Choosing Fertility Treatment

It is estimated that around three and a half million couples a year in the UK struggle to conceive through natural methods, which represents about one in seven couples. Over the last thirty years, assisted reproduction techniques (ART) fertility treatment have become commonplace, offering new opportunities to these childless couples.

Yet while such procedures are now widely available, only around 30,000 women undergo fertility treatment in the UK each year. This is mainly due to the costs of private clinics and the limited provision on the NHS. So what are your options when considering ART?

This article on ART fertility treatments is written by Jackie Griffiths, a freelance journalist who writes health, medical, biological, and pharmaceutical articles for national and international journals, newsletters and web sites.

NHS Treatment

The National Institute for Health and Clinical Excellence (NICE) produced guidelines in 2004, which stated the criteria for fertility treatment on the NHS. They recommended that couples aged between 23 and 39 who have either a specified fertility problem, or who have been unsuccessful in conceiving for three years or more, should receive up to three cycles of IVF on the NHS.

In practice, however, since this treatment depends on local NHS budgets, the availability can vary widely from one health authority to the next, creating what’s known as a ‘post-code lottery’. Furthermore, as budgets get tighter, so do the criteria for acceptance. For instance, some authorities have started enforcing the NICE recommendation that the woman’s Body Mass Index should be between 19 and 30.

As with most non-urgent NHS treatment, even if you are successful in being offered a place, you can still face a substantial waiting list.

Private Treatment

Because of the vagaries of the NHS system, many couples prefer to be treated privately, and a large number of fertility clinics have sprung up to meet this demand. These clinics will charge for their services, however you will have more choice about when and where you are treated.

Choosing a Clinic

Having chosen to ‘go private’, it’s important to choose the right fertility clinic for you. The HEFA website lists all private clinics in the UK and can help you find a selection of clinics near you. Once you’ve drawn up a shortlist, there are many factors you should consider in making your final choice, including:

  • Location – you may need to make several visits to your chosen clinic, so you might want one that you can reach easily. High travel costs and overnight accommodation will only add to the overall expense.
  • Range of services – you should ensure that the clinic offers the full range of services you may require, in case your first choice of treatment proves unsuccessful.
  • Success rates – the success rate varies from clinic to clinic, with some claiming up to 50% per cycle. Most will publish their success rates.
  • Eligibility – there are no set criteria for private clinics so you should check that they are prepared to accept you.
  • Price – the cost of treatment varies widely, as does the charging policy. Some clinics offer an all-in-one price per cycle, while others will charge for each individual aspect of the process.

Clearly many of these factors will overlap, and your overall decision must balance the relative merits. A fertility clinic with a high success rate may charge more, but could cost you less overall if you’re successful in your first cycle. Similarly, a distant clinic that will cost you more in travelling could still save you money through early success. However, you may find that clinics with a high success rate achieve this by having very strict acceptance criteria, and you may find it hard to gain a place there.

The HEFA provide a detailed inspection report on every clinic to help you choose, but you should also make your own inspection to be completely sure. ART is a big investment and it’s important you should be happy with your choice, so don’t be afraid to ask questions.

If you’re hoping to use donor eggs or sperm, then you should ask additional questions about the clinic’s policies for recruiting and screening their donors.

Treatment Abroad

It may be possible to save money by having your fertility treatment abroad, however it’s important to remember that overseas clinics may not be regulated as strictly as those under the jurisdiction of the HEFA. All EU clinics are bound by the quality and safety standards of the EU Tissues and Cells Directive, however these standards may not be enforced as rigorously in some countries. On the other hand, fertility clinics abroad may offer services that are either not available in the UK or are very pricey.

Treatment Costs

The same caution should be applied when purchasing ART treatment as when making any other major purchase. Be wary of bargain basement prices, as there will invariably be a reason for this. Similarly, you may not get that much more from the most expensive clinics than you would from a reputable, mid-priced establishment.

As discussed earlier, clinics may charge an overall price per cycle or offer menu pricing per individual aspect of your treatment. As a guide, overall treatment prices fall into the following ranges:

  • Standard IVF – between £1,000 and £4,000 depending on your circumstances
  • Donor IVF – between £6,500 and £8,000 per cycle
  • Frozen Embryo Transfer – around £1,000 per cycle
  • Frozen Embryo Storage – around £250 initial charge plus around £250 a year
  • GIFT – up to £5,000 per cycle
  • ICSI – an additional £1,000 per IVF cycle
  • IUI – between £500 and £1,000 per cycle

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