Nice guidelines – but how about implementing the existing ones?

I know, I’m a day late with this story, but work and wine contrived to get in the way. Again.

Still, I didn’t want the story about the Nice guidelines to raise the age of women qualifying for free IVF treatment on the NHS to go without comment. Now women up to the age of 42 “should” be offered free fertility treatment if their situation demands it. I say, “should”, as NICE guidelines have always been just that, guidelines, and many PCTs were not fulfilling the previous ones that recommended that women up to the age of 39 be treated under the NHS.

Many media responses were reassuringly predictable, and showcased the opinions of people who believed a) the NHS should not be funding IVF for anyone, regardless of age, as having a baby is not a “right” and b) that women were waiting too late as it is and raising the limit would only encourage these career-hungry mavens. Of course, the latter pundits neglected to mention the fact that it’s not a choice for most women to have their first child very late in life. These women know that the risks of having complications with the pregnancy and the baby increase dramatically after age 40. They know that having a newborn is exhausting, and more so the older you are. They know they’ll be mistaken for the child’s grandmother at times and not have as much time with their children as those who had reproduced in their twenties.

But maybe they hadn’t met the right person? Maybe they had experienced multiple miscarriages? Maybe they had become disabled during their most fertile years. Who knows? But the fact is that most women don’t actively choose to have their first child in their forties. Ok, some might think, “I’ll wait longer to have kids as I can always have IVF”. But these people are in the minority, and you can’t legislate for the misguided.

You might think I’m pro-fertility treatment regardless of the situation. Yes, I’ve written a book about surviving infertility treatment, but that doesn’t equate to blanket approval of everyone’s “right” to have it, especially funded by the NHS. I thought the fertility expert on Channel 4 news last night was quite convincing on this point – he was arguing that just because the technology existed, didn’t mean we should exploit it regardless of the individuals, and called instead for a move to make it socially and financially easier to have children younger.

But enabling women to have fertility treatment at an older age is not promoting older motherhood, it is just enabling the very few who will need it the chance to become a mother without crippling themselves financially, levelling the playing field with those who are able to afford many private cycles.

The new guidelines actually make it easier for more people to have funded IVF younger, as they recommend people seek treatment after waiting for two years, rather than the current three. As we know, the success rates of IVF decrease with age, so by reducing the waiting time for treatment they are hopefully going to catch people during a more fertile window. It is surely this recommendation, rather than the one about increasing the age, that will encourage more people to seek treatment, potentially successfully. But that doesn’t have the same “OMG” factor as the other recommendations, and therefore goes largely unreported.

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