So, it’s in the news in the UK that NICE (a rather jolly little acronym for the National Institute for Health and Clinical Excellence) have recommended that IVF should be offered to couples after 2 years of trying to conceive, and that the upper age limit for a woman should be moved from 39 to 42.
Which seems very progressive and less arbitrary than the previous cut-off age.
But the reality is that we can debate it until we are blue in the ovaries, it’s not going to make very much difference at all.
The trouble is that these are only recommendations so the NHS trusts are not bound by these guidelines, which only means that they CAN continue to treat for fertility problems past 40 if they choose, not that they will.
Additionally, after 2 years of trying to conceive naturally, a couple can be referred for fertility treatment, instead of 3, so the ball should roll earlier on in the process.
But what does that mean in real terms?
My dear husband and I started trying to conceive, in a general “let’s see what happens” kind of a way when we were in our mid 20s. Nothing happened, but we didn’t get checked out until we had been not “not trying” for around 5 years.
We were tested and found to have “unexplained subfertility” and, because it had been longer than 3 years, we were referred immediately for tests within the NHS. Our GP “fast-tracked” us, told us that we were lucky that we lived in the right Post Code, and that our IVF journey could start from the moment I was first stabbed in the arm with a vicious needle by an angry phlebotomist.These preliminary tests (both male and female) took around 9 appointments and 11 months to complete. By which time, the first set of tests were out of date, and so had to be done again.
Around a year or so after we were referred, and after several days off work and trips to the hospital, a consultant (not our consultant – the one we were officially under; we never actually met him) advised us that we were eligible for one NHS funded round of IVF and that we could start as soon as something or other was sorted.
This was most confusing, as we thought we’d already started a year previously.
Anyway, from that point we had to do lots of visits to private clinics, because that’s where fertility treatment is actually done, and we had to have a bit of counselling, and then we had to have some more tests, because the results of my day-21 blood tests had been mislaid, and by the time we actually were booked into the clinic for our first appointment with the clinician, it was just over 2 years from the date we had been initially referred.
After trying to conceive for 5. And that was before the treatment had even begun.
What I am trying to say is that the guidelines can be whatever they want to be, the facts are that the reality is often completely different.
The NHS is underfunded for fertility treatment as it is – so increasing ages and decreasing timescales isn’t worth a bean, if they ain’t got the cash. And if, as in our case, the guidelines are nothing more than a dusty book on a shelf, then there’s nothing to even debate about, because until the real problems of consistent treatment and care are addressed, this is just another non-starter. Add to that the fact that IUI (Intrauterine Insemination) has now been found to be no more effective than sex, then it seems that there are even medical issues to balance out before we mess around with eligibility.
There are arguments out there (generally from people who have never struggled to conceive) that IVF is a waste of NHS funding anyway, and the money should be better spent on cancer research, the elderly and other more worthy conditions, but the trouble with that line of thought is that you head down a murky road of those who “deserve” medical assistance. And the NHS is about care for everyone, not just those with life-threatening conditions.
Because the truth is, that even though having children is not a right, and that infertility is not life-threatening, it is a condition which is all-consuming, heart-breaking, devastating debilitating and painful. And, no, that isn’t an exaggeration.
Depression and infertility go hand-in-hand, and the truth; the ugly, ugly truth, of infertility is that it can adversely impact every facet of your life. So even though it isn’t life-threatening, it is still hugely important, and fertility treatment exists. Therefore it should be offered.
Let’s face it, it’s not like for every couple who are refused NHS funded treatment, the Trust bung a few thousand quid into the cancer pot. Budgets don’t work that way.
The NHS is free at point of use, and fertility treatment is a service that they offer.
It is already a lottery, and the funding is based on throwing up a dice and seeing if it lands on a 6. Or something equally capricious. So, really, all of this consultation and recommending that something or other ought to be something else, is nothing other than smoke and mirrors.
There are already problems within the system, and these changes may improve some people’s chance of parenting, which is all to the good, but it’s not really a new issue, and it’s not tackling the real ones.
And if you were wondering, we actually refused fertility treatment in the end. Felt it was invasive, with little chance of success, too expensive and not for us.
And have never regretted that decision.