Many would-be parents are moving house in order to access free IVF on the NHS, sometimes saving themselves £10,000, according to the lead fertility doctor at the UK’s largest sperm bank.
Dr Raj Mathur, a consultant gynaecologist at Saint Mary’s hospital in Manchester, said he “constantly” saw patients moving house and/or GPs in order to get more free IVF cycles.
Mathur, whose clinic accepts NHS patients from 23 clinical commissioning groups (CCGs) across the north-west of England, said the geographical differences in funding were discriminatory.
“It’s a bloody nightmare, localism in the NHS. I’m all for centralisation. It’s a scandal because it should really be decided by the National Institute of Clinical Excellence [Nice] … They came up with national guidelines but everywhere in the country has its own version of those criteria,” he said.
Nice recommends that women aged under 40 should be offered three cycles if they have been trying to conceive for two years. Cost-cutting CCGs are defying advice set out by the government and NHS advisers.
“Some CCGs will specify that both should be childless; others will specify that there should be no children in that relationship … In my clinic Mrs Manchester will get one cycle and Mrs Rochdale will get three,” Mathur said.
Some borders between Greater Manchester boroughs are so tight that patients can be one house away from qualifying for extra NHS fertility treatment. Some streets in Bolton, which offers one free IVF cycle, turn into Bury (three free cycles) across the road.
Mathur said people constantly move house to register with a GP in another CCG: “You set up a game and people will play the game.”
Greg Horne, a consultant embryologist at Saint Mary’s, agreed: “It’s like if you try to find a house in the catchment area of a particular school.”
The average market price for a single cycle of IVF in a private clinic is £3,348, research by Opinium found. With just one in three cycles resulting in pregnancy, many patients spend in excess of £10,000 on three attempts or more.
“It’s discriminatory. It’s a classic example of a postcode lottery, it goes against evidence-based guidelines,” said Mathur, who is also secretary of the British Fertility Society.
Provision is being reduced as a cost-cutting measure in some areas and has been cut altogether in others. Mathur’s patients in most parts of Cheshire used to have three IVF cycles funded but as of last April are offered one.
Saint Mary’s, which was the first hospital in the UK to offer an NHS IVF service, is home to the UK’s biggest sperm bank. Working in partnership with a private American company, Fairfax Cyrobank, sperm from 100 American donors is held in a depot in Manchester.
The sperm is frozen in liquid nitrogen and flown over in “dry shippers”, which look like metal milk churns. It is then inserted directly into a woman’s uterus via a small catheter through the cervix – a process known as Intrauterine Insemination, IUI, which has a one-in-10 success rate – or is used for IVF where a woman’s egg is fertilised in a laboratory and is then returned to her womb as an embryo.
Like most fertility clinics, Saint Mary’s has faced a severe shortage in donor sperm since a 2005 change in the law giving children the right to know the identity of their donor once they reach 18. Donors cannot be paid more than basic expenses and can contribute to a maximum of 10 families.
In recent years, the hospital had just three regular donors on its books, all of whom were white. This was a problem as 20-25% of the hospital’s fertility patients are British Asians.
In Sunni Islam, sperm donation is forbidden “… so they wouldn’t have told people it’s a donor child, so it’s very tricky. There’s a red-haired gene that pops up in the caucasian population of the UK, for example,” said Mathur.
In 30 years working at the clinic, Horne said he could recall just one Asian donor. Ten of Fairfax’s current US donors are of Asian heritage and all have accepted that their donor children may contact them in adulthood.
Faye Penny is the donor coordinator at Saint Mary’s, and sits down with each patient to look through Fairfax’s online catalogue. They can search by detailed criteria including physical characteristics, personality, baby photos and can even hear his voice. “Most straight couples don’t want to see the photos,” said Penny. “Often all they want to know is the hair and eye colour and the ethnicity.”
Donor 4848 is 175cm tall and 90kg and is of Indian origin. His favourite animal is a hamster, he is Muslim, likes going to the theatre and reading.
Donor 5319 is described as: “Shy at first, he is insightful with a warm heart and caring spirit. He loves spending time around children and seeing the potential of the world’s future first-hand … Our staff consider him attractive, with a handsome face and a tall, athletic build.”
Penny believes that being able to offer patients a choice of donor without making them wait is important. “Previously, you didn’t know the donor was going to be available the next time someone came in, because they can only make 10 families.”
According to the Human Fertilisation and Embryology Authority (Hefa), more than 300,000 children in the UK have been born from licensed fertility treatment since 1991. Of those, at least 15,000 were born at Saint Mary’s in Manchester.