IVF Hurdles

The advancement of science and technology has created options with IVF treatment enabling more couples than ever to start a family. However, there are issues with accessing this treatment.

There are additional hurdles and costs for those in a same-sex couple to overcome. These hurdles have created an inequality between same-sex and heterosexual couples, making their journey to parenthood more challenging and costly.

Currently, female same-sex couples hoping to conceive via reciprocal IVF (which is when one woman provides her egg and the other carries the child) must first go through screening for infectious diseases such as hepatitis B, hepatitis C or rubella. This screening can cost up to £1,000 whereas under current rules, heterosexual couples do not need to undergo this screening. The government have now announced this will be changed, removing the additional hurdle and cost of accessing this treatment.

Dr Catherine Hill, Fertility Network UK’s Head of Policy and Public Affairs, said:

“As the national charity, Fertility Network UK welcomes this change in fertility legislation which will remove an inequality between how women in same-sex couples are treated when donating an egg to their partner as part of reciprocal IVF, and how heterosexual couples undergoing fertility treatment are treated.

This legislative change, when enacted, will also be a step forward in removing the massive financial barriers facing female same-sex couples hoping to become parents via fertility services.”

In addition, the government has announced that for same sex couples where one or both partners have HIV but have an undetectable viral load (meaning the level of HIV virus in the body is low enough to not be detected by a test), they can now access IVF treatment. This will also include known sperm or egg cell donation to friends or relatives.

These changes have been made to reduce the inequality that exists between same-sex and heterosexual couples accessing fertility treatment. It does not however end the barriers and inequality couples face when trying to access fertility treatment. Current National Institute for Health and Care Excellence (NICE) guidelines suggest women aged under 40 should be offered three cycles of IVF treatment on the NHS if:

• They have been trying to get pregnant through regular unprotected sex for two years
• Or they have not got pregnant after 12 cycles of artificial insemination

However, if your tests show that there appears to be no chance of you conceiving naturally and that IVF is the only treatment that is likely to help, you should be referred straightaway for IVF.

This is guidance which is not universally adopted, instead is up to individual integrated care boards to set the policy for their local area and it is this which has created a postcode lottery as to what treatment is available and when.

For example, in Whitney and Megan Bacon-Evans launched a judicial review following their hospital trust requiring them to demonstrate that they had tried to conceive for 2 years or self-funded treatment before they could access NHS funded treatment, therefore leaving with no option but private fertility treatment at great expense. They withdrew the application in July 2023 following Frimley ICB recognising the need to update their policy to remove the inequality between same-sex female couples.

The government has committed to removing all financial barriers and has outlined their strategy for doing so in the Women’s Health Strategy published in August 2022. This includes removing the requirement for female same-sex couples to pay privately for artificial insemination cycles before they are eligible for NHS funded IVF treatment. The current requirement is that same-sex couples are expected to self-fund six Intrauterine Insemination cycles before they are eligible for NHS IVF treatment. In comparison, opposite sex couples are not required to self-fund any treatments before being eligible for NHS IVF treatment. NHS England are intending to issue commissioning guidance to Integrated Care Boards to support implementation, which the Government have said “is expected shortly”. This change is therefore still awaited.

The latest announcements therefore are just part of the picture; more change is needed and hopefully will come soon.

Article written by Gemma Davison who is a Team Leader Partner at Stowe Family Law