Susan Seenan is Chief Executive at Infertility Network UK and Co-Chair of Fertility Fairness which campaigns for people to have comprehensive and equal access to a full range of appropriate NHS investigations and treatments for infertility
From my own experience, I know how difficult it can be finding out that you can’t conceive, and the agony and heartbreak that brings cuts right to heart of what it means to be human. Being able to reproduce is a basic biological function, but the impact of infertility is not just a physical one. Infertility can have a huge emotional and psychological impact, for men as well as for women, and then finding out that you can’t access the treatment which could help because of your postcode can be devastating. The question which should be asked is ‘would someone benefit from the treatment’ not ‘where do you live’.
And yet across England that is the question being asked of couples who need help to conceive. For far too many people. Their postcode is the primary driver behind whether they can access fertility treatment and it has to change. In Scotland, Wales and N Ireland access to treatment is not perfect, but it is at least equitable. In England, there is a national recommendation from the National Institute for Health and Care Excellence (NICE), backed up by a recent NICE Quality Standard, for eligible couples to receive up to three full cycles of treatment; the reality however is that the Clinical Commissioning Groups are free to decide whether they think fertility treatment is a local priority. Many of the commissioners making these decisions simply do not understand the clinical, or indeed the economic need, to provide fertility treatment and decide to only offer one or two cycles. Even those which offer three cycles place additional restrictive social criteria on couples, effectively denying them access to treatment which they could potentially access if they lived elsewhere. How unfair is it to tell a patient with a diagnosed fertility problem that she can’t access treatment because her partner has a child from a previous relationship when that ‘child’ is 25 and doesn’t even live in the UK? Or to tell another couple whose home address comes under one CCG which funds three cycles that they can’t access treatment because their registered GP a few miles away falls under a CCG which funds no fertility treatment?
I am one of the lucky ones who finally became a mother after struggling with fertility problems. I got the chance to try IVF. I want to see all others in need have the same opportunities. On the wall in my office, I have a quote from a patient pinned up: ‘I can accept failure; everyone fails at something. But what I cannot accept is not trying.’ People deserve the right to try, to access the treatment that can help them become parents. That’s why we need to end this postcode lottery, and ensure that everyone who should be able to access treatment can do so.