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Parenting

NHS outrages straight women by asking for proof of ‘a stable relationship’ before IVF, but queer folk have it much, much worse

Lily Wakefield August 20, 2020
NHS IVF queer women

Same-sex couples must pay huge amounts of money to "verify" their infertility. (Envato)

The revelation that women in opposite-sex relationships are being asked for proof of a “stable relationship” to access IVF on the NHS in England is causing outrage, but queer folk are being forced to shell out thousands before they can access the treatment.

New research from the British Pregnancy Advisory Service (BPAS) has highlighted a “systemic problem” with NHS-funded fertility treatment, revealing a “postcode lottery” that has seen some women asked for proof that their opposite-sex relationships are “stable”, and others being turned away based on their BMI (body mass index).

The BPAS investigation looked into the provision of fertility services by all clinical commissioning groups (CCGs) across England, and found that policies varied drastically and often contradicted National Institute for Health and Care Excellence (NICE) recommendations.

While NICE advises that women under the age of 40 be offered three full cycles of IVF, and those aged 40 to 42 be offered one cycle, 80 per cent of CCGs in England were not abiding by those guidelines.

The research found that 24 CCGs required women to be in “stable relationships” to access NHS-funded fertility treatment, and 96 per cent of CCGs enforced BMI restrictions, rules which are not recommended by NICE.

Dr Marta Jansa Perez, director of embryology at BPAS, told iNews: “Access to any form of healthcare should be rooted in clinical evidence.

“Sadly, this report demonstrates that for most patients in need of fertility treatment, this is simply not the case.

“It is deeply unfair that systemic problems with funding have effectively created a fertility pot-luck, with devastating consequences for some patients.

“People living just a few streets apart are facing a gulf between them when it comes to the care they are entitled to – and that care could change the course of the rest of their lives.”

Queer women in same-sex relationships are forced to spend thousands of pounds on fertility treatment before ever getting IVF funded by the NHS.

However, queer women in same-sex relationships face much greater obstacles to starting a family via fertility treatment, a fact that was covered in the BPAS research but was largely ignored by the media and those outraged by the report.

Same-sex couples are disproportionately affected by the varying rules surrounding NHS-funded IVF, as the treatment is not offered on the NHS to those without fertility problems.

NICE guidance suggests that a mixed-sex, cisgender couple should be referred for IVF after two years of unprotected intercourse that has not resulted in a pregnancy, although the BPAS investigation found that 12 per cent of CCGs required a period of at least three years.

This waiting game, while undoubtedly agonising, is free.

On the other hand, those who do not or cannot have penis-in-vagina sex are forced to “verify” their infertility to get any help from the NHS, even when fertility is not the problem, which often means first spending thousands of pounds on artificial insemination.

According to the report: “This sometimes applies to heterosexual couples for whom vaginal intercourse is difficult or impossible, but mostly it is a requirement of same-sex female couples and single women.

“CCG policy requires single women or same-sex female couples to undergo six to 12 cycles of artificial insemination (AI), of which six are often required to be intrauterine insemination, (IUI) before their infertility can be determined.”

A cycle of artificial insemination costs on average between £350 and £1,000, and while around a third of CCGs offer a “portion” of funding towards this cost, the majority (54 per cent) provide no help whatsoever.

The report added: “Additionally, the live birth rates for AI and IUI treatments per cycle are around half that of IVF, and also lower than normal conception rates – placing single women and same-sex couples at further disadvantage.”

The authors of the BPAS investigation concluded: “This status quo is antithetical to the most fundamental principle of the NHS, that care should be provided according to each patient’s clinical need and not their ability to pay.

“This mantra is enshrined in the NHS constitution, but it is sadly not manifested in the provision of fertility services.”

More: artificial insemination, CCGs, clinical commissioning groups, fertility treatment, infertility, Intrauterine Insemination, IUI, IVF, NHS, queer women, same sex couples

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