A new survey of fertility patients looking at overseas treatment carried out for Fertility Network UK and the website Fertility Clinics Abroad has unsurprisingly found that cost is the major reason why people travel for treatment. Of those who responded to the survey, nearly 80% said fertility treatment in the UK cost twice as much as they were willing or able to pay and 68% said that they would travel for treatment because IVF overseas was generally cheaper.
When people first started travelling overseas for fertility treatment, it was often to access donor eggs but according to this survey most of the respondents were using their own eggs for IVF treatment abroad. The survey found that people believe that treatment can often be offered more quickly abroad. There was also a perception that the standard of care was better overseas with clinics offering a more personalised approach.
Interestingly many were also attracted by the apparently high success rates overseas, but some respondents had noticed that these rates could be confusing and misleading. A majority had said a centralised database of all overseas clinic success rates would be welcome but it would be very hard to verify these rates. Some overseas clinics claim success rates of more than 80% for women using their own eggs for IVF, and it is important to be clear that these rates are not comparable with the figures you will get from a UK clinic as they are using different criteria, are not always including all the patients treated at the clinic and may be giving rates for positive pregnancy tests rather than for live births.
Almost a quarter of respondents wanted to go overseas because they would have access to anonymous donors and it would have been very interesting to find out why they felt this was an advantage – did they feel it was linked to a larger pool of available donors or was it the anonymity itself which was attractive, and if so why. So, a survey which provides some interesting information – and also raises many questions! You can read more details about it here
NHS Commissioners in yet another area are considering cutting fertility services. This time, it’s Richmond Clinical Commissioning Group which is consulting on whether to continue to offer one fresh and one frozen cycle of treatment or to cut the service entirely. You can give your views by completing their survey – https://www.surveymonkey.co.uk/r/IVFandICSIconsultation
The consultation closes on Tuesday 4 April 2017, so please do let your views be heard especially if you live in or near Richmond.
Could you help a researcher by filling in a survey? I know I am always posting links to surveys and research – but I do think it’s a good idea to do these whenever we can because every piece of research helps further understanding of what it’s really like to be a fertility patient and how it feels to go through treatment.
This particular survey is being carried out by an MBA researcher who previously worked in a fertility clinic and is totally anonymous but will be used for part of her MBA. Do feel free to share the link with anyone who has had or is having fertility treatment in the UK – you can access it here https://www.surveymonkey.co.uk/r/JSXXS25
If you’re concerned by the postcode lottery for fertility treatment, you can join the Fertility Network UK Day of Action on 25 March. You don’t have to go out marching anywhere, but just a few small actions can make all the difference
There are three ways you can join in –
Contact your MP, Tell them how the postcode lottery is affecting you and what is happening in your local area. You can find out more about how to find your MP’s contact details and what you might want to say in an email or letter here on the Fertility Network UK website.
You can tweet your support using the hashtags #IVFx3 #tellyourMP #righttotry
Fertility guidelines from the National Institute of Health and Clinical Excellence (NICE) say that if you should be able to access 3 full cycles of NHS IVF if you under 40 and eligible for treatment, An overwhelming 98 per cent of England’s 209 local clinical commissioning groups (CCGS) do not follow this guidance fully and have either cut the number of IVF cycles they offer and ration services by introducing additional non-medical access criteria, such as denying IVF to individuals if their partner has a child from a previous relationship.
Do join in and help your charity to help you to make a difference!
A really interesting new study has found that women who worked night shifts or who had jobs involving heavy lifting produced fewer eggs when having fertility treatment than those who worked normal day shifts. The research team from the United States investigated around 500 women who filled in detailed questionnaires about their work shift patterns and any heavy lifting involved in their jobs. The researchers found that there were clear differences in the number of eggs produced by women who worked at night and those who did heavy lifting at work.
I found this study particularly fascinating as I worked night shifts before I started trying to conceive, and was very aware of the negative impact it had on my overall health – but often wondered whether it could affect fertility too. This was an observational study – which means the researchers were not linking cause and effect but just seeing what happened with the different groups of women and fertility experts have urged caution in interpreting the results. However, if you are doing a job which involves working nights or a lot of heavy lifting and are having difficulty getting, the study would suggest it may be worth investigating if there is anything you can do to change your shift pattern or lifting at work.
New research from the States suggests that women who are depressed are less likely to carry on with fertility treatment. The researchers from the University of North Carolina (UNC) screened 416 women with fertility problems, and 41% scored positive for depression although apparently more than half said that they felt depressed most or all of the time.
