«Breaking Pic News» Desperate mothers are 'putting their health and their babies at risk' because of IVF rationing

Desperate mothers are putting the health of themselves and their babies at risk because of IVF rationing, fertility experts have warned.

Couples are increasingly being limited to one round of fertility treatment or forced to fund it themselves amid cutbacks by NHS chiefs.

The rationing is leading many couples to 'taking risks' by asking for multiple embryos to be implanted to improve their chances of conception either in the UK or abroad, where treatment is less regulated.

Officials say the cuts are having 'unwitting consequences' on both mothers and their children, as twin pregnancies have far higher complication rates.

A joint report led by regulator the Human Fertilisation and Embryology Authority warned rationing treatment was costing the NHS money in the long term due to increased care costs.

Couples are increasingly being limited to one round of fertility treatment or forced to fund it themselves amid cutbacks by NHS chiefs

It has led to calls from the Royal College of Obstetricians and Gynaecologists to follow the example of Sweden by slashing the proportion of multiple IVF births from 11 per cent to less than five per cent.

Twin pregnancies were seven times more likely to result in stillbirth with babies born 10 times more likely to need neonatal care than babies born in single pregnancies, the report found.

Mothers are 2.5 times more likely to die during labour, with babies from multiple pregnancies far more likely to be born by emergency caesarean.

There is also a greater risk of miscarriage, pregnancy-induced high blood pressure, pre-eclampsia, gestational diabetes compared with single pregnancies.

Sally Cheshire, chairman of the HFEA, said: 'These decisions are about life and death… the commissioner [must] understand the cost of making those [funding] decisions. 

'This report is intended to inform commissioning decisions so that the risks to patients and costs to the NHS are minimised.

'There isn't enough funding going into IVF and what is spent we don't believe is being spent effectively. 

'We understand CCGs are cash-strapped but funds that aren't directly spent by them may come back to their local area through increased costs on local trusts because of multiple births, or through mental wellbeing in people who are denied a family.'

The report by the British Fertility Society, the Multiple Births Foundation, and Fertility Network UK and compiled by the National Guideline Alliance, part of RCOG, analyses the costs associated with multiple pregnancies.

WHEN IS IVF OFFERED?

IVF is only offered on the NHS if certain criteria are met. If you don't meet these criteria, you may need to pay for private treatment.

In 2013, the NICE published new fertility guidelines that made recommendations about who should have access to the treatment on the NHS in England and Wales.

However, individual NHS Clinical Commissioning Groups make the final decision about who can access it in their local area, and their criteria may be stricter.

According to NICE, women aged under 40 should be offered three cycles of IVF treatment on the NHS if:

• they've been trying to get pregnant through regular unprotected sex for two years


• or they've not been able to get pregnant after 12 cycles of artificial insemination

If you turn 40 during treatment, the current cycle will be completed, but further cycles should not be offered.

If tests show that IVF is the only treatment likely to help you get pregnant, you should be referred for IVF straight away.

Source: NHS Choices

It found twin pregnancies are almost three times as expensive as single pregnancies, rising from £4,892 to £13,959 because of the costs incurred during procedures such as emergency c-sections and neo-natal care.

At present, multiple births occur in 1-2 per cent of natural pregnancies and 11 per cent of assisted conceptions.

It suggests a 10 per cent reduction in the twin pregnancy rate from its current level would lead to a saving of £15 million to the NHS.

It said the aim of all IVF treatment should be the birth of a single healthy child and that local health bodies should encourage this by ensuring that eligible couples with fertility problems are given access to the recommended three cycles of IVF treatment, in line with NICE guidelines.

Professor Lesley Regan, president of the Royal College of Obstetricians and Gynaecologists, said: 'Transfer of multiple embryos is often performed during IVF due to a perception that this will increase the chances of success.

'However, developments in IVF technology and practice have improved the live birth rate for single embryo transfer, allowing success rates to increase while lowering the multiple birth rate and associated complications.

'The multiple birth rate in the UK in 2016 had fallen to 11 per cent; however, further action is needed to lower the rate even more to be in line with other countries such as Sweden, which achieved a multiple birth rate of 4.9% in 2011.

'The RCOG has been calling for government funding of three full IVF cycles - as recommended by national guidelines - since it is regarded to be the most important factor in maintaining low rates of multiple pregnancies following treatment and reduce associated complications for mothers and their babies.

'This would provide a greater incentive for IVF centres and their patients to adopt single embryo transfer more regularly.

'Reducing multiple pregnancies would significantly improve the health of mothers, their babies and families, take pressure off NHS services and contribute to national financial savings.' 

Aileen Feeney, chief executive of Fertility Network UK, said: 'We are concerned that further progress will be limited if the lack of access to NHS fertility services in England continues to drive patients overseas for fertility treatment - where different regulations around the number of embryos that can be transferred means the risk of multiple pregnancies is much higher.

'We urge the Government to commit to funding the recommended treatment of three full IVF cycles for clinically eligible women under 40.' 

The organisation said in England 88.5 per cent of local health bodies do not provide the recommended three full cycles of IVF.

Dr Jane Stewart, chairman of the British Fertility Society, said: 'There remains a drive for patients to consider 'taking a risk' when they are self-funding complex treatment to complete their much-wanted family.' 

HOW DOES IVF WORK?

In-vitro fertilisation, known as IVF, is a medical procedure in which a woman has an already-fertilised egg inserted into her womb to become pregnant.

It is used when couples are unable to conceive naturally, and a sperm and egg are removed from their bodies and combined in a laboratory before the embryo is inserted into the woman.

Once the embryo is in the womb, the pregnancy should continue as normal.

The procedure can be done using eggs and sperm from a couple or those from donors. 

Guidelines from the National Institute for Health and Care Excellence (NICE) recommends that IVF should be offered on the NHS to women under 43 who have been trying to conceive through regular unprotected sex for two years.

People can also pay for IVF privately, which costs an average of £3,348 for a single cycle, according to figures published in January 2018, and there is no guarantee of success.

The NHS says success rates for women under 35 are about 29 per cent, with the chance of a successful cycle reducing as they age.

Around eight million babies are thought to have been born due to IVF since the first ever case, British woman Louise Brown, was born in 1978.

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https://hienalouca.com/2018/09/04/desperate-mothers-are-putting-their-health-and-their-babies-at-risk-because-of-ivf-rationing/
Main photo article Desperate mothers are putting the health of themselves and their babies at risk because of IVF rationing, fertility experts have warned.
Couples are increasingly being limited to one round of fertility treatment or forced to fund it themselves amid cutbacks by NHS chiefs.
The rationing is...

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Dianne Reeves Health HienaLouca





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