A national consultation on NHS-funded
infertility treatment aimed at improving equality of access across Scotland
was launched today.
The consultation, which runs until December 8, will examine:
- Clinical criteria
E
.g should the (38 year-old) age limit for women
to receive infertility treatment be increased ?
- Social criteria
E
.g should priority for treatment be given to
couples who have no other children living in the home ?
- Other issues
E
.g what impact would widening the access criteria
have to NHS waiting times for treatment ?
Deputy Health Minister Lewis Macdonald said:
" Infertility affects roughly 75,000 couples in Scotland. Demand
for NHS-funded assisted conception has increased and we need to ensure
there is equal access for all regardless of where people live in Scotland.
_ We
have national criteria for accessing infertility treatment provided by
the NHS, and Boards are expected to follow this guidance.
However I am aware there is still some variation among Boards regarding
the provision of infertility treatment, and that not all Boards are following
this guidance as they should.
_ I also know there are differences
in criteria and waiting times for the most specialist treatments within
the four specialist centres
in Scotland. This is why we are launching a national consultation today,
with the aim of securing equity of access to high quality infertility
services across Scotland.
_ We want to seek views on what
changes are necessary to improve access to assisted conception treatment.
This
consultation is mainly
aimed at NHS Boards and service providers so we can examine the issues
that are preventing the implementation of consistent access criteria.
We also hope to find out why there are discrepancies in waiting times
across different areas in Scotland.
_ I am also keen to hear from
people who use infertility services and other interested groups. We are
asking questions to gauge people's
views on issues that may affect access to infertility treatment for women
in Scotland like age or whether their partner has a child who lives in
their home.
_ We are consulting widely in the
hope that we can secure an equal service for all in Scotland."
Infertility is defined as a 'failure to conceive after regular unprotected
intercourse for one or two years".
There has been no real increase in prevalence of infertility, but evidence
shows that more couples are seeking fertility assistance.
The Expert Group on Infertility Services in Scotland (EAGISS) set out
recommendations for national criteria for NHS-funded infertility treatment
in 1999. It was hoped the publication of the report would provide equity
of access to service and treatment. In 2000, the Chief Medical Officer
asked Boards to adopt this framework.
EAGISS criteria states a woman should be less than 38 at the time of
treatment. It also states that eligible women should be entitled to a
maximum of three assisted conception cycles.
Following one cycle of treatment, a couple should be able to undergo
successive cycles within a timeframe of their own choosing.
However more recently, guidelines produced by NICE in 2004 state the
age limit for women to receive infertility treatment should be 40 and
that cycles of treatment should be increased to five. Clinicians, NHS
Boards and service users will be consulted to find out what criteria
should apply in Scotland.
Access to infertility treatment is not currently covered by the waiting
times guarantee as it is measured separately from national waiting times
standards. Following this consultation on access criteria for NHS-funded
infertility services, the need to apply a target waiting time for tertiary
infertility treatment will be considered.
- A woman's age is the single most important variable that affects
the success of conception.
- Women aged 35 to 39 have a 50% less chance
of conceiving spontaneously than women aged 19 to 26 years.
- Approximately
30% of infertility is unexplained and the rest can be contributed
to ovulatory failures, low sperm count or quality, tubal damage
or conditions
such as endometriosis.
- Lifestyle factors such as diet, smoking
and substance misuse also influence a couple's chance of successful
conception.
There are four tertiary (specialist) centres in Scotland in Aberdeen,
Dundee, Glasgow and Edinburgh. These centres carry out procedures such
as In-Vitro Fertilisation (IVF) and Intracytoplasmic Sperm Injection
(ICSI) that require a licence from the Human Fertilisation and Embryology
Authority.
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was first released by the Scottish Executive
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