Funding

Patients have the best overall chance of getting pregnant if the success rates from a single fresh embryo transfer are combined with any follow-on treatment using frozen embryos.

In addition, single embryo transfer (SET) will give your baby the best possible start in life by reducing the chances of being carried and born as a twin – multiple pregnancy is the single most serious risk to the health and welfare of children born after in vitro fertilisation (IVF).

Your clinic will discuss the most suitable treatment options for you to achieve the birth of a healthy child. They may suggest transferring a single embryo if:

  • your embryos are of good quality, healthy and likely to implant. 
  • there is a significant chance that you would be more at risk of a multiple pregnancy if you were to undergo double embryo transfer.

The expert says...

Clare Brown“At present, we have huge differences between Primary Care Trusts or Health Boards across the UK in access to NHS infertility treatment. It is therefore understandable that some NHS patients are resistant to the move to SET.

It is vital that ALL parts of the UK address this inequality as quickly as possible to offer patients – whether receiving NHS-funded or self-funded treatment – a fair chance of conceiving." 

Clare Lewis-Jones, Infertility Network UK

What about follow-on treatment?

Usually your treatment should include the freezing and storage of any remaining good quality embryos, and the transfer of these embryos, if the initial embryo transfer is not successful.

If you are receiving NHS-funded treatment, whether or not you have to pay for freezing and transfer of remaining embryos depends on the policy of your Primary Care Trust (PCT) or Health Board.

The National Institute for Health and Clinical Excellence (NICE) Clinical Guideline on Fertility treatment published in February 2004 states that a full IVF treatment cycle should include both the initial fresh embryo transfer and subsequent frozen embryo transfers.

If you are paying for your own treatment, it depends on the policy of your private clinic whether you have to pay separately for freezing and transfer of embryos. 

NHS-funded treatment

Eligibility for NHS fertility treatment varies depending on where you live in the UK. Check with your PCT/Health Board as to the criteria they have in place for accessing NHS-funded fertility treatment.

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Official guidance


England
At the time the NICE Guideline was published in February 2004, the then Secretary of State for Health, Mr John Reid MP, issued a statement on the same subject. He said that all PCTs in England were expected to provide 1 full cycle of treatment to all those fulfilling the criteria (women between the ages of 23 and 39), by April 2005. The NICE guideline defines a full cycle as including the freezing and replacement of suitable embryos not transferred during a stimulated IVF cycle.

John Reid also said that he expected PCTs to implement the full guideline (that is, 3 full cycles) in the longer term.

In a letter from Dawn Primarolo MP (Minister of State for Public Health) in July 2007 to PCTs, the Department of Health restated the NICE recommendation on what constitutes a full cycle. The letter also said “The department is looking to PCTs to move towards the provision of three full cycles of IVF, for those who need it, as recommended in the NICE guideline.” 

  • PCTs’ policies

    However, at present, the decision-making is carried out by each of the Primary Care Trusts (PCTs) and can vary from region to region. The definition of what is included in each cycle also varies. For example, treatment under some PCTs includes freezing, storage and transfer of frozen embryos, if the initial treatment with a fresh embryo is not successful, but other PCTs may not include this subsequent treatment.

    Your GP can give you the contact details for your local PCT, who will be able to advise you of their funding criteria, or you can contact the PCT direct. You can find contact details for your local PCT in your local telephone directory or by visiting your local council’s website.

Wales
From April 2010 eligible patients in Wales can receive two full cycles of IVF/ICSI  (in vitro fertilisation/intra-cytoplasmic sperm injection) on the NHS. As in England, there are eligibility criteria to access NHS treatment. For more information on the criteria, contact your health board.

Scotland
In Scotland, eligible patients can receive two or three fully funded IVF/ICSI cycles.

Northern Ireland
In Northern Ireland, only one fresh cycle of IVF/ICSI is available. Eligibility criteria vary regionally, for example, in Northern Ireland those with a child from a previous or current relationship are allowed access to treatment.
• See the INUK website for more information - INUK website - funding factsheet

Privately funded treatment
Because clinics' costs are not regulated, prices can vary widely, especially in London.

When discussing prices with clinics, find out exactly what the price includes. For example:

  • some clinics may include blastocyst culture, freezing, storage and transfer of frozen embryos, if the initial treatment with a fresh embryo is not successful in their overall price; others may not. 
  • fertility drugs are usually extra, and can be very expensive.

Your clinic should give you a personalised costed treatment plan that sets out what is included in your treatment and any possible changes and cost implications. Make sure you establish exactly what your treatment includes before you begin, to avoid any unwelcome surprises later on.

  • Find out more about private treatment on the HFEA website – HFEA website
     

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