IVF treatment – evaluating your chance of success
To the uninitiated, it may seem that anyone who has difficulty conceiving can just have a baby through IVF. However, for women in Britain, the leap from infertility to the birth of a baby is not nearly so straightforward. Fertility Coach, Lisa Marsh, explains the steps you need to take to assess your chance of having a baby through IVF treatment.
If you are thinking of approaching the NHS or a private clinic for IVF treatment here is my step by step guide to what you can expect and what you can do to assess your chances of success.
- Understanding the obstacles to IVF
- NHS delivery of fertility treatment
- The costs of private treatment
- Transparency is necessary to make an informed decision
- How to assess your chances of accessing, and being successful with, fertility treatment
The biggest obstacle that women face in having a baby through assisted reproduction is finding affordable, quality care that will realistically help them achieve a live birth. It comes down to cost and transparency; both of which are meant to be regulated by the HFEA. The problem may lie in how strictly both the NHS and private fertility clinics have to adhere to the HFEA’s recommendations.
While the HFEA recommends that the NHS provide 3 cycles of IVF for women who are between the ages of 23 and 39, Primary Care Trusts (PCTs) can use different criteria for eligibility which may result in women being refused treatment or given fewer than three cycles of IVF. In what is known as a postcode lottery, a woman in one area of the country can access a different level of care than a woman living elsewhere. For example, one PCT may refuse to provide IVF to a woman who has a child from a previous relationship, while in another area; a woman may be treated as long as she does not have children with her current partner.
The way that the financially beleaguered PCTs are handling the high demand for fertility treatment causes huge confusion and stress to patients. GP’s may feel pressured to delay in referring patients to a specialist clinic, using criteria such as weight, smoking or alcohol to determine readiness for treatment. Younger patients can be sent away to keep trying naturally for 6 more months, while older patients who are concerned their time is running out may be encouraged to seek faster treatment in the private sector. In other cases, people are put on long waiting lists which can increase their anxiety about whether they will be treated before rules change or budgets are slashed. Some PCTs have cut the number of cycles it offers each patient or simply stopped offering IVF altogether.
The difficulty in accessing NHS fertility treatment results in about three quarters of the 40,000 women receiving IVF in the UK annually paying thousands of pounds for private medical treatment. MPs in the House of Lords criticized the HFEA this week for not sufficiently controlling what these clinics can charge, what they can claim and how their success rates can be delivered to the public.
The average fee for an IVF cycle is publicised as approximately £3,500; however, costs can run to additional thousands as hormone drugs and the freezing and storage of eggs and embryos, not included in that fee, are charged at inflated prices. This can, in some cases, nearly double the cost of treatment, regardless of the outcome of the cycle. The annual increase in the number of women having IVF, especially in the upper age brackets precluded from NHS treatment, suggest that they have no choice but to accept these prices.
Despite HFEA regulation of what registered fertility clinics in the UK can claim in their advertising, published success rates are frequently misleading to the consumer. In a discussion of the HFEA’s effectiveness, Lord Winston, the Labour Peer, complained about dubious success rates that hinge on pregnancy rather than delivery of a live baby, not taking into account the high number of miscarriages that result, especially in women over 40 or 42.
The decision-making process about whether to pursue fertility treatment essentially hinges on two factors: how realistic it is that you will have a baby as a result of fertility treatment and whether you can access that treatment.
1. Investigate the current allowance of IVF cycles and criteria used by your local Primary Care Trust;
2. Discuss a referral for fertility treatment with your GP. If (s)he seems reluctant to refer you, ask to see the Senior Partner of the GP Practice, or ask your PCT directly for clarification of your entitlement;
3. Even with NHS treatment, it is important to be fully aware of the type of proposed treatment, who is providing it, their success rates, how long it will take to access that treatment and how many cycles you will receive;
4. If you are not going to be referred for NHS treatment it may be worth investigating what other PCTs are offering. In some instances, you may want to balance your ability to pay for private care against the cost and inconvenience of moving to a different postcode.
5. Investigate your options for private treatment carefully. Compare advertised claims with published data on the HFEA website for each clinic, which also explains how to interpret that data;
6. Make an appointment for a consultation with each clinic, ensuring that you have the opportunity to ask about
a. its success rates in achieving live births for women, or couples, with your particular fertility challenges, whether due to age or medical condition;
b. the total cost of the proposed treatment, including consultation fees, procedures, scans, prescribed drugs and the freezing and/or storage of sperm, eggs and embryos;
c. exactly what the proposed treatment entails and its possible impact upon you, both physically and emotionally; and
d. the level of ongoing patient support, such as coaching or counseling, offered by the clinic, and whether it is included in the fee or separately charged.