Couples in Norfolk and Suffolk denied fertility treatment based on age or if 'overweight'
PUBLISHED: 21:03 29 October 2018 | UPDATED: 21:05 29 October 2018
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Couples in Norfolk and Suffolk are being turned down for fertility treatment because men are too old or overweight, it can be revealed.
Data released by campaign group Fertility Fairness found clinical commissioning groups (CCGs) in the two counties would not give treatment such as IVF or intracytoplasmic sperm injection (ICSI) to women with a body mass index (BMI) of more than 30, or men with a BMI of more than 35.
And in some areas if the man was aged over 55, that would also make the couple ineligible for free treatment.
Fertility Fairness said this “arbitrary criteria” should not be used to restrict access and did not form part of the National Institute of Health and Clinical Excellence’s (Nice) fertility guidelines.
As well as introducing extra “access to NHS IVF” criteria, all of the CCGs ration NHS fertility services by refusing to provide the recommended three full IVF cycles.
In south Norfolk would-be parents cannot get any rounds of IVF on the NHS, while in the rest of Norfolk and Suffolk two rounds are on offer.
Nice recommends Government funding for three full IVF cycles, but funding varies across the country and access is often described as a postcode lottery.
It means six out of 10 IVF cycles in the UK are funded by patients themselves, according to the Royal College of Obstetricians and Gynaecologists (RCOG).
Fertility Fairness co-chairwoman Sarah Norcross 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. What criteria will CCGs introduce next - star signs and shoe size? CCGs need to remove their extra ‘access to IVF’ criteria now.”
Both Suffolk CCGs capped a man’s age limit to be eligible at 55 , while in Norfolk and Waveney there was no cut off.
However in four areas (all of Suffolk, Great Yarmouth and Waveney, and West Norfolk) if a man had a BMI of more than 35 it would rule the couple out.
In all areas the woman must have a BMI of between 19 and 30.
But Nice said this was only used as guidance as to how successful IVF might be, and not as access criteria.
Mike Macnamee, chief executive of Bourn Hall Clinic, which provides both NHS and private fertility treatment in Wymondham and King’s Lynn, said: “Some conditions associated with sub-fertility make it very difficult to reduce weight – a woman with polycystic ovaries (20pc of IVF patients) will find it very difficult to loose weight due to their hormone balance. A high BMI in women hoping to become parents with IVF treatment will marginally decrease the likelihood of success but more importantly may make pregnancy and childbirth more medically challenging.
“High BMI in men is likely to reduce their sperm count but not significantly enough to affect the likelihood of success with IVF treatment.
“At Bourn Hall we often see the distress of fertility patients who are ineligible for NHS funded treatment. The differing criteria between CCGs has resulted in a postcode lottery for our patients and we would welcome a single set of fair criteria applied throughout the country”.
Nice recommends that IVF should be offered to women under the age of 43 who have been trying to get pregnant through regular unprotected sex for two years, or who have had 12 cycles of artificial insemination.
But the final decision about who can have NHS-funded IVF in England is made by CCGs, and their criteria may be stricter than those recommended by Nice.
Aileen Feeney, co-chairwoman of Fertility Fairness and chief executive of the 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.”
She added that anyone affected can join Fertility Network’s #Scream4IVF campaign, which is calling for fair access to IVF in the UK. A petition is available to be signed at www.scream4IVF.org.
An NHS England spokesman said: “Ultimately these are decisions for local GPs who rightly decide how best to balance the various competing demands on the NHS.”
While a spokesman for the Suffolk CCGs said they “sympathetically consider” requests for IVF and policies were developed alongside Suffolk Public Health and GPs using the available clinical evidence and clinical opinion.
He said: “This criteria for eligibility ensures that our limited healthcare resources are put to the very best use and benefit those patients with the best chance of success. At no point are these policies used to discriminate.”
A spokesman for the Norfolk and Waveney CCGs said: “The NHS Clinical Commissioning Groups in Norfolk and Waveney have each determined clinical criteria for assisted conception, according to their local circumstances. Clinical criteria is based on many factors, including providing the best outcomes for their population within the resources available. There are no changes to these.”
How reliable is a BMI score?
Body mass index (BMI) has long been used to find out how healthy a person is, based on their weight, height, and age.
It was first created in the 1800s and by the late 1900s had been adopted by governments as a way to assess weight.
But researchers and health experts have increasingly said it is not the perfect measure. A 2016 study by scientists at UCLA found tens of millions of people whose BMI showed they were overweight or obese were perfectly healthy.
But they also found 30pc of people with healthy BMI scores were not actually in good shape.
One of the issues is BMI cannot distinguish between fat and muscle, so many fit people are labelled as overweight.
But many doctors also say it is the best measurement available and is mostly accurate.
Tim Cole, professor of medical statistics at University College London Great Ormond Street Institute of Child Health, said BMI was “still extremely relevant”.