New criteria, designed to make access to fertility treatment fairer in Scotland, promises that women under 40 can have two cycles of IVF funded by the NHS. This follows further investment of £12 million over three years to drive down waiting times.
However, treatment will be limited to patients who are not obese, where neither partner smokes nor drinks alcohol before or during treatment.
The new guidance from the National Infertility Group also states that the couple should be in a stable, co-habiting relationship for at least two years before starting treatment. The group has since conceded, though, that this particular criteria may be difficult to police.
The new rules will effectively mean an end to Scotland’s IVF Postcode Lottery, with those areas already providing three cycles of IVF (currently half of all health boards in Scotland) similarly required to provide only two cycles in future.
The report reveals wide differences between boards in terms of waiting times. At the end of last year, these ranged from no waiting time in NHS Borders, to three to six months in NHS Orkney, Shetland and Western Isles, to a high of three years and eight months in Grampian.
Boards also often have different criteria dictating who is eligible for treatment. The guidance gives women a guaranteed maximum of two fresh cycles of IVF up to the age of 40.
The new guidelines also guarantee women aged 40 to 42 one full cycle of IVF if they meet extra criteria, which shows they would have a reasonable chance of becoming pregnant. From 31 March, 2015, all couples will start treatment within 12 months of being accepted for IVF.
The Scottish Health Minister, Mr Matheson, said: “Currently, the service and criteria offered to women vary across the country. This is not acceptable. For the first time, NHS provision of IVF will not vary, regardless of where you live.
“All patients in Scotland will have access to a more generous and fairer service than elsewhere in the UK.”
Opposition politicians welcomed moves to make access more equal, but questioned the drop in provision.
New rules include:
NHS IVF services are provided in centres in Aberdeen, Dundee, Edinburgh and Glasgow. The access recommendations for all couples from 1 July, 2013, are:
• Eligible patients up to the age of 40 may be offered up to two cycles of IVF where there is a reasonable expectation of a live birth.
• Both partners must be non-smoking for at least three months before treatment and continue to be non-smoking during treatment.
• Both partners must abstain from illegal and abusive substances.
• Both partners must be methadone-free for at least one year prior to treatment.
• Neither partner should drink alcohol prior to or during the period of treatment.
• Body mass index (BMI) of female partner must be above 18.5 and below 30.
• Neither partner to have undergone voluntary sterilisation, even if sterilisation reversal has been self-funded.
• Couples must have been co-habiting in a stable relationship for a minimum of two years.
• NHS funding will not be provided to couples where either partner has already received the number of NHS-funded IVF treatment cycles supported by NHS Scotland, regardless of where in the UK they received treatment.
• No individual (male or female) can access more than the number of NHS-funded IVF treatment cycles supported by NHS Scotland under any circumstances, even if they are in a new relationship.
• Patients should not be placed at the end of the waiting list following an unsuccessful treatment cycle.
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