New restrictions on IVF funding

It’s National Fertility Awareness Week and today the campaign group Fertility Fairness has released an audit which has found new restrictions on IVF funding. The survey covered all the Clinical Commissioning Groups (CCGs) in England and found that 80% are failing to follow the NICE guidance which says that all eligible couples under the age of 39 should be offered 3 full cycles of IVF treatment.

Many are also setting new criteria to limit eligibility for treatment. Despite the fact that neither male age nor weight affect the success rate of IVF, more than a quarter of CCGs have decided to use the male partner’s body mass index (BMI) to decide whether a couple can access NHS treatment, and 8% no longer offer NHS funding if the male partner is 55 or over. Around one in four CCGs also use AMH or antral-follicle count to check a women’s ovarian reserve (an estimate of the number of eggs in the ovaries) to decide whether she is eligible for IVF. The NICE guidance gives some guidance on levels at which these may be helpful to assess how a woman may respond to the drugs used in IVF to stimulate the ovaries, but there is no suggestion at all that this might be used to decide who should be eligible for treatment.

Consultant gynaecologist and Fertility Fairness committee member Raj Mathur, said: ‘ Male age and BMI are not in the NICE guidance as criteria for IVF and there is no strong evidence of impact on clinical outcomes of IVF. AMH and antral follicle count are in the NICE guideline as predictors of ovarian response, but NOT as predictors of the chance of having a baby through IVF. Commissioners are making unjustified extrapolation in using them for rationing.’

The audit found that

  • 3.6% of CCGs have removed NHS IVF entirely
  • 40% do not offer a full IVF cycle, limiting the number of frozen embryo transfers
  • 20% offer one full IVF cycle, transferring all fresh and frozen embryos
  • 23% offer two IVF cycles.
  • 13% offer three IVF cycles.

In the last two years, 30 CCGs have reduced NHS fertility services, and one in ten CCGs is currently consulting on cutting or removing NHS fertility treatment.

Sarah Norcross, co-chair of Fertility Fairness, said: ‘It is shocking to see CCGs introducing their own ‘access to IVF’ criteria, as well as reducing the number of IVF cycles they offer. It is not the CCG’s job to decide the criteria for accessing NHS fertility services. NICE has accessed the evidence in its guideline and developed access criteria for NHS patients and they do not include male BMI, male age, a woman’s AMH level or whether or not a couple has a child from a previous relationship. What criteria will CCGs introduce next; star signs and shoe size? CCGs need to remove their extra ‘access to IVF’ criteria now.’

Aileen Feeney, co-chair of Fertility Fairness and chief executive of leading national charity Fertility Network UK said: ‘ Fertility Network is extremely concerned about the effect that reducing access to NHS IVF has on already distressed patients. Infertility is a devastating disease causing depression, suicidal feelings, relationship breakdown and social isolation; removing the recommended clinical help or making it harder to access is cruel and economically short-sighted. Access to NHS treatment should be according to medical need and not your postcode. We urge anyone affected to join Fertility Network’s #Scream4IVF campaign calling for fair access to NHS IVF in the UK; with your help we can reach 100,000 signatures and hold a debate on the issue at Westminster. Sign the petition at www.scream4IVF.org and share your #Scream4IVF during Fertility Week.’

Have you had your smear test?

Figures released today by Public Health England show that there has been a drop in the number of women having regular cervical screening tests. They show that around three million women under 50 have not had a smear test for more than three years, and another million women in the 50 – 64 age bracket have not had a test for more than five and a half years. These rates are at their lowest levels for almost twenty years.  This matters to anyone worried about their fertility as treatment for cervical cancer may leave you unable to have children in the future.

It is vital that we all go for regular smear tests as cervical cancer as the screening test is estimated to save more than 4,000 lives every year. Having regular screening means that if there are any unusual changes in the cells in your cervix, this will be identified at an early stage and if you need treatment, it can be given early to stop cancer developing.  You can read more about cervical cancer screening on the NHS website and there is information about screening and cervical cancer on Jo’s Cervical Cancer Trust and the Eve Appeal’s websites.

Seasonal sperm

New research from the United States has found that men produce better sperm in the spring and autumn, although the reasons for this remain unclear. A big study analysed sperm samples from more than 29,000 men over a period of 17 years, and found that there were more moving sperm in the spring and more normally-shaped sperm in the autumn.

The researchers, from Icahn School of Medicine in Mount Sinai in New York presented their research at the annual conference of the American Society for Reproductive Medicine in Denver. They have suggested that the milder weather might have something to do with this as the sperm will stay cool but men are likely to be more physically active and that they may be less likely to be drinking too much alcohol than in the summer or at Christmas. As it takes three months to produce sperm, it is not entirely clear what the causes may be – but the researchers make it clear that more research is needed to be able to confirm that their findings would have an impact on the chances of a successful pregnancy at different times of year.

Royal pregnancy announcement

Pregnancy announcements are never easy when you’re trying to conceive, but one which has swamped the media and is this morning taking up endless pages of many newspapers is particularly difficult to avoid. What makes this announcement even more challenging is that the Royal couple were only married a matter of months ago, and seem to have conceived with effortless ease.

It was unfortunate that the announcement came during Baby Loss Awareness Week, on a day when many people were preparing to light candles for the Wave of Light in memory of their own losses. Although the couple have been criticised online for this, the most likely reason is that they simply didn’t know the significance of the day.

