFS) welcomes the publication of the 2013 NICE Fertility Guidelines released today (20 February 2013), following a prolonged period of consultation since the draft was published in May last year.  We now call for these guidelines to be fully implemented by healthcare providers across the country, so that patients do not face a postcode lottery for treatment.

The published NICE document covers the comprehensive range of fertility treatments ranging from simple techniques of ovulation induction to fertility preservation for individuals facing fertility damaging treatments or conditions and including assisted conception therapies such as IVF.  Whilst the BFS is pleased that the guideline update has been undertaken (the previous version was published in 2004), we highlight once again that the majority of Primary Care Trusts still do not provide funding to cover the current recommendations of three funded cycles of IVF for eligible couples and patients still face a postcode lottery for treatment.  This is in spite of many strong statements and assurances from government ministers and the Prime Minister1, 2 that the guidelines should be fully implemented.

The recommendations of NICE 2013 confirm that fertility problems can be managed cost effectively.  Infertility is major healthcare problem of young people of working age and continuing to prioritise such treatment differently, separating its management from the rest of the National Health Service and its core principle of “free at the point of delivery” does them a significant disservice and is fundamentally unjust.  The guidelines are well timed to the April initiation of the new Clinical Commissioning Groups and the BFS in conjunction with patient groups calls on all commissioners to fulfil their obligations, comply with the NICE guidance and provide couples with proper access to fertility care.

The British Fertility Society welcomes this review and the important role that NICE plays in defining cost-effective healthcare.  The updated publication ensures those providing fertility treatment have access to information based on the best available evidence.  It is incumbent on commissioners to ensure that the guidelines are fairly and appropriately applied.  The BFS will consider the detailed content of these guidelines, their implications for patients, professionals, Commissioners and the wider NHS and will continue to strive to assist in the implementation of the 2013 guidelines across England, Wales and Northern Ireland.

British Fertility Society spokesperson, Dr Sue Avery said:
“Infertility affects one in seven couples in the UK and is one of the most common reasons for people of childbearing age to visit their doctor. The British Fertility Society welcomes the publication by NICE of these updated fertility guidelines.  The area of reproductive medicine has advanced hugely over the past decade since the last guidelines were issued.  This update reflects these changes and makes sure that healthcare professionals have treatment information based on the best evidence currently available.

“However, it is now almost ten years since NICE first published guidelines on fertility treatment and we are still in the untenable position that the majority of Primary Care Trusts have not fully implemented these and patients in many areas of the country are unable to access treatment.  Being denied appropriate fertility treatment can have a devastating consequence on patients’ lives, effectively denying them the right to a family.  The British Fertility Society calls on the new Clinical Commissioning Groups, coming into force from April, to reconsider this position and fully implement the NICE fertility guidelines to provide patients with the appropriate care and treatment options to which they are entitled.”

Clare Lewis-Jones, Chief Executive of Infertility Network UK, said:
“Let’s not forget that infertility is a medical condition and that people with a fertility problem have the same right to be treated by the NHS as anyone else. It is now nearly 10 years since the guideline was first published yet sadly we are still facing an arbitrary approach to IVF funding around the country.

“By updating the Fertility Guideline and extending the range of people it is recommending receive treatment, NICE clearly understands the impact which infertility has on people. I hope these updated guidelines will give the NHS a new push to make fertility services more available to those who need them because there are some real positives in the recommendations. 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.

“NICE clinical guidelines demonstrate the level of care to which the NHS should aspire. Although the NHS is not legally obliged to follow NICE clinical guidelines, they are considered to be best practice  because recommendations are based on the best available evidence. The new guideline gives hope to more infertility sufferers – but it is pointless if the recommendations are not put into practice”.

Background information
Problems with fertility affect one in seven couples with a significant and unwelcome delay in either starting or completing their families and there are increasing numbers of women in the UK who have never had a child.  These statistics carry with them a burden of psychological harm which is often disregarded.  Fertility treatment however, has become a mainstream, normal part of healthcare which no longer carries the stigma or shame previously associated with it and which can relieve couples of that otherwise lifelong burden.


Notes for editors:

This statement is in response to today’s publication by the National Institute of Health and Clinical Excellence’s (NICE) of updated guidelines on fertility.  A full copy of these guidelines can be found here from Wednesday 20 February onwards.  These updated guidelines replace some but not all parts of the original 2004 fertility guideline.

A full copy of the British Fertility Society’s submission to consultation on the NICE guidance from June 2012 can be found here.

1 Prime Minister’s Questions, 8 June 2011. Question 11. Accessed 14/02/13

2 Interim report of the Expert Group on Commissioning NHS Infertility Provision: letter from the Public Health Minister Dawn Primarolo, to Chairs of Primary Care Trusts – 22 August 2008. Accessed 15/02/13