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All eligible couples across Scotland will now be guaranteed fair, reliable and faster access to IVF treatment, Minister for Public Health Michael Matheson announced yesterday.

The guarantee comes as the National Infertility Group publishes a report with recommendations on new IVF criteria.

Ministers have agreed the Group’s recommendations and the changes will come into force on July 1, 2013.

The new criteria will, for the first time, unify NHS IVF services in Scotland and reduce current inequity of services and waiting times to 12 months by  March 31, 2015.

Further changes include:   

• A guaranteed maximum of two full cycles of IVF, as well as unlimited frozen transfers (if available) for eligible couples until the woman’s 40^th birthday.
• Where the woman is aged between 40 and 42, couples will be offered one full cycle of IVF provided they meet all necessary criteria and specific additional conditions. 
• From March 31, 2015 all eligible couples will start treatment within 12 months of being accepted for IVF treatment.
• Those currently awaiting treatment will be supported in making lifestyle changes.  Where the woman is obese she will be supported to lose weight and if either partner smokes they will be supported to stop smoking.  Couples will be placed on a holding list, returning to their original place for treatment once lifestyle changes are made.
• All couples seeking treatment from July 1, 2013, must meet the new criteria before being referred for IVF. Those who do not will be supported to make those lifestyle changes necessary.

A review will take place in early 2015 and will look at the implementation of new criteria, capacity and waiting times across Scotland.

Minister for Public Health Michael Matheson said:

“The Scottish Government is committed to providing fair, reliable and faster access to IVF treatment.  Currently the service and criteria offered to women varies 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 UK.

“We are investing £12 million over three years to help drive down waiting times for IVF treatments, and waiting times are already reducing in a number of NHS Board areas.  We also have to be responsible about the effects of smoking and obesity on pregnancy and beyond.  Smoking not only reduces the effectiveness of IVF, but also doubles the risk of pregnancy loss.

“NHS Boards will offer patients the support needed to make the lifestyle changes demanded of the new criteria.  The safety of mother and baby is of utmost importance and the recommendations will ensure healthier outcomes for both families and babies born as a result of IVF treatment.”

Ian Crichton, chair of the National Infertility Group, said:

“The National Infertility Group Report provides very clear guidance for quickly tackling inequity in the provision of infertility treatment in Scotland whilst improving its quality. Using the latest clinical evidence available we have done our best to balance the needs of couples & the resources available in recommending treatment that is both safe and effective.  Failure not only impacts NHS cost effectiveness, it has a huge emotional impact on those involved. Our recommendations will significantly improve the likelihood of a healthy birth with all the associated benefits that accrue.”

Gwenda Burns, Infertility Network Scotland said:

“Infertility Network Scotland are pleased to have represented patients on the National Infertility Group. It is crucial that we have Scotland wide criteria that will deliver prompt investigations followed by appropriate treatment within a time frame that ensures the optimum chance of success for the patient. It is our view that the work of the group and subsequent recommendations by the Minister will ensure that patients are treated promptly and fairly.”

Membership of the National Infertility Group included infertility experts, NHS Boards, Infertility Network Scotland and the Scottish Government. Full membership and remit is available in the final report.

NHS IVF services are provided in centres in Aberdeen, Dundee, Edinburgh and Glasgow.

Access criteria recommendations for all couples from 1 July 2013:

• Eligible patients may be offered up to two cycles of IVF/ICSI where there is a reasonable expectation of a live birth.
• Both partners must be non-smoking for at least 3 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.
• 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.
• NHS funding will not be provided to couples where either partner has already received the number of NHS funded IVF treatment cycles supported by NHSScotland 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 NHSScotland under any circumstances, even if they are in a new relationship.
• Fresh cycles of treatment must be initiated by the date of the female partner’s 40th birthday, and all subsequent frozen transfers must be complete before the woman’s 41st birthday.
• Couples must have been co-habiting in a stable relationship for a minimum of 2 years.
• NHS funding may be given to those patients who have previously paid for IVF treatment, if in the treating clinician’s view, the individual clinical circumstances warrant further treatment.
• Patients should not be placed at the end of the waiting list following an unsuccessful treatment cycle.

For couples where the woman is aged from the day after her 40^th birthday to 42 one full cycle will be offered if:

• They have never previously had IVF treatment
• There is no evidence of poor ovarian reserve and if, in the treating clinician’s view it is in the  patients’ interest
• There has been a discussion of the additional implications of IVF and pregnancy at this age.

Related information:

• National Infertility Group report