South Central Specialised Commissioning Group
Proposals to change the assisted conception policy outcome of public engagement
Public engagement
The period of public engagement on proposals to change the eligibility criteria for Assisted
Conception Services1 closed on 17 April 2009. We would like to thank everyone who
responded and also the local media for their interest and help.
The NHS across South Central has sought to involve local people and key stakeholders
and seek their views on access criteria for assisted conception services. The involvement
exercise was launched by the Specialised Services Commissioning Group (SCG) on
behalf of all of the Primary Care Trusts (PCTs) in South Central. The SCG is a decision
making body comprising representatives of the nine Primary Care Trusts across the NHS
South Central which includes Berkshire East, Berkshire West, Buckinghamshire,
Hampshire, Isle of Wight, Milton Keynes, Oxfordshire, Portsmouth and Southampton
PCTs.
For the South Central as a whole, over 500 responses were received from the public (466
from residents in the region) through the on-line questionnaire. Written responses were
also received from local MPs, clinicians and treatment providers, national charities, and
the local authority Health Overview and Scrutiny Committees.
Response to the public engagement period
The public responded to ten questions related to each of the proposed changes. The
feedback on the proposals was reviewed by the Specialist Commissioning Group and as a
result amendments have been made to four of the original recommendations.
The revised recommendations are as follows:
1. Will there be immediate access to service for those with a diagnosed cause of
infertility?
The original proposal was that was that all couples should have infertility of at least
three years duration before becoming eligible for NHS funded IVF regardless of
whether they have a diagnosed cause of infertility. During the engagement period
many people expressed the view that there should be immediate access to services for
couples with a diagnosed cause of infertility. The recommendation been changed to
reflect these views and it is now proposed that couples with a diagnosed cause of
infertility which completely prevents natural conception will have immediate access to
IVF if the other criteria for accessing service (including the age range) are met.
Couples who might be infertile, but no cause for their infertility can be found, will need
to continue to try for a baby for three years before NHS treatment is considered.
1
In-vitro fertilisation (IVF); egg and sperm donation; intra-uterine insemination (IUI); In-vitro maturation (IVM); egg,
sperm, gamete and embryo freezing and storage (cryostorage); sperm washing for HIV infected patients; surgical sperm
retrieval.
2. Will sperm and egg freezing and storage be funded?
Currently, the techniques for egg freezing and storage are not nearly as effective as
those for sperm and embryos. However, the feedback received suggested that new
techniques are currently being sought. It is therefore recommended that, whilst egg
freezing and storage should not be funded at present, the evidence should be kept
under regular review, and the policy amended if appropriate. Sperm storage will
continue to be funded for men about to undergo treatment liable to make them
permanently infertile.
3. Will Inter-uterine Insemination (IUI) be funded?
The original proposal was that IUI should no longer be available. However, new
information was provided, and it is now recommended that a further review is
undertaken in 2009-10 to establish the effectiveness of IUI. Depending on the outcome
of this review the policy on IUI will be reconsidered in 2010-11.
4. Will surgical sperm retrieval be funded?
The original proposal was that this service should not be provided. However, on the
basis of new information and evidence provided by clinicians, it is now recommended
that surgical sperm retrieval is made available to appropriate patients.
Six of the commissioning proposals remain unchanged. These are:
5. At what age can women access the service?
The proposed age range gives access to assisted conception treatment to women
aged 30-34 to reflect the evidence that IVF is most effective in those under age 35.
6. How long will the NHS fund frozen embryos for?
The NHS will fund the storage of frozen embryos for up to three years, or until the
woman’s 40th Birthday (whichever is sooner).
7. Will the NHS fund one cycle of treatment for all couple who meet the eligibility
criteria?
One NHS-funded fresh cycle of IVF will be available for patients who meet the eligibility
criteria even if they have previously self-funded up to two cycles.
8. Will the NHS fund IVF using donated eggs?
Donated eggs (available through the Human Fertilisation and Embryology Authority
(HFEA) UK licensed centres only) will be funded for eligible patients where appropriate.
9. Will the NHS fund fresh and frozen cycles of IVF?
Only fresh cycles of IVF will be funded.
10. Will the NHS fund sperm washing?
Sperm washing will not be commissioned.
How a final decision will be made
The Specialised Commissioning Group will meet in July to finalise these proposals which
will be reported to the Hampshire PCT Board (as the organisation that hosts the SCG) at
its meeting on 23rd July. Once recommendations are finalised an implementation date will
be agreed to ensure appropriate transitional arrangements are in place