Posts Tagged ‘postcode lottery’

Accessing fertility treatment on the NHS is a question of ticking the right boxes.  We haven’t been able to have a second child, despite trying for the last three years.  I have had to go through undignified testing, including a laparoctomy and I have been diagnosed with ‘unexplained infertility’ which effects around 10% of couples who have been trying for a baby for more than a year.  The recommended action for this is In Vitro Fertilisation (IVF), only I’m not entitled to funding for this because we already have a child together. 

NHS resources are finite, and I’m not complaining that we’re not entitled.  It is disappointing, and it’s hard to decide whether to pay for private treatment.  It costs around £5,000 with a 1 in 3 chance of success.  Should we spend this on trying to give our daughter a brother or sister, or should we keep hold of the money to make sure she is financially secure in later life?  Of course, we are extremely fortunate to be able to make this choice – £5,000  is out of the range of many couples I know.

What is horrifying though is how eligibility criteria varies throughout the country.  Tory MP Grant Shapps has 3 children thanks to IVF and he contacted every single PCT in the country in June last year to find out their policy.  He found that two PCTs were refusing to offer IVF at all. 80% of PCTs aren’t providing the three IVF cycles set out in NICE guidance in 2004.

Shapps found that in one area, a woman would be too young to be considered, and in others the same woman would be too old.   For instance, in Lincolnshire, IVF is funded if the mother is aged under 35, in Hampshire and the Isle of Wight, it is only funded to women aged over 36 (despite the fact that IVF is significantly less effective each year after a woman turns 35).  In Wiltshire, there was a very narrow window for having fertility problems – you had to be aged 31-35 to be offered assistance.

More than half of trusts wouldn’t fund IVF to people who had previously had treatment and 1 in 6 wouldn’t offer it to people who’d had privately funded IVF before.  These inconsistencies mean that as well as the added trauma of not being able to plan your family in the way you assume you will, you are also at the mercy of rules seemingly made up at random with no medical thought put into them.  The full report is available here  if you want to read up further.

This isn’t the first time we’ve experienced fertility woes. When my husband and I first decided to have a family, I assumed I’d be pregnant within a couple of months.  All the other women in my family had got pregnant straight away – sometimes without meaning to – and I’d never had any reason to suspect I’d be any different. You could set your calendar by my periods and I was starting reasonably young, at 28.

I did get pregnant quite quickly, but sadly lost the pregnancy at nine weeks.  I was still optimistic, I read all about miscarriage and I knew that first pregnancies carried a higher risk of miscarriage than subsequent pregnancies. As four more early miscarriages followed, each taking their own emotional toll, I tried to ignore that the chances of never having a baby were increasing.  I eventually went to my GP and was referred to a miscarriage specialist.  I was so lucky, he was an amazing man.  Unlike many of the consultants I read about on fertility forums, he had a genuine interest in keeping pregnancies going and didn’t just fob me off to try again.

After a battery of tests, he deduced that the likeliest reason for my pregnancies failing was that the placenta didn’t form properly and needed drugs to improve the conditions.  When I got pregnant again, I was closely monitored and with the help of progesterone and heparin I gave birth to a beautiful baby girl exactly three years after I first started trying and two weeks shy of my husband’s 40th birthday.  Nothing prepared me for the joy of watching her sleeping face and the feel of her skin against mine.

I was so lucky to live near to a leading fertility hospital and that my PCT paid for this.  I have no doubt that without this help I would have gone on to have further miscarriages and it’s very possible that my little girl wouldn’t be sitting next to me now eating her breakfast.

I have heard it said, in real life and reading the comments on the bottom of newspaper articles, that fertility treatment shouldn’t be funded by the NHS at all.  Leaving aside the moral question of whether children are a right or a privilege, the emotional impact of infertility can not and should not be underestimated.

I grew up in a big family and pictured myself as the mother of a big brood; laughing and joking on days out, serving long breakfasts at the weekends and my husband and I holding hands and watching proudly as our children left home and it was extremely difficult to come to terms with none of this happening. Looking to a future with no children seemed so bleak.

Comments from friends and relatives that couples with no children had the happiest marriages, that God would give us a child when the time was right and that if all else failed we could always adopt, were really not helpful, no matter how good the intention behind them.

It was after the last miscarriage that things got very dark.  I’m sure it was partly hormones, I was bursting into tears all the time, I lost interest in a job I’d previously enjoyed and had all the guilt that entailed, I couldn’t hear about anyone else getting pregnant without thinking ‘What about mmmmmmmeeeeeeeeeeeeeeee?’ .  I know from talking to other couples with fertility problems that I am not the only one who begged her partner to leave her so he could have children with someone else.

In fact, it’s only recently that I was able to tell my husband that during a mad moment, I considered throwing myself in front of the train I was waiting for on the way to work.  It wasn’t thinking about him or my family that stopped me doing it either, it was the fact the train was coming in too slowly and I didn’t think it would kill me.  At that moment life seemed so futile and I seemed so pointless.

I think it’s irrelevant that in the past people have had to get on with it if they couldn’t have children.  We have made medical advances that mean that no one should have to feel like I did.  If you can’t offer IVF to every childless couple, at least make the system fair!


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