Fertility treatment `unfair and chaotic'

National Health Service funding of fertility treatment is "chaotic, patchy" and amounts to "treatment by postcode" according to new research.

Despite an increase in the number of health authorities offering treatment on the NHS, a couple in Scotland wanting in-vitro fertilisation (IVF) are seven times more likely to be successful than a couple in the South and West region, while partners in Northern Ireland have no access at all to NHS funds.

One in six couples experience difficulty in conceiving at some point in their lives, and the largest number of fertility problems are unexplained. For those who choose IVF the live birth success rate is 14.1 per cent per cycle.

The report, commissioned by the National Infertility Awareness Campaign (Niac), found that the number of health authorities that formally purchase infertility services has increased from 21 per cent in 1993 to its current level of 65 per cent, an increase Niac thinks is partly due to the reorganisation of health authorities last April.

But the divide between those authorities funding increasing levels of fertility treatment and those that fund little or no treatment has increased. Whilethe proportion of health authorities funding more than 20 cycles of IVF per 100,000 population has almost doubled, the proportion of those refusing to fund any form of assisted conception has not changed.

The majority of authorities reported no change in funding since last year although one in five reported an increase. Despite an increase of 15 per cent in IVF rates to 9.3 treatment cycles per 100,000 population in 1996, as opposed to 8.1 treatment cycles per 100,000 in 1995, the rates of IVF treatment are still well below the recommendations given in a 1992 report of 40 IVF treatments.

The most generous region listed in the latest report was Scotland, with 29.3 IVF treatments per 100,000, followed by the North West which funds 15.9. Only four regions funded more than 10 cycles per 100,000 population. The lowest rates were found in the West Midlands (5.2), South and West (4.2) and Northern Ireland (0).

Eligibility criteria have become more uniform among health authorities, with the majority specifying a maximum age for the woman of between 35 and 40. Some authorities still only fund treatment for people who have lived within their area for a specified period.

Clare Brown, chair of Niac, said: "The great divide between the health authorities is worrying. Although we are pleased that some health authorities are increasing the amount they already spend in infertility services, we are extremely saddened that there are many health authorities who refuse to fund treatment.

"We are still having to deal with a chaotic, patchy `treatment by postcode' method of deciding who can and who cannot have their infertility treated by the NHS.

"This is obviously totally unfair, unacceptable and a desperately unhappy situation for the couples this affects."

Susan Rice, chief executive of the national fertility association Issue, described the situation as "abhorrent". She said: "Issue calls on health providers to stop this `trade in babies' and consider the detrimental effect infertility has on all areas of people's lives."