Rationing babies: IVF is still a postcode lottery

The true extent of the postcode lottery that blights the chances of IVF treatment for thousands of couples in Britain is revealed here for the first time. New data gathered from primary care trusts (PCTs) throughout the UK shows starkly that where you live determines your chance of getting infertility treatment on the NHS.

Childless couples in Scotland, where almost all PCTs routinely offer three cycles of IVF treatment – the nationally recommended level of treatment likely to result in successful conception – stand the best chances of pregnancy. Elsewhere in the UK, however, the picture for would-be parents is bleak, according to research by the charity Infertility Network UK.

PCTs in Wales, Northern Ireland and most of England offer just one cycle of IVF – far short of the three recommended by the National Institute for Clinical Excellence (Nice) five years ago – the charity says. It warns that many trusts frequently have strings attached to IVF that bar people unless they fit into narrow restrictions, such as age limits, weight, and bans on couples who smoke or who are not in a stable relationship.

The failure of most PCTs to provide adequate treatment for thousands of childless couples came under fire last night in a scathing attack by medical experts and politicians on the Government's failure to honour its pledge, made in 2004, that couples would be given three cycles of IVF treatment.

Norman Lamb, the Liberal Democrat health spokesman, said: "The postcode lottery is alive and kicking and is impossible to justify given the absolute clarity of guidelines on IVF. It is scandalous that so many PCTs are flouting the guidelines and... making a mockery of them in the process." He added that health trusts needed to be held to account and "exposed for their failure".

The current situation is unacceptable, according to Dr Allan Pacey, secretary of the British Fertility Society: "Five years is long enough for people to wait for the Nice guidelines to be implemented, and it's a disgrace that they still haven't been. If this had happened with other aspects of healthcare... there'd have been a major scandal."

The "unfair and unjust" system of treatment is resulting in thousands of couples being denied treatment that could help them have children, said Clare Lewis-Jones, head of Infertility Network UK, which has launched the www.fundingforfertility.com website to help people know what their situation is. "Sadly, access to NHS funding for fertility treatment is still a postcode lottery – right across the UK," she said. "This is affecting the lives of thousands of people – one in six couples seek treatment."

Health bosses are coming under increasing pressure to offer greater IVF treatment on the NHS, and there are signs of improvement in some areas, notably eastern England, which last week announced that from this month patients will be able to get up to three cycles.

Campaigners claim the criteria used to decide who qualifies for help need to be standardised. "It is the criteria to access treatment that varies enormously. It... leads to huge confusion and is basically unfair," said Ms Lewis-Jones.

Last year the Expert Group on Commissioning NHS Infertility Provision called on PCTs to make IVF treatment a higher priority. Next month, the health minister Dawn Primarolo is expected to launch a new guide to best practice, to encourage NHS commissioners to fully implement the Nice guidelines.

Almost 45,000 cycles of IVF are performed in Britain each year, but the shortage of NHS treatment means that around three-quarters have to resort to expensive private treatment.

A Department of Health spokesperson said last night: "Local variations in the provision of IVF cause distress to many childless couples," but insisted that there had been "significant improvements".

The lucky few: two families and their fight for treatment

The Powrie family, Gloucester

Lucy Powrie was able to get her IVF treatment funded by the NHS. "We weren't quite sure if we were going to get funding; we moved down from Scotland in July 2006 and we would have got three funded cycles up there. I was expecting a fight, but we were relieved when we were told we'd have one funded cycle."

Mrs Powrie was lucky. The 33-year-old fell pregnant after one IVF cycle in 2007. "People need to understand the pain that infertility brings with it, it's a huge loss, almost like bereavement, and to have got the funding and to have got Isaac was so wonderful," she said.

"I do feel very lucky, but it's not fair that some people have access to funded treatment... It does come down to desperation for some people who will even consider moving home to an area where there is NHS-funded treatment."

The Dawson family, Bracknell

Nicola Dawson, 35, was told she did not qualify for treatment because she was too young and had already had private treatment. "We found out that our primary care trust had added extra criteria on top of the Nice guidelines, which rendered us ineligible for treatment. We were lucky that we were able to borrow money to pay for private treatment, but it must be heartbreaking for people who are not able to have a child because they cannot afford to have treatment that they should be getting on the NHS in the first place," she said.

"Infertility is absolutely devastating. It really kicks you when you are down at your lowest ebb to then have somebody turn round and tell you that because you happen to live in a certain area, you can't have the treatment... I was very upset and angry about it all."