FERTILITY TREATMENT: WHERE CAN YOU GET HELP?
It is not easy to get fertility treatment on the NHS and sometimes only drug treatments are available. A study carried out by University College Hospital and Medical School in London showed that 75 per cent of couples end up on long NHS waiting lists and would choose to go privately if medical insurance companies would foot the bill. The best system is in France where the state pays for four IVF cycles. In Germany the couples are allowed four and 30 per cent of the cost is paid for by the state and the rest made up by the insurance companies. The availability of NHS treatment can often depend on where you live. There are no central guidelines. Some couples I see have had a number of IUIs on the NHS, and others who have gone privately for IVF have had their fertility drugs funded by their GP. There are also some non-profit-making clinics where the cost is much lower than private IVF clinics.
Choosing a Clinic
In the UK, all clinics offering assisted conception have to be licensed by the HFEA, Human Fertilisation and Embryology Authority. The HFEA produces ‘league tables’ showing how successful the clinics are – essential reading for all couples deciding where to go for treatment. CHILD also produces a helpful booklet called Choosing a Clinic.
If you are going privately, remember that you are a paying customer and you want the service that suits you best. Some couples prefer a small intimate clinic, where they see the same professionals at each visit. Others prefer a large clinic, headed by a well-known name who you may or may not see. This can be more impersonal and it is likely that you will see different doctors each time you go. Some couples say that, in a big clinic, they feel as if they are on a conveyor belt. Others prefer this. It’s best to get brochures from a number of clinics and visit up to three of them to decide whether you would feel comfortable being treated there. Convenience also has to be a factor because you will be going quite a few times and you don’t want to travel too far.
Success Rates
Each clinic releases its own statistics but you can’t really compare them because they are often calculated differently so that you’re not comparing ‘like with like’. The HFEA guide, on the other hand, presents standardized statistics, the most important of which is the ‘take-home baby rate’ per treatment cycle. If the pregnancy rates alone are compared these can look very impressive. But these would tell you nothing about what happened later – the rates of miscarriage, ectopic (tubal) pregnancies, and any other problems that meant the pregnancy did not continue.
The other point to bear in mind is that, since the publication of these HFEA ‘league tables’, some clinics have become more selective in their patients. If they take everybody, including ‘older’ women and other complicated cases, their position in the league tables may be affected.
Some clinics are more honest and upfront than others in telling a couple that, in view of their medical history, they have an extremely small chance of getting pregnant. Others will take anybody who is willing to pay.
Useful Questions to Ask the Clinic
• What tests and treatments are provided?
• Do they specialize in any particular type of infertility?
• Are there any restrictions (e.g. due to age or previous treatments)?
• How often will you have to attend the clinic?
• Is counseling provided and is it included in the treatment costs?
• Are there any hidden costs, such as diagnostic tests or anesthetic charges?
• What is the up-to-date take-home baby rate?
• What is their success rate like for a woman the same age as you? (Some clinics have more experience with ‘older’ women.)
Ask each clinic the same questions and compare the answers. You can visit them or some clinics will answer these questions over the phone. The HFEA publishes a patient’s handbook which will help you to compare the different clinics. You really want to get as much information as possible so that you can get the best treatment to suit your individual needs.
Before You Start
Embarking on IVF treatment is a big step, both financially and emotionally, so it- needs to be thought out carefully. Many couples are not aware of the amount of time it is going to take up, the physical effects of the drugs on the woman’s body, and the emotional roller-coaster that it will put them through.
The success rate for IVF is around 20 per cent, which means that 80 per cent of treatment cycles will fail. This success rate is the same for each cycle and is not dependent on how many cycles you have had already. The odds are the same as if you toss a coin. If you have tossed four heads, there is still a 50:50 chance that the next one is going to be another head.
Some couples can feel under pressure to have one IVF cycle after another. Sometimes this pressure comes from the clinics, especially if the woman is ‘older’. However, with the quantities of drugs that are used and the emotional ups and downs that can be experienced, together with the effects of these drugs on your system, it is better to have a break, say two or three months, between attempts and let your body get back to a natural cycle before it is bombarded again.
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Tags: Women’s Health