The endless discussions about the Royal pregnancy are going to go on – and on, and on – during the next few months. One of the best ways of dealing with that is to spend time with other people who understand how you feel about this because they share similar experiences. Why not try one of Fertility Network UK’s fertility groups which run across the UK? They’re an ideal opportunity to meet others and can be really empowering. I admit I am biased about this as I run the group in South East London, but that’s because I know how much it can help. Being with other people who understand, and who share your conflicted feelings about pregnancy announcements can make all the difference. It can help you to realise that you are not having a personality change and becoming an unkind person, but are reacting in a perfectly normal way to an emotional challenge. You can find details of all FNUK’s groups here, and it there isn’t a group near you, they can offer other support too – have a look at their website

Rally for fair fertility funding

It was great to be able to attend the rally at Westminster this evening organised by Fertility Network UK as part of their Scream4IVF campaign to try to push for fair funding for IVF based on the NICE guidelines, which conclude that it is both clinically effective and cost-effective to offer three full cycles of treatment to eligible women who are under the age of 40.

There were a range of excellent speakers at the rally including Fertility Network UK’s Chief Executive, Aileen Feeney, and London Organiser, Anya Sizer. They were joined by Paula Sherriff MP, Steve McCabe MP and author and Director of Fertility Fest Jessica Hepburn as well as Damion Sizer giving a male point of view and the brilliant Hope Sizer talking from the perspective of someone conceived by IVF.

It was an inspiring rally, and ended with some of the recorded screams (which were very loud!) and an opportunity to Scream for IVF ourselves. If you haven’t already signed the campaign petition to get a parliamentary debate on IVF, it’s not too late – you can find it here 

World Mental Health Day, and why it matters to fertility patients

Today is World Mental Health day, and a good time to think about the mental health impact on fertility problems, tests and treatment. All too often, there’s an attitude from those with no experience of infertility that it isn’t a really serious problem, and yet anyone who has been through this themselves will be only too aware of the way it can impact on your health.

A survey for the patient charity Fertility Network UK and Middlesex University found that respondents reported feeling sad, frustrated, fearful and worried, out of control and helpless most of the time. They often felt stressed, tearful, inadequate, angry, isolated, despairing, depressed, guilty or shamed and experienced low confidence and concentration and a loss of sex driven. They also felt unsupported. Even more alarmingly, 42% of respondents said that they had experienced suicidal feelings.

If you are going through treatment and are finding it tough, there is help and support out there. The patient charity Fertility Network UK offers free group meetings around the country where meeting with other people going through similar experiences can be hugely helpful, and have a support line and online forum too. The British Infertility Counselling Association has a host of specialist counsellors ready to help with emotional support, and you can also talk to your GP if you are feeling in need of counselling. Don’t suffer alone.

Pregnancy test recall

A false positive from a pregnancy test is the nightmare of anyone who has been through fertility treatment, but more than 58,000 digital pregnancy tests called Clear & Simple have been recalled after it became apparent that the test had mistakenly told some women they were pregnant when in fact they weren’t.

If you have bought a Clear & Simple test, manufactured by Guangzhou Wondfo Biotech, you should return it if it is from the potentially faulty batch. You can check the lot number on the inside and outside of the package – it is Lot Number DM10220170710E with an expert date of January 2020 which is affected.

The manufacturers stress that only a small number of problems have arisen with the tests and that they have been removed from shops already, but if you do have a test from this batch, you should return it and anyone who has had a false positive result from these tests should report it.

Scream4IVF

I am sure you will all be aware of Fertility Network UK’s Scream4IVF campaign, aimed at ending the postcode lottery for IVF treatment. If you haven’t signed the petition yet which calls for a parliamentary debate on the subject you can do so here. The charity has been asking people to donate their scream on social media to give a voice to people with fertility problems and allow their frustrations to be aired. The screams will be collated to form the world’s longest scream for IVF to be played at a rally outside Westminster. The charity is encouraging people to join them at at the rally which takes place at Richmond Terrace at Westminster on October 10th from 5pm to 7pm.

Music to support fertility charities

If you are in London on September 29, why not take the opportunity to attend a concert to help raise funds for two fantastic charities, the Donor Conception Network and the Daisy Network.

Taking place in St Mary’s Church in Rotherhithe, the  concert is with Dunajska Kapelye, a trio who play beautiful gypsy and Eastern European music and are led by one of London’s most respected violinists, Polish Piotr Jordan. The concert will feature plaintive Gypsy ballads, tub-thumping Romanian wedding dances, elements of tango and klezmer. It promises to be a wonderful evening – and great to be able to be raising money to support such important charities with their work at the same time.

You can find more information on Facebook https://www.facebook.com/events/710467139299822  and you can buy tickets here  http://tunedin.london/tunedin.php

Have you had fertility treatment in the last 5 years?

If you have had fertility treatment in the UK in the last five years, would you be willing to help identify key areas for improvement to ensure everyone receives high-quality care in the future?

The Human Fertilisation and Embryology Authority (HFEA) which regulates fertility clinics in the UK has launched a national fertility patient survey and your views are vital to help the Authority understand experiences of treatment. The survey is being run by YouGov, and the more people that take part, the clearer the views and the greater the impact.

This is an excellent opportunity to help other people going through fertility treatment by giving the information and opinions the HFEA needs to help ensure these are taken into consideration in the future. The survey takes about 15 minutes to complete, and the link is here.