By: 20 November 2017
Number of CCGs offering three IVF cycles has halved since 2013
The number of clinical commissioning groups (CCGs) in England offering the recommended three IVF cycles to eligible women under 40 has halved in the last five years: just 12 per cent now follow national guidance, down from 24 per cent in 2013. In contrast, the number of CCGs which have removed NHS IVF has almost doubled in the last year, according to latest figures released at the start of National Fertility Awareness Week by campaign group Fertility Fairness.
Fertility Fairness’ 2017 audit of England’s 208 CCGs reveals the severity of disinvestment in NHS fertility services, with potential further cuts ahead. While the number of CCGs following national guidelines and providing 3 NHS-funded IVF cycles has dropped to 12 per cent, the number of CCGs offering just one NHS-funded IVF cycle has leapt to 61 per cent (from 49 per cent in 2013), and there are now 7 CCGs that have removed NHS IVF (3.4 per cent). In 2015 the number of CCGs offering 0 cycles lay at 1 per cent, since then this figure has tripled. 7 per cent of CCGs are currently consulting on removing or reducing NHS fertility treatment.
Fertility Fairness’ data also reveals the best and worst places to live in England in terms of ability to access NHS IVF treatment, and for the first time provides the data in a league table of 17 ranked positions, so patients can see how their CCG compares to the rest of the country. The top 4 areas (ranked position 1) are all in Greater Manchester: Bury, Heywood, Middleton and Rochdale, Tameside and Glossop, and Oldham – the birth place of IVF 40 years ago. The worst areas (ranked position 17) do not offer any NHS IVF: Herts Valleys, Cambridgeshire and Peterborough, Croydon, South Norfolk, Basildon & Brentwood, MidEssex and North East Essex.
There is a striking north-south divide in terms of NHS IVF provision. Just 24 CCGs offer 3 cycles: 21 of them are in the north. The 3 in the south are Thurrock, Camden and Luton.

As well as cutting the number of IVF cycles offered, CCGs are finding alternative ways to reduce provision. National Institute for Heath and Clinical Excellence (NICE) guidelines recommend that eligible couples should have access to 3 full IVF cycles, where a full cycle of IVF treatment is defined as one round of ovarian stimulation followed by the transfer of all
resultant fresh or frozen embryos. However, approaching half of all CCGs (49 per cent) use their own definition of what constitutes a full IVF cycle – and only transfer a finite number of embryos, rather than all resultant embryos.
Some CCGs stipulate entirely arbitrary age criteria for access to NHS IVF, in contravention of NICE’s guidelines stating that eligible women under 40 should be offered 3 full IVF cycles and eligible women aged 40-42 should be offered 1 full IVF cycle. Approaching half of all CCGs (48 per cent) do not offer NHS IVF to women aged 40-42; 10 per cent of CCGs refuse access to NHS IVF if women are over 35. And a few are currently consulting on proposals to only offer NHS fertility services to women aged between 30-35.
Sarah Norcross, co-chair of Fertility Fairness said: ‘The scale of disinvestment in NHS fertility services is at its worst since NICE introduced national fertility guidelines in 2004. Fertility Fairness is calling for full implementation of the NICE guidelines, standardisation of eligibility criteria across England and the development of a national tariff in England for tertiary fertility services – eliminating regional cost variants and removing a key barrier to CCGs’ compliance with national guidelines.’
Susan Seenan, co-chair of Fertility Fairness and chief executive of patient charity Fertility Network UK, said: ‘This National Fertility Awareness Week we are commemorating 40 years of IVF, 40 years of a life-changing technology pioneered in England. However, that achievement means nothing if only those who can afford private IVF benefit. The Government should be ashamed that, after 40 years of IVF, it is your postcode and your pay packet, and not your medical need, which are the key determinants of whether you will be able to try IVF.’

Source: Fertility Fairness