Number of NHS IVF procedures in UK down sharply, report finds | IVF

The NHS has dramatically reduced the number of IVF procedures it offers in the UK, leaving infertile women either unable to access treatment or forced to pay for it privately.

Just one in four IVF cycles (27%) in 2022 were covered by the health system – the lowest figure since 2008 and a sharp drop from the 40% it provided in 2012.

The sharp decline in recent years is revealed in the latest annual report from the Human Fertilisation and Embryology Authority (HFEA), which regulates fertility treatments in the four countries of origin.

Women desperate to have a child are facing a postal lottery when it comes to placement, linked to the fact that many people wrongly believe that childlessness is “a lifestyle choice”, experts say.

The National Institute for Health and Care Excellence (Nice) has called on the NHS in England to offer all eligible women three cycles of IVF. However, this rarely happens, and provision is patchy.

Dr Kevin McEleny, president of the British Fertility Society (BFS), said women were being hit hard by a huge variation in the availability of IVF, which was “heartbreaking and so unfair”.

“Cost reduction by NHS funding bodies which should implement the Nice IVF recommendations [means] Patients in one part of the country are unable to access NHS-funded fertility treatments, unlike people in a similar situation elsewhere in the country.

“Infertility is recognised as a health problem. Yet many people still view involuntary infertility as a lifestyle choice, and this attitude explains why the NHS fails to adequately fund the problem,” he added.

According to HFEA, the number of NHS-funded IVF cycles fell by 17% in England, 16% in Wales and 7% in Scotland between 2019 and 2022. The East Midlands of England saw the biggest decline over this period, down 48%, but in Yorkshire and the Humber it increased by 17%.

The BFS, which represents fertility specialists, is “very concerned that an increasing proportion of people are having to pay out of pocket for IVF treatment that they should be entitled to on the NHS. This risks creating a situation where only wealthy people can afford IVF. Are we saying that wealthy people are better parents?” McEleny said.

Expectant parents are selling their homes, cashing in their pensions, calling off weddings and maxing out their credit cards to fund private fertility treatments because of rising costs and inadequate NHS benefits, according to a report published last year by Fertility Network UK.

Patients of childbearing age are also starting treatment later. The average age at which women first have IVF has risen above 35, to 35.1, for the first time since records began in 1991, the regulator said. This is six years later than the age at which women first give birth in England and Wales, at 29, it added.

The trend is due to delays in accessing NHS gynaecological care during the Covid pandemic, people’s difficulties in funding fertility treatments and cuts to NHS IVF services, HFEA added.

However, Julia Chain, president of Hfea, warned women who delay seeking help are less likely to have a child. “The chances of having a child decrease rapidly with age,” she said.

McEleny added: “The age of first parenthood has been rising steadily since the 1960s, for both men and women, reflecting broader societal changes. [But] This worrying trend could have an impact on success rates.

The good news is that the proportion of women who become pregnant after IVF using fresh embryo transfers and their own eggs has reached 31%, a sharp increase from 21% in 2012 – “a tremendous result,” McEleny said. However, the chances are much higher for women aged 18 to 34.

The proportion of IVF pregnancies resulting in twins or other multiple births has fallen to 4%, the lowest level ever. HFEA welcomes the decline because multiple births carry a higher risk of late miscarriage, premature birth, gestational diabetes and other problems.

More broadly, the number of births in England and Wales – 598,400 in the year to mid-2023 – has fallen to its lowest level since 2002, according to figures from the Office for National Statistics published last week.

NHS England declined to comment directly on the reduction in IVF provision, but stressed that local health bodies should provide the three full cycles recommended by Nice.

A spokesperson said: “While these decisions are legally the responsibility of local health commissioners, it is absolutely right that they ensure equal access to services based on the needs of people in their area.”