Thursday, 21 February 2013

"Lesbians to get free IVF treatment"

You may have seen an awful lot publicised yesterday in the UK press about the new guidance for fertility treatment, which has been extended to include lesbian couples, older women (over 40), diasbled couples and those with a HIV-positive partner. Whilst this may seem like a huge step forward in equality, after all, lesbian couples cannot pro-create without assistance and therefore will require some form of fertility treatment, the startingly inaccurate portrayal of what these guidelines actually state has really surprised, and annoyed me!

The National Institute of Clinical Guidance, the governing body who publish all guidelines from which all individual trusts in the UK write their guidelines for clinical practice, originally published guidelines for Fertility; assessment and treatment, in 2004.
Embedded within this were the suggestions that lesbian couples with KNOWN and PROVEN fertility issues that prevented them from concieving from artificial insemination alone may be eligible to apply for funding for IVF on the NHS. They also had to be in a legal partnership to be eligible.

Therefore, a couple who had formed a civil partnership, and had tried home insemination / unmedicated insemination in a clinic for at least 6 consecutive months, had then been referred for fertility testing and it had been found that she had polycystic ovaries or endometriosis, for example, would be eligible to apply for funding. However, many PCTs (Primary Care Trusts) also put on the added block of writing in to their guidelines that any couple who required donor gametes, e.g. donor sperm, were automatically excluded from funding. Lesbian couples were therefore in a no-win situation, and although there has been a few cases of lesbian couples taking their PCTs to court to fight for funding in this instance, the vast majority of couples have deemed this fight to lengthy and financially draining, choosing instead to put their money towards private treatment.

As is a requirement of any clinical guidelines, whether they be issued by NICE or by local hospital trusts, written in to them must be a date by which the whole guideline will be reviewed and updated, thus ensuring any guidelines include the most up-to-date evidence. And hence, on the 18th February this year, NICE released their updated version of the same guideline. And guess what? The guidance has not changed! The guidelines still state that lesbian couples with known and proven fertility problems may be eligible to apply for funding on the NHS for IVF, providing they have a proven record of attempts to concieve. The guidelines have, however, been extended to include the option of unmedicated IUI (inter-uterine insemination) for same-sex couples, however the cost of the donor sperm will not be met, and therefore all the clinic will do is do the physical insemination. But remember that clause that states couples who require donor gametes will not be eligible for funding? So again, a no-win situation.

As someone who takes a keen interest in the area of fertility, and the childbirth continuum as a whole, the mis-representation in the UK press, yet again, of NICE guidance frutrates me no end. It gives false hope to couples who will read headlines and make appointments at fertility clinics only to be told "sorry, no", and adds more fuel to an already temperemental fire surrounding the issues of same-sex marriage and families. Those who were busying themselves strongly opposing equal marriage a few weeks back are now jumping back on their soapboaxes in response to the headlines.
Just a few of the headlines yesterday.
On a personal level, this guidance won't affect us, having never been under any illusions that our treatment would fall under the NHS funded category. We are prepared to pay for private treatment in order to fund our future family, as I hold the very personal view that having a family is a privilage, not a right. The NHS wasn't set up to fund IVF any more than it was set up to fund boob jobs!

Yes, heterosexual couples recieve limited amounts of free IVF treatment, but only when they have a fertility problem, the same as lesbian couples. But that's an argument for another day! In the meantime we are looking to the future and preparing our bodies for the treatments they will soon undergo - cutting down on caffeine, ensuring my BMI is in the normal range, cutting out alcohol (not hard, we rarely drink anyway!) and ensuring our lives are as stress-free as possible. Funnily enough all of these points are made in the NICE guidance as assessment criteria before treatment will be considered, but you don't see headlines of "overweight / those who smoke / those who drink too much coffee will not be offerred IVF treatment" do you?!

In short, as present, unless you have a medical fertility issue, you can pretty much bank on not recieving funding: which is fine in our eyes - surely dreams are worth saving up for?

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  1. In Finland, single women and lesbian couples can't get any funding for fertility treatments, either...I've gone through a couple of rounds alone but have had to stop now because I ran out of money. About 1200€/try for IUI...And around 2500€/try for IVF plus the very expensive meds.

  2. It's funny, because different PCT's have different rules regarding lesbian couples. Here in Edinburgh we're really lucky because lesbian couples (who have a CP) can have up to three IUI's and three cycles of IVF. Obviously, you still need to pay for the sperm / storage and some of the drugs (I think) but it does lift the burden a little bit. However, like you guys, I think that when we want to have kids we'll end up going privately, simply because going via the NHS means you have to follow their timetable, and waiting lists are already pretty long. Oh, and the media portrayal of the 'change' in guidelines pisses me off too - it's all about sensationalising headlines.

  3. Hey there! Just found your lovely blog! I live in the US and I am fortunate enough that my insurance covers me for some ivf and since I'm a Lezzie they file me under "unexplained infertility" ha! Also since our marriage isn't recognized here, we get to file individually and use twice the amount of insurance. We are doing reciprocal ivf so this really helps! Stop by sometime

  4. We have been doing the "at-home-method" with a donor from an internet site. We saw this as the only chance we have for a family.
    We cannot afford private care and from what we can tell have no chance of recieving any funding or help from the nhs. Although we have booked an appointment with the GP to see what he can do for us?
    I think its very unfair that many lesbians (we have been in a CP for 2 years and together for 6 years.) who want a normal life to include a family, have to try to concieve in what i see as a seedy and unsafe procedure that we are having to go through monthly.
    Can anyone offer words of guidance or advice for us? Its really taking its toll now

    1. Hi Lisa,
      if the at home method isn't working for you, it may be because you have a fertility problem - talking to your GP is a good idea, as you may be entitled to help/funding. As we say in this post, being in a same sex couple is not classed as a reason for free/discounted ivf (annoyingly) but having a fertility problem is.
      Good luck with your journey!
      S xx

    2. It may be worth looking at having the sperm looked at by a clinic to make sure the swimmers are actually swimming? Last time I looked it was £95 think that was MFS (online). Not a bad price to pay for knowing its worthwhile continuing.

  5. As a lesbian with several pre existing medical conditions, I'm very uncertain about whether or not I would be able to have any financial support from the NHS. On top of IVF, I would need pre implantation genetic diagnosis to ensure non of my illnesses were passed onto my child. I guess only time will tell...

  6. I could cry. we tried to get funding a year ago and they turned us down. makes me really mad the letter I got bk. if I could afford to go for treatment to prove we have tried then why am I going to the NHS, DUH!, we have a new donor and are trying again at home. but if this don't work I don't know what I am goin to do. id rather die than not have a family. I want it more than I can say. sure I could save up but by the time I have done that a few years would have gone by and id have no money and I wouldn't want to have a kid with nothing to back me up. really wish I wasent gay some times. and may the people who decided all this rot in hell for all time.
    Faye xxx


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