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Health Correspondent Richard Hannaford
"It's thought as many as one in seven couples have infertility problems"
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Professor Allan Templeton
"We are trying to ensure high standards across the country"
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Thursday, 20 January, 2000, 08:33 GMT
Call to end IVF 'lottery'

Only two embyros per woman, say experts

Fertility experts have called for everyone needing IVF treatment to have the same access to care on the NHS.

The guidelines on treating infertility - from the Royal College of Obstetricians and Gynaecologists - offer a blueprint for cost-effective fertility treatment across the UK, say infertility charities.

Because of the high cost of IVF treatment, the amount of help a couple receives on the NHS currently depends on where they live.

Some health authorities only allow one treatment to women under 36, while others allow two or three to women under 40.

IVF is expensive and carries risks for the woman
In addition, some couples are forced to pay thousands of pounds while others living a few miles away receive the treatment free.

Clare Brown, chairman of the National Infertility Support Network, said: "The government commissioned these guidelines as a first step - now they're here. We are waiting to see what the government does now."

The college says that the majority of health authorities do not yet "make adequate provision" for assisted reproduction treatments, and points out the unequal access across the country.

Professor Robert Shaw, its president, said: "I hope it will be possible to develop a national service framework so that equitable services can be provided on a nationwide basis."

Much of the infertility "best practice" suggested by the Royal College is already enshrined in the law which governs clinics offering fertility treatment.

The guidelines make it clear that counselling must be given to couples about the risks and chances of success of treatments.

They also call for the screening of egg and sperm donors for disease.

Older women

Doctors, it adds, must consider both the future "welfare of the potential offspring" and additional health risks to the mother before allowing women who are beyond the menopause to have fertility treatment using donated eggs.

It also advocates the implantation of only two embryos in younger women to avoid the risk of multiple births, particularly triplets.

This would ease the economic impact of IVF on the state.

Professor Allan Templeton, who chaired the group which produced the guidelines, told the BBC: "We are trying to improve treatment throughout the country, to improve availability, to make it more equitable in the provision of service.

"But we are also trying to improve initial management and investigation of the infertile couple.

"If you talk about IVF, the availability is very patchy to say the least in many parts of England. That is a sad situation compared to many European countries."

Susan Rice, chief executive of ISSUE, the National Fertility Association, said: "We need a national service framework put into effect backed up by the necessary funding, so that patients with infertility can have access to the treatment they need wherever they live regardless of the ability to pay."

The National Institute for Clinical Excellence, a body set up by the government to consider the cost-effectiveness of treatments, new medicines and medical equipment, is currently examining the evidence for and against fertility treatments.

It has the power to recommend that a treatment be NHS funded, but that must be endorsed by the secretary of state for health.

The Department of Health suggested last year that it would issue guidance to health authorities shortly after the release of the Royal College report.

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See also:
23 Aug 99 |  Health
Age limit for NHS fertility treatment
20 Dec 99 |  Health
Sperm and eggs: the legal background
31 Mar 99 |  Medical notes
IVF: The facts
27 Apr 99 |  Health
Aspirin 'doubles IVF pregnancy chances'
05 Nov 99 |  Health
IVF competition 'adds to birth risks'

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