IVF age limit 'should be raised to 42'

Justine Bold: "I do feel let down by the NHS"

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Women in their early 40s should be given access to IVF on the NHS, draft guidelines for England and Wales recommend.

NICE says the current age limit of 39 should be raised to 42 for women who have no other chance of conceiving.

The draft, which updates 2004 guidance, suggests other new groups who should be eligible for treatment.

They include same-sex couples and people facing cancer treatment who wish to preserve their fertility.

Also included are couples who have been trying for a baby for two rather than three years, those who carry infectious diseases, such as hepatitis B or HIV, and those who are unable to have intercourse, for example, if they have a physical disability.

Too old?

Justine Bold, now 43, was told she was too old to have IVF on the NHS. When she was turning 40 she decided to seek the treatment privately and has spent over £33,000 on fertility treatment with no success as yet.

"I think I might have one more go in me. It's been a long journey. It's very hard.

"Unfortunately, the changes won't help me but I hope they will help other women even though it is still a postcode lottery."

Under the National Institute for Health and Clinical Excellence's guidelines, a single cycle of IVF could be offered to a small group of women aged between 40 and 42 who have never tried fertility treatment before and for whom the treatment offers the only chance of having a baby.

It is difficult to say precisely how many women this might include - but experts agree it will be a minority.

And experts say the guidelines, which are non-compulsory, do not alter the fact that many primary care (PCTs) trusts still do not provide enough funding for IVF.

In some parts of the country couples are denied free IVF even when they are eligible for treatment.

Your GP may decide to refer you for IVF, but it is up to individual PCTs to decide whether or not to fund it on the NHS. Each course or cycle costs about £3,000.

Success is not guaranteed for those women who do receive the treatment. A woman in her early 40s has about a one in 10 chance of having a baby using IVF.

'Excuses'

Professor Adam Balen, of the British Fertility Society, said: "Excuses for not complying with NICE guidelines generally state that infertility is not a life-threatening condition, but this is unjustified: infertility causes psychological harm for many of the one-in-six couples it affects, and is recognised as a medical condition by the World Health Organisation.

New eligible groups added

  • Women aged 40-42 where there is no chance of pregnancy with expectant management ('absolute infertility') and where IVF is the only effective treatment
  • Gay couples - this already applies in Wales
  • Cancer patients
  • People with infectious disease such as HIV and Hepatitis B
  • Those with a physical disability who are unable to have intercourse

"Furthermore, many treatments are simple, cheap and effective and even the most high-tech IVF therapies can be provided in a cost-effective manner through NHS clinics.

"No-one who stands a reasonable chance at conception should be denied the opportunity, and these NICE guidelines outline how that can be achieved."

Susan Seenan, of the charity Infertility Network UK, said: "We must be clear: the current 'treatment by postcode' situation surrounding the treatment of infertility here has gone on for far too long and it is vital that PCTs act quickly - and act now."

'Best help'

The new guidelines stipulate how many embryos should be used for IVF treatment.

In 2004 it was recommended that no more than two embryos should be transferred during any one cycle of IVF. The new draft says single embryo transfer should be the norm in most circumstances.

IVF success rates (based on figures for 2008)

  • 33.1% for women under 35
  • 27.2% for women aged 35-37
  • 19.3% for women aged 38-39
  • 12.5% for women aged 40-42

And women will able to use frozen embryos for their free NHS cycle of IVF treatment.

Dr Gill Leng, deputy chief executive at NICE, said: "The aim of these new and updated recommendations is to ensure that everyone who has problems with fertility has access to the best levels of help. We are now consulting on this draft guideline and we welcome comments from interested parties."

In 2010, more than 47,000 women received fertility treatment.

During IVF, an egg is surgically removed from the woman's ovaries and fertilised with sperm in a laboratory. The fertilised egg, now called an embryo, is then returned to the woman's womb to grow and develop.

The success rate depends on the age of the woman - younger women are more likely to have healthier eggs, which increases the chances of success.

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