NHS Or Private?
One of the main problems with fertility treatments is the cost. Just having diagnostic testing cost the NHS around £350 per couple ten years ago and costs have gone up considerably since then. Although some treatments can be relatively cost effective it is still a huge burden both for the National Health Service and for you as a couple if you decide to go private. This means that very often the treatment you are offered on the NHS is based on what is the most cost effective overall, not necessarily on what is most appropriate in your case. It can also vary a lot depending on where you live.
Decision Tree
The Health Service encourages GP's to use a decision tree as a way of deciding appropriate treatment for infertility. As the NHS has limited resources it is not possible to explore every type of treatment for every couple. By comparing costs of various treatments and their outcomes it is possible to work out which treatments will maximise the number of actual babies taken home by the most number of couples.
Not Only IVF
Everyone thinks of IVF when they think of fertility treatment but in actual fact there are many other options, depending on the reason for the infertility, so don't be surprised if you are offered something else first.
For example if you have blocked tubes an operation to clear them may enable you to conceive naturally. If your partner has problems with his sperm ducts a varicocelectomy may fix the problem. Leading a healthier lifestyle, taking vitamin supplements and learning about fertility awareness can also optimise your chances of getting pregnant naturally in cases of unexplained fertility. However if you have very severe endometriosis, IVF treatment may be your only option.
Treatment Guidelines
NICE (National Institute for Health and Clinical Excellence) guidelines say that infertile couples should be offered up to 3 cycles of IVF treatment. This costs the NHS around £15,000. But only about a quarter of NHS Primary Care Trusts offer this. For example in 2009 women living in the North Yorkshire and York PCT area were offered only one cycle of IVF treatment if they were between the ages of 39 and 40! A very restrictive policy lessening the chance of success as the older you are the less you are likely to conceive.
Other PCT's like those in Eastern England offer 3 cycles of treatment with up to six embryo transfers. Some PCT's insist that women lose weight and give up smoking before being eligible for treatment as this will improve the chances of conception. Some women who do lose weight and give up cigarettes, especially if their partners do too, are able to conceive naturally.
Going Private?
About 3/4 of infertile couples choose to go private as the waiting list on the NHS can be long and precious time can be lost. However, not everyone is in a financial position to do this. If you are thinking of going private ask about the 'baby take home rate' rather than the 'pregnancy rate'. This is very important as less than a third of women having fertility treatment, even under 35, actually take home a baby!
The other thing that is important to discover whether you go through the NHS or go private is how much experience your doctor has.
Lord Robert Winston, for example, Professor of Fertility Studies at Imperial College, is a world expert in fertility issues. A doctor trained by him and his team would give you a good chance of taking home a baby.
