25th February 2004

FERTILITY SPECIALISTS WELCOME NICE GUIDELINES: “THE FIRST STEP TO CATCHING UP WITH EUROPE”

The British Fertility Society1, representing professionals in this field, is delighted that the suffering of those that are unable to conceive has been recognized by NICE, and that the need for equality in fertility services has been addressed.

Implementation of these guidelines will mean that for the first time NHS infertility treatment will be available throughout England and Wales. We hope that the impact of this decision will be to give ordinary people in Britain access to fertility treatment, and that today’s guidance marks the turning point for a new generation of children born to assisted conception.

Since UK scientists and clinicians pioneered IVF with the birth of Louise Brown 25 years ago the service has struggled with underfunding and lack of resources, and has had to deny many thousands that suffer with infertility the chance of biological parenting.

For a generation, assisted conception treatment has largely relied on patients funding their own treatment in the private sector – those that are unable to pay, are therefore unable to have children. In fact the UK currently has one of the lowest rates of publicly funded assisted conception in Western Europe.2

This guidance takes place against a background of greater funding being made available to the NHS. NICE has evaluated the cost-effectiveness of fertility services, it has identified the real problems presented by infertility, and has concluded that it’s fair and equitable for the NHS to offer certain treatments. NICE has decided that the service would be a cost-effective use of NHS resources.

The challenge that now faces the Health Service and fertility professionals is to implement the NICE guidance. The British Fertility Society looks forward to working with patients, professionals, and the Health Service to achieve this aim.

Consultant gynaecologist and professor of reproductive medicine Alison Murdoch, the chair of the Society, said:

‘Every parent knows how important their children are to them. For too long the chance for infertile couples to have children has been governed by their postcode, or by their income. Implementation of this guideline will mean for the first time the opportunity to have children is not governed by the priorities of your health authority.’

‘A generation ago, with the birth of Louise Brown, Britain led the world in assisted conception. Since then although we’re world leaders in research, we’ve fallen behind in provision. Now fewer people receive publicly funded fertility treatment here than in much of the rest of Europe. This is the first step to catching up. The quality of fertility services in the UK is of international class, we hope the next generation also sees international levels of access to these services.’

‘It should be understood that publication of the guideline is only the first step of the process. The next challenge is of course for us to be supported in implementing these changes. We will work with Commissioners, PCTs, the Department of Health and patients to achieve the ultimate aim set out in this guideline: to bring England and Wales up to world-class standards in fertility treatment provision.’
Clare Brown, Chief Executive of the patient organisation, Infertility Network UK and Chair of the National Infertility Awareness Campaign, said:

“Our organisation has campaigned alongside the British Fertility Society for more than 10 years to end the totally unacceptable treatment by postcode situation applied to NHS funding for infertility treatment during that time. We are therefore equally delighted with the publication of these guidelines. We are one huge and significant step nearer to achieving our aim of a fully funded, equitable, efficient and cost-effective NHS service for the treatment of infertility. Now we must ensure that this guidance is fully implemented as quickly as possible so that those affected by fertility problems are able to access the treatment they need as quickly as possible. Time is of the essence.”


Responses to predictions that ministers will over-rule the NICE recommendations and allow only one IVF cycle for each eligible patient, with no fixed deadline for full implementation:

Alison Murdoch, chair of the BFS, said ‘I applaud the scope of the NICE guidelines, which should profoundly improve service provision in the UK. The program of implementation will of course take time, and to get up and running will require compromise from all parties. However, we should not accept compromise in the content of the guidelines – anything less than NICE recommend will mean that services continue to be inadequate. A deadline for compliance must be given, and clinics must be supported in achieving this fully.

Patients will feel understandably cheated if the NICE guidelines – which have been developed over two years of consultation – are ignored when it comes to implementation.’
Dr John Mills, ex-chair of the BFS, said ‘A gesture has been made by NICE to correct a geographical imbalance of provision of treatment. If this is not implemented fully the opportunity of treatment for each couple will be quite inadequate. It has been made clear to NICE that a couple who need this treatment should have three attempts to allow them a reasonable chance of success. The need for equality in fertility services has been addressed but will fall short of what is appropriate, with patients in England and Wales continuing to receive a quality of care lower than those in Scotland or other EU countries. I am disappointed that such a poor provision of service is seen as an adequate compromise by the Health Secretary, who has missed this opportunity to redress a major failing of the NHS.’

NOTES TO EDITORS

1 The British Fertility Society is national multidisciplinary Society representing professionals practising in the field of reproductive medicine

2 According to a report compiled for the European Society of Human Reproduction and Embryology (ESHRE).