An absolute postcode lottery: England's CCGs ration access to NHS-funded fertility treatment

The majority of England’s 106 clinical commissioning groups (CCGs) are rationing access to NHS-funded fertility treatment by introducing arbitrary, non-clinical criteria or redefining what constitutes an IVF cycle, according to new national audit data from leading patient charity Fertility Network UK.

The audit released at the start of National Fertility Awareness Week 2021 reveals a stark and damning picture of fertility care in England:

the majority of CCGs (89.9%) don’t offer the recommended three full IVF cycles to clinically eligible women under 40;
the majority of CCGs (72.4%) don’t offer the recommended one full IVF cycle to clinically eligible women aged between 40-42;
one in five CCGs (20.7%) have redefined what an IVF cycle constitutes and offer partial or reduced cycles instead of full IVF cycles where all fresh and frozen viable embryos are transferred;
over 90% of CCGs deny help if an infertile individual’s partner has a child from a previous relationship;
approaching one in four CCGs (23.3%) have introduced additional age hurdles for women, with six CCGs refusing to offer help to women over 35;
over two-thirds of CCGs (69%) refuse to treat single women; and
over a quarter of CCGs (26.6%) deny access to same-sex couples. Of the CCGs who do offer fertility treatment to same-sex couples, the majority withhold treatment until couples have proved their infertility by paying privately for six or 12 rounds of intrauterine insemination (IUI).

Gwenda Burns, chief executive of Fertility Network UK said: ‘Fertility patients in England are being failed by an absolute postcode lottery which denies them access to NHS-funded treatment and forces them to either find financially-crippling amounts of money for private treatment or endure the extreme distress of being childless-not-by-choice. This is cruel and unethical and a national disgrace for the country that pioneered IVF.’

‘Fertility Network UK is calling on Government to act now and end England’s postcode lottery. CCGs should not be able to ignore the evidence-based national guidance from the National Institute for Health and Care Excellence and instead implement their own completely arbitrary and non-clinical criteria or redefine what constitutes an IVF cycle. In National Fertility Awareness Week, it’s important to remember infertility is a disease and women and men who cannot become parents without medical help are as deserving of healthcare as others.’

The audit reveals that the north of England is the best place to live in terms of being able to access three full IVF cycles: all of the 14 CCGs offering this are in either the north west or the north east of the country. However, each of these CCGS then rations access in another arbitrary way, such as refusing to treat infertile individuals whose partner has a child from a previous relationship.