Coronavirus sees women in 40s denied IVF treatment
Women are being denied the chance to become mothers because NHS commissioners are ignoring guidance to extend IVF deadlines for those who passed the age threshold during the pandemic.
The upper age limit on fertility funding, ranges from 34 to 42-years-old for female patients, but delays associated with coronavirus have left some women ineligible for funded treatment.
NHS England in combination with the Nice and the Human Fertilisation and Embryology Authority (HFEA) recently issued a statement calling for ‘special consideration’ for those who faced delays.
But 50 out of the 136 Clinical Commissioning Groups (CCGs) in England have still not brought in an extension, with most saying the rules are being applied on a ‘case by case’ basis.
It means that many women have been left in limbo, not knowing if their treatment will be continued.
Steve McCabe, MP for Birmingham Selly Oak, who tabled an early day motion on the issue, said: “Infertility is a medical condition recognised by the World Health Organisation but for too long treatment has been rationed by accountants seeking to trim CCG budgets.
“No one should miss out on vital treatment because they no longer meet arbitrary age criteria due to delays caused by the pandemic.
“If it was cancer treatment there would be uproar. Advice and guidance is not enough, I am urging the Health Secretary to instruct CCGs to Stop The Clock for fertility patients. It is the right thing to do.”
Fertility clinics were closed for several weeks during the height of the pandemic and despite being allowed to reopen from May, many are still operating a reduced service, leaving patients facing long delays.
Freedom of Information (FOI) requests submitted by British Pregnancy Advisory Services (BPAS) before the recent intervention from NHS England show that CCGs were adopting vastly different approaches, with some offering extensions and others stating that no exceptions to the age limit will be made.
But The Telegraph found that none of the CCGs have changed their stance since new guidance was issued.
For some women, the postcode lottery means neighbouring areas have brought in extensions while their own borough is sticking to the old rules. While many of the London boroughs are allowing extension, City and Hackney, Tower Hamlets and Newham say they are deciding on a case-by-case basis. Likewise while women in Hull have been granted an extension, those in North Yorkshire and Sheffield CCGs cannot automatically continue with treatment.
In Scotland, Wales and Northern Ireland, there have been commitments to extend patient age limits and ensure patients will remain eligible for NHS-funded care despite the delays caused by the pandemic.
The BPAS has found that the delay in accessing treatment, and uncertainty about their ability to qualify for treatment, are causing significant harm to some patients’ emotional and mental wellbeing.
A recent survey found that patients reported feeling worried (78 per cent) and upset (78 per cent) during the time that clinics were closed, with more than 50 per cent reporting bad or very bad sleep during that period.
Carla, 41, of Leicestershire, started her IVF journey in May last year with her husband, who suffers male infertility, but is concerned that delays mean she will not begin a cycle until March 2021.
Under rules in Leicester she must complete the process before the age of 43 or funding will run out but there have been constant delays because of the pandemic. The CCG only allows one round of IVF.
Carla’s husband has undergone a course of antibiotics, sperm analysis and surgery to remove a vein, but the couple are running out of time.
“We’re now in limbo land,” she said. “We have to wait three months to see if the operation has been successful. My maternal age is getting older and it has taken quite a lot of pushing to see specialists and get tests done.
“I could have done IVF by now and had the baby in the time between all the faffing.
“Fertility treatment is bad enough without another layer of covid and there is now a question mark about me having endometriosis but the wait time for an operation is 12 months, so I’ve been advised to just go ahead with IVF.”
Guidance released by NHS England states: “We encourage CCGs to continue to take account of NICE guidelines and adapt the referral pathways – giving special consideration to the need for flexibility and sensitivity at this time for individuals whose waiting times, investigations or planned treatment have been disrupted due to COVID-19, ensuring that all women and their partners seeking fertility treatment are treated fairly.”
Marta Jansa Perez, Director of Embryology at BPAS, said: “It’s great to see the HFEA, NHS England and NICE offer clear guidance on this issue, to ensure patients’ needs are met by CCGs.
“In England we already have an injurious postcode lottery system whereby certain patients are denied IVF purely because of where they live.
“This leaves many no option but to privately fund their treatment. It’s against the most basic principle of the NHS – that care should be provided according to need and not ability to pay. We can’t allow the same approach in our response to the pandemic.
“I really hope all CCGs in England will heed this advice and stop the clock. Fertility patients have been hit hard this year – this is the least they deserve.”