Assisted conception review - engagement exercise
Emailed questionnaire for: Sussex, Kent and Medway patients and public stakeholders
What this questionnaire is for:
This questionnaire is part of a review of assisted conception policy in Sussex, Kent and Medway. This review is being undertaken in the light of the
latest National Institute for Health and Care Excellence (NICE) Clinical Guideline 156 on Fertility which came out in February 2013 (called “New NICE” in
the questionnaire) and the requirements of the Equality Act 2010. The New NICE guideline replaces their previous guideline issued in 2004, and is
different both in terms of their scope and the recommendations they make. This has implications for current local policy and eligibility criteria, which were
largely based on the 2004 NICE guideline.
Because of this, the NHS Clinical Commissioning Groups (CCGs) in Sussex, Kent and Medway (who are responsible for deciding on the provision of
services in their local area) have commissioned the Kent and Medway Commissioning Support Unit (KMCS) to work with clinicians and patients to review
the local policy about assisted conception.
CCGs will need to make decisions about how best to meet the assisted conception needs of the local population and the needs of the local population in
general. A number of factors will need to be taken into account, such as the new NICE recommendations, local capacity and resources, population needs
and the views and experiences of local clinicians, stakeholders and patients. This is a complex task and will take some time to work through.
What we would like to know from you:
We would value the views of patients about how best to meet the assisted conception needs of the local population and to assist us in this decisionmaking process. We are particularly interested in what you think are the relative priorities for local assisted conception services. Please go through the
tables in Parts 1 – 3 below. All responses will remain confidential.
ART questionnaire for patients and public 2013 - HPSU©
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Part 1 - Information about you
Your age:
Your gender (M/F):
First part of postcode where you live (e.g.ME20):
Have you or your partner had assisted conception treatments
before? If yes, please answer additional questions below:
What treatment(s) did you or your partner receive?
At which clinic(s) did you or your partner receive
treatment?
How were the treatment(s) funded (NHS or private)?
Which year did you have the latest treatment?
Part 2 - Relative priorities for local assisted conception services in Sussex, Kent and Medway
Instructions: Overleaf (on page 3) you will find a list of components of assisted conception services and salient points relating to the new NICE guidance.
Please read the information overleaf then answer the four questions in the table below
Which components do you think are the top three priorities
for inclusion in local policies?
1.
2.
3.
Why do you feel these should be the top three priorities?
Which components do you think are the least essential for
inclusion in local policies?
1.
2.
3.
Why do you feel these are the least essential components?
ART questionnaire for patients and public 2013 - HPSU©
1.
2.
3.
1.
2.
3.
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Component
Salient points about new NICE
a.
Referral criteria for IVF

Patients be referred to IVF (± ICSI) after two years of unexplained infertility (rather than three years in previous NICE and
locally)
b.

Offer three full cycles of IVF (± ICSI) for women under 40 years.
c.
Number of IVF cycles
offered
Age range


No lower age limit for referral
Offer one full cycle of IVF (± ICSI) to women aged 40-42 years (if: not had previous IVF and there’s no evidence of low ovarian
reserve)
d.
Surgical sperm retrieval

Surgical sperm retrieval prior to ICSI should be considered if needed
e.
Donor sperm for donor
insemination

Offer a minimum of six cycles of unstimulated donor IUI for couples with a number of male sperm conditions or high risk of
genetic disorders or infectious disease transmission
f.
Donor eggs for use in
IVF

Use donor eggs for women with relevant ovarian disorders (such as premature ovarian failure) or women with a high risk of
transmitting a genetic disorder.
g.
Donor embryos for use in
IVF

New NICE does not mention the use of donor embryos for use in IVF. (a woman can receive a donor embryo that was spare from
another woman’s treatment).
h.
Provision of IUI for wider
patient groups

New NICE recommends considering unstimulated IUI as an alternative to vaginal sexual intercourse, if relevant, for:
- People with physical disabilities or psychosexual problems and
- People in same-sex relationships
i.
Surrogacy

New NICE does not mention the use of surrogates. (Surrogacy means a ‘surrogate mother’ will receive an IVF embryo from
another couple and carry it till the baby is born).
j.
Fertility preservation for
patients undergoing
gonadotoxic treatments

Offer freezing (cryopreservation) of eggs, sperm or embryos for patients who wish to retain fertility after undergoing
treatments that might affect their fertility e.g. chemotherapy
Cryopreservation for 10 years initially, and longer for sperm
Sperm washing

k.

New NICE has recommended the provision of sperm washing in couples with an HIV positive man who is not compliant with
HIV therapy or who has a high blood viral load
Glossary:
IVF = In Vitro Fertilisation, IUI = Intra Uterine Insemination, Unstimulated IUI = IUI without having ovary stimulating drugs beforehand, ICSI = Intracytoplasmic Sperm
Injection (to help the sperm penetrate into the egg), Embryo transfer = putting the embryo back into the woman’s uterus, Sperm Washing = technique used to reduce the
risk of transmission of HIV from an HIV positive man to an HIV negative woman who are trying to conceive, Gonadotoxic treatments = treatments that might affect fertility
e.g. chemotherapy
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Part 3 - Other comments on the local service
Instructions: Please answer the questions below
Any other general comments about
provision of assisted conception
services locally
Equality issues – do you have any
comments on how the local service
can meet the needs of people with
protected characteristics (listed
below*)?
* The new Equality Act 2010 means that the NHS must show due regard to equality issues in its policies and practice. There are nine ‘protected
characteristics’ in the Equality Act: age, gender, race, disability, religion / belief, sexual orientation, gender re-assignment, pregnancy and maternity and
marriage / civil partnership.
Thank you very much for taking the time to answer this questionnaire.
All responses will remain confidential and will only be used to analyse responses.
Your answers will be considered carefully as part of the policy making process.
Please now save the document and send the saved version to: spctc.KSSHealthPolicySupportUnit@nhs.net
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