The research team found that the women whose screening test showed that they were depressed were less likely to carry on with treatment, and therefore less likely to end up with a pregnancy. You can see more about the research, which was published in the journal Human Reproduction, here
It isn’t really surprising that so many people who are having difficulty getting pregnant experience depression, but it is sad that some may end up avoiding or delaying accessing treatment that could help because of depression and anxiety.
We should all thank Steve McCabe, the Member of Parliament for Birmingham Selly Oak for raising the issue of NHS funding for fertility treatment in a Backbench Business Debate at Westminster supported by Tom Brake, the MP for Carshalton and Wallington, and Ed Vaizey, the MP for Didcot and Wantage. He’d been contacted by a number of constituents about the problems of the postcode lottery for fertility treatment, and called on the Health Secretary to investigate the cost disparities and the variations of IVF provision across England to find out why NICE guidance isn’t being followed universally.
The Health Minister Nicola Blackwood said that she would be writing to NHS England to ask that it communicates clearly with CCGs the expectation that NICE fertility guidelines should be followed by all.
It is a difficult time for the NHS which we know faces financial challenges, but stopping funding IVF would make little difference to the monetary woes – and indeed may actually end up costing far more if you factor in the long-term distress and depression caused by not being able to access treatment and the risk of patients having multiple embryo transfers overseas and returning with multiple pregnancies which can lead to health risks for both mother and baby.
The debate at Westminster was not well-attended, despite a big campaign by the charity Fertility Network and the campaign group Fertility Fairness. If you haven’t written to your MP about the problems of the postcode lottery yet, it is not too late. You can find details of how to find your MP and what to write on the Fertility Network website and if you are interested in watching the Westminster debate, you can find it here
New research suggests that if you want to find out about outcomes from fertility treatment at a particular clinic, the best place to go is not the clinic’s own website. Researchers from Manchester University discovered that fertility clinics use a variety of different ways to present their data which makes it very difficult for anyone trying to compare one clinic with another. They found that clinic websites often use league tables which they construct themselves using their own parameters to compare clinics in their area and that these are “invariably constructed so that the comparison was favourable to the reporting clinic.”
If you do want to look at outcomes, it is worth bearing in mind that most clinics have broadly similar success rates and that relatively small percentage differences can be pretty meaningless and may have more to do with the patients being treated at any given time than anything else. The HFEA publishes outcomes broken down by age and this is by far the best place to go for information if you want to look at treatment outcomes as the figures are collected and collated the same way for all clinics across the UK
Do you think there should be a cut-off age after which people shouldn’t have children? Or is it fine at any age at which it is remotely feasible? And is it right that we ponder this subject so much when it comes to women having children later in life, and yet barely raise an eyebrow when Mick Jagger has a baby at the ripe old age of 73?
The subject has been back in the news again after Dame Julia Peyton-Jones, former director of the Serpentine Galleries, became a mother at 64. It isn’t clear how she had her daughter, although we can be sure she didn’t use her eggs and that she may well have paid for a surrogate to carry the baby too. I know we all feel and act younger than our grandparents may have done at the same age, but she will be 80 by the time her daughter is 16 – and I can’t help wondering what it would be like for a 16 year old to have an 80 year old mother? Or what it would be like to be responsible for a teenager when you were 80?
Of course, the other problem with news stories like this is that they muddy the waters when it comes to NHS funding for fertility treatment, as many people seem to assume that it is the NHS which is footing the bill for older women to try to have babies. In fact, in most areas there is limited funding for women up to the age of 39, and often nothing at all beyond that. At most women of 40-42 will get one cycle, but if you are older, there is no likelihood of funded treatment.
You may have come across Alexandra Heminsley before as she wrote a previous book, Running Like a Girl,, about her experiences of running (which I found really inspiring as someone who is not remotely sporty but who has discovered an unexpected love of running – albeit very slowly…).
This article is about her new book Leap In, which deals with swimming and fertility treatment. We learn that she has been through two rounds of treatment, one of which resulted in a positive pregnancy test followed by a miscarriage. There is always a feeling of connection when you read about someone going through fertility treatment – we all understand something that others never really can – and I found her article incredibly moving. She talks about her changing feelings as she goes through the unsuccessful treatment and miscarriage, about how she feels betrayed by her body and rejects it. Describing all this through a focus on swimming somehow makes it an even more powerful read. When she talks about the “sort of breathlessness, almost a vertigo” that comes over her when she thinks about never having a child, she captures in just a few words the vast hollow emptiness and fear which are so familiar to many of us.
I’ll be posting a book review soon, but in the meantime, do read the article.