Doctors denying IVF in some parts of the country are "going against" the core principles of the NHS, one doctor has said.
Professor Gillian Leng, deputy chief executive at Nice
Infertility is a recognised medical condition that can affect people of any age and has a potentially devastating effect on people's lives.
It can cause significant distress, depression and can possibly lead to the breakdown of relationships.
Our updated guidance which published last year provides clear recommendations on the most clinically and cost effective way to treat people with fertility problems. Unfortunately, we know that not all areas are following our guidance to the letter.
This creates variations in treatment within the NHS, which...goes against the fundamental aims of the NHS.
- Couples should be referred to a fertility specialist after their first full year of unsuccessful attempts to get pregnant.
- They should be referred sooner if they know of a clinical cause behind their infertility.
- Women under 40 who have been trying to conceive are offered three full cycles of in vitro fertilisation (IVF).
- Patients aged 40 to 42 are offered one cycle.
- The quality standards also say that people who are of a reproductive age who are preparing to have treatment for cancer should be offered to have their eggs or sperm frozen and preserved.
The IVF postcode lottery on the NHS needs to end if couples struggling to conceive are to have fair access to fertility drugs, the health watchdog has said.
Treatments available to couples trying to get pregnant were set out by the National Institute for Health and Care Excellence (Nice) last year.
However, it has emerged many of the treatments are rationed or just not available from some health bodies, leaving some couples to pay thousands of pounds as they try to have a baby.
Nice recommended infertile couples where the woman is under the age of 40 are offered three full cycles of IVF treatment, but figures have shown health bodies are only offering one or none at all.
IVF pioneer Lord Winston has warned that a growing market for fertility treatments could "threaten our humanity" if the rich were able to pay for so-called 'designer babies'.
The fertility expert who developed key advancements in IVF treatment told academics at a conference "we have been carried away" by breakthroughs in reproduction.
The Daily Mail reported him as saying that enthusiasm to develop fertility techniques and desperate patients has become a "toxic mix".
During his speech at the University of Kent he said humans may end up with a society where some people may actually have something "that might threaten our humanity".
But Dr Allan Pacey, chairman of the British Fertility Society, said parents are not interested in enhancing their babies' genes.
"Most infertile couples are desperate for a baby, rather than a specific type of baby, and I don't see that changing."
Some 72% disagree with women using IVF to conceive a baby when they are passed their childbearing years, a poll has found.
Research, carried out alongside a documentary on older mothers, also showed how one quarter did not believe women should bring babies into the world past the age of 40 and men should stop at 43.
Over 2,000 people were quizzed across the UK and 31% of those said the current NHS limit for IVF, 42, is too old.
A further 26% supported lowering the age limit to 40 for either IVF on the NHS or private treatment.
When asked what was the ideal age for women to have their first baby, 27 was the most popular age.
A four-year old girl has been awarded £35,000 in damages after her mother was given abnormal donor sperm at a leading London fertility clinic, which may result in the girl facing fertility problems when she is older.
The child's mother attended the London Women's Clinic in Harley Street for IVF treatment using an anonymous sperm donor and gave birth to the baby girl in October 2009.
The four-year-old girl is healthy, but has a rare genetic defect that means she is likely to need IVF if she wants to start a family of her own, as she is at greater risk of miscarriage or giving birth to a child that suffers from severe disabilities.
The clinic's solicitor, Nico Fabri apologised to the mother and daughter for its duty of care failings at a brief hearing in London earlier today.
The mother's solicitor, Matthew Waite said: "My client understandably put her trust in the clinic and expected the care she was paying for to be of the highest standard."
"Choosing to undergo IVF with an anonymous sperm donor was not a decision I made lightly, but I believed the London Women's Clinic was one of the leading fertility centres in the country and I spent £30,000 with the clinic expecting a high-level service," said the mother.
Dr Allan Pacey, senior lecturer in reproductive and developmental medicine at the University of Sheffield and chairman of the British Fertility Society, said those embarking on IVF should feel reassured by the reports findings, he said:
This is a very important study which defines the risks of IVF children being born with two neurodevelopmental disorders. It is a large study and is exactly the kind we need if we are to give patients accurate information before they embark on treatment.
The main message of the paper is a positive one, suggesting that any risk of these disorders is very low, or absent, in comparison to children conceived naturally. However it does highlight the importance of preferentially using standard IVF rather than Icsi, and also using ejaculated sperm rather than those recovered surgically from the testicle, in situations where it is possible to do so.
Patients about to embark on treatment should not worry and should discuss any concerns about their treatment plan with the team responsible for their care.
Study leader Dr Avi Reichenberg, from the Institute of Psychiatry at King's College London, said:
Our study shows that treatments developed to manage male infertility are associated with an increased risk for developmental disorders in offspring.
The exact mechanism is unclear, but there are a number of risk factors, from selection of IVF procedures, to multiple embryos, and to pre-term birth.
Whilst intellectual disability or autism remain a rare outcome for IVF, being aware of the increased risk associated with specific types of IVF means offspring at risk can be identified and potentially monitored for developmental disorders, ensuring they receive early detection and appropriate support and care.
The researchers insisted the research should not hinder childless couples seeking IVF treatment.Co-author Dr Karl-Gosta Nygren, from the Karolinska Institute in Stockholm, said:
There's no question that we would stop any treatment or anything like that because of the findings. On the contrary, the results are reassuring.
It's important to remember that the majority of children are born perfectly healthily following IVF.
Our study provides much-needed information for parents and clinicians on the relative risks of modern IVF treatments, enabling them to make the most informed choice possible.
Compared with 'natural' conception, IVF overall had no effect on autism rates and led to a very small 18% increased risk of low IQ which appeared to be linked to multiple births.
The significant findings only emerged when researchers compared six different types of IVF involving the standard "mixing-in-a-dish" method of fertilising eggs or Intra-Cytoplasmic Sperm Injection (Icsi).
Icsi used with fresh or frozen embryos produced 51% more intellectually impaired children than standard IVF.
The direct injection method, Icsi, was originally developed to help infertile men, but it now makes up half of IVF treatments in the UK including those resulting from female fertility problems.
Certain forms of IVF treatment are significantly associated with an increased risk of low intelligence in children, a major study has shown.
A link was also found with an especially severe type of autism, but only in the case of twins or triplets.
Scientists who analysed data on more than 2.5 million births stressed that the chances of an IVF baby being affected remained tiny in real terms.
The Swedish study, published in the Journal of the American Medical Association, is the first of its kind to compare a wide range of IVF treatments.