Army&You’s guide to IVF

Following our article IVF and Army life in the autumn Army&You, we look at the criteria and entitlement for Armed Forces families living in different areas of the UK…

Women under 40 years old should be offered two full cycles of IVF if they have been trying to get pregnant through regular unprotected sexual intercourse for a total of two years or if they are using artificial insemination to conceive and have not become pregnant after 12 cycles (at least six of these cycles should have been using intrauterine insemination).

If a woman has had any previous cycles of IVF (including cycles paid for by the couple themselves) will count towards the two cycles that should be offered by the NHS. If a woman turns 40 during a cycle of IVF, she can finish the current full cycle but should not be offered further cycles.

However, they will still be able to have any frozen embryos transferred from their most recent episode of ovarian stimulation since these count as part of the same full cycle.

The same criteria regarding regular unprotected sexual intercourse and artificial insemination also apply to women aged 40–42. They should be offered one full cycle of IVF if in addition, they have never had IVF treatment before; their fertility tests show that their ovaries would respond normally to fertility drugs; they have discussed the risks of fertility treatment and pregnancy in women 40 years or older with their doctor.

IVF criteria

• One partner should be serving and registered with a Defence Medical Services (DMS) practice
• The female partner should be under 43 years of age
• Female weight (BMI) should be more than 19 and less than 30
• Male BMI should be less than 30
• No living children from the current relationship including adopted children but excluding fostered children
• No children from previous relationships
• Non-smokers
• Written consent for treatment is required by both partners
• Neither partner should have been sterilised.

For more information, visit:

http://www.england.nhs.uk/wp-content/uploads/2013/11/N-SC037.pdf

In Northern Ireland, NHS-funded IVF is limited to those who have a medical cause of infertility. Couples need to have been trying to conceive for a year to be diagnosed or infertile without a recognised cause for three years.

Couples who meet the treatment criteria are entitled to one cycle of IVF/ICSI treatment and one cycle of frozen embryo transfer (FET), if appropriate, for patients referred to the Regional Fertility Centre after 1st April 2012

IVF criteria

• Upper age limit for a woman using her own eggs is 40 and the upper age limit for a woman using donor eggs is 49 (depending on other criteria)
• Couples who have children living with them (in any capacity) have access to services
• If someone has undergone voluntarily sterilisation, treatment can be provided at clinical discretion.

For more information, visit:   http://www.infertilitynetworkuk.com/niac_2/nhs_funding_in_northern_ireland

All women who meet the Welsh Health Specialised Services Committee (WHSSC) access criteria are entitled two full cycles of IVF.

A cycle includes one fresh and one frozen embryo transfer. Couples (either partner) who have had three or more IVF cycles will be excluded from any further NHS IVF Treatment.

Previous cycles whether NHS or privately funded will be taken into account.

IVF criteria

• Women who are under 40 years old and who meet the access criteria are entitled to two cycles of IVF. However, if the woman reaches the age of 40 during the first cycle of treatment they will not be entitled to a second cycle of IVF
• Women aged between 40 and 42 years who meet the access criteria are entitled to one cycle of IVF provided the following three criteria are also fulfilled: they have never previously had IVF, there is no evidence of low ovarian reserve, there has been a discussion of the additional implications of IVF and pregnancy at this age
• There should be no children (biological or adopted) living with the couple and one of the partners has never had a biological or adopted child
• The couple must have a body mass index of between 19 and up to and including 30
• Neither partner should have undergone sterilisation (this does not include sterilisation as a result of another medical problem). If sterilisation has been reversed couples should not be referred for treatment
• Both partners should be non-smokers.

For more information, visit: http://www.infertilitynetworkuk.com/niac_2/nhs_funding_in_wales

Since July 2013 all 14 Health Boards in Scotland must follow the same criteria for IVF treatment. Eligible patients may be offered up to two cycles of IVF/ICSI where there is a reasonable expectation of a live birth.

Couples are diagnosed as infertile if: there is infertility with an appropriate cause of any duration, there is in heterosexual couples an unexplained infertility of two years or in same sex couples there is unexplained infertility following six to eight cycles of donor insemination.

There will be a review held in early 2015 to consider moving to 3 cycles. NHS funded treatment will not be given to couples if they have already received two cycles of NHS funded IVF treatment regardless of where in the UK they received treatment, even if an individual is in a new relationship.

IVF criteria:

• Fresh treatment cycles must be commenced by the female partner’s 40th birthday and all subsequent frozen transfers must be completed before the woman’s 41st birthday
• Non-smokers for at least 3 months before treatment and non-smoking during 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 should have undergone voluntary sterilisation, even if sterilisation reversal has been self-funded.

For more information, visit: http://www.infertilitynetworkuk.com/niac_2/nhs_funding_in_scotland

Service couples living in British Forces Germany and the Netherlands and Belgium will not receive funding for assisted conception treatment but there is support for fertility investigations to entitled couples.

There is funding for surgery to correct any anatomical abnormality that is causing the infertility. A charitable organisation will provide up to three cycles of funded IVF or ICSI to couples based in BFG if they meet the criteria provided by the Hammersmith hospital in London. For more information, speak to your doctor.

BFC does not fund assisted conception treatment but will fund fertility investigations up the point of diagnosis. If you require assisted conception treatment, they will advise you to return to the UK. For more information, speak to your doctor.

It is not advisable to have IVF or other infertility treatment in any other overseas bases because treatment cannot be quality assured or regulated in line with national UK guidelines.