NHS shouldn’t fund IVF just because you want a baby
NEXT week, it will be 40 years since scientists first created life in a test tube — and IVF was born.
The first baby born from this revolutionary breakthrough, Louise Brown, now 39, has been speaking about the ‘devastating’ impact of the NHS rationing of fertility treatment.
She’s right, of course. Fertility treatment on the NHS is an iniquitous situation, because different health authorities sanction different numbers of treatment cycles.
Figures this week showed that just 12 per cent of areas in england gave the full three cycles of IVF treatment that NICE recommends. (In 2013, it was 24 per cent.)
Campaigners such as Louise Brown want it to be readily available to everyone who wants it. And while I understand this sentiment, it’s not a view I share.
Yes, the IVF postcode lottery is unfair on couples who are desperate to conceive, and I don’t for a second deny the heartache this can cause, but there’s another kind of unfairness here, too.
I’m afraid, as unpopular as this opinion may be, that in the real world of scant resources in the NHS, the desire to have a child simply because you want one is not something I think our health service should be prioritising.
A generation ago, infertility was a life sentence. Medicine could offer no help, and couples had to choose between adopting or remaining childless.
But with the advent of IVF, a whole industry has developed around fertility. IVF clinics are now established in most large hospitals, not to mention the array of private fertility clinics. It has all served to promote the idea that having a child is a right, not a biological privilege.
Any challenge to this is controversial, so sensitive is the subject matter to so many people and so strong the sense of entitlement.
But while IVF doctors champion their specialty and the incredible advances that have been made in recent years, many other doctors are more reticent about its widespread use in the NHS.
Those who work in services where funding is often tight, such as dementia care, cancer services and geriatrics, and who face having to make decisions based on cost, rather than what would really be best for their patients, question funding such procedures on the NHS when so many medications or treatments which could have a dramatic effect on people’s lives are denied because the money is not available.
And those, such as myself, who have worked with children in care, question the sense of bringing more children into a world where there are already so many who are desperate for a loving and stable family life.
BUT there’s another angle to all this that people rarely talk about, and that’s the psychological toll of going through IVF. Couples embarking on IVF can struggle to appreciate quite how gruelling, exhausting, frustrating and — for many — ultimately futile it will be.
even for those for whom it is a success, the toil of treatment — the unpleasant hormone injec- tions, surgery to retrieve eggs and then implant embryos, the weeks of waiting anxiously to find out if it’s worked — can leave nerves frayed and relationships on the rocks. I have two friends who are both now separated from their partners because of the strain of IVF treatment.
But because the technology exists, there is an implicit assumption that those who struggle to conceive will go down the IVF path.
It is sold as a definitive answer to infertility, when the reality is less straightforward. The brave new world of reproductive technology that was ushered in with the birth of Louise Brown promised a cure to the alleged blight of infertility. Yet this has not proved to be the case. IVF still fails more often than it works. According to the NHS, IVF is successful for about one-third of women under 35. This drops to 13 per cent in women aged 40-42 and to 5 per cent in women aged 43 to 44. That’s pretty poor odds for something that is so costly and so emotionally draining.
A study conducted nearly 20 years ago showed that after five years or more, couples still had significant psychological problems, and that this was most marked in those who did not conceive, thanks largely to the sense of failure that this brings.
For all the joy it has brought to some, IVF has also heralded an era where childlessness is seen as even more stigmatised. Sadly, I fear it often causes far more problems than it solves.