National Fertility Awareness Week – the unfairness of the IVF postcode lottery

31 October 2019

This week is National Fertility Awareness Week. The purpose of this week is to spread awareness of fertility issues.  In the UK 1 in 6 couples have problems with fertility. 

The birthplace of IVF (in-vitro fertilisation) was Oldham, England on 25 July 1978.  The UK has been pioneering in treating fertility problems and one of the most important methods for treatment of infertility is IVF.  However, patients are now faced with a postcode lottery and essentially where they live will dictate whether they are entitled to NHS IVF treatment. 

The National Institute for Health and Care Excellence (NICE) published updated guidance in February 2013. The guidelines recommend that women aged up to and including 39 years should have access to 3 full cycles of IVF treatment and women aged between 40 and 42 years old, who do not have a low ovarian reserve, should be offered 1 full cycle of IVF treatment. Unfortunately, the majority of patients in England are not receiving the recommended treatment. This is despite the fact that in October 2014 NICE published a new quality standard setting out how health authorities should plan and deliver fertility services and calling an end to the IVF postcode lottery in England. 

Research conducted by Fertility Fairness, a campaign group led by various charities, has found that the number of clinical commissioning groups (CCGs) in England offering the recommended 3 NHS IVF cycles to eligible women under the age of 40 has halved in the last 5 years.  Only 12% of CCGs now follow the national guidance, down from 24% in 2013.  In an estimated 4% of CCGs have removed NHS IVF treatment in its entirety. In London alone, only one borough out of 32 meets the NICE criteria by offering 3 full cycles of IVF. 

Many underestimate the impact that fertility issues have on patients. Evidence suggests that the impact on patients’ mental health and psychological wellbeing can be devastating.  Many people will be faced with the dilemma of whether to forego their dreams of having children or whether to embark on the process of funding IVF privately, which can often be extremely expensive. This leaves us with a situation in which only those with financial means can afford to have a family.

Information obtained in 2018 via a freedom of information request by Fertility Fairness revealed that on average, CCGs that fund a single cycle of IVF spent 0.089% of their total commissioning budget on the fertility treatment. CCGs that funded 3 cycles spent 0.108% of their total budget on IVF.  Sarah Norcross, co-chair of Fertility Fairness said

when fertility fairness analysed the difference in costs between providing a full NICE compliant service and providing a partial service, savings were miniscule.  The difference amounted to 0.019% of a CCG’s allocated budget”.  Ms Norcross went on to say that “not providing a proper service is a false economy, as it causes more money to be spent elsewhere – for example, mental health services for involuntary childless people, or neonatal wards following multiple births." 

So what can be done about this? If you have been told that you are not eligible for NHS IVF funding you can write to your CCG to appeal the decision. Fertility Network UK has prepared template letters on their website, which patients can use to write to their CCG. Patients can also contact their local MP and the Health Secretary to raise awareness of this issue in Parliament to try and bring about change. 

The current state of affairs is unfair and given that 1 in 6 people struggle to conceive it is a widespread problem. The current system needs to change and the IVF postcode lottery needs to end.

Further information

If you, or a member of your family, are affected by any of the issues covered in our blogs please contact one of our specialist lawyers on or call us on 020 7814 1200.

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