Can I get fertility treatment on the NHS?
This is one of the most common questions when it comes to IVF financing in the UK. And the short answer is… maybe.
NHS Scotland offers three rounds of IVF for women under 40 and one round for women who are aged 41 and 42. Wales offers two rounds of IVF to all women. Northern Ireland is slightly different, with one fresh and one frozen embryo transfer funded by the NHS (however, there is only one centre in the country, and wait times are long).
In England, it’s a completely different situation. Despite NICE (The National Institute for Health and Care Excellence) guidance that all women and AFAB people (assigned female at birth) who struggle to conceive receive three rounds of IVF, this is not always the case. In fact, it’s often far from it.
English residents are subject to what’s often called ‘the postcode lottery’ for IVF funding. This is because each borough has drastically different rules about what they will and will not pay for in IVF. In addition, they have strict eligibility criteria that also differs.
No matter where you are in the UK, your first point of call should be your GP. They will order some basic tests and tell you more about your eligibility for NHS-funded treatment. You can also contact your local clinical commissioning group (CCG), since they are the ones who make the funding decisions. You might be eligible for up to three rounds of fully-funded IVF, or you might get none.
Even if you are not eligible for funded treatment, you have the right to a referral to an NHS clinic for initial investigations. If you do live in the right borough and qualify for treatment, you may not be able to choose your clinic. It’s also crucial to note that wait times can stretch into the years, and Covid has made these lists even longer. Many people feel despair and frustration while they wait, which can add stress to an already stressful situation.
Are private fertility treatment costs regulated?
No, private fertility clinics across the UK are allowed to set their own costs as they see fit, just like any other healthcare company. Therefore, some clinics might be two or even three times more expensive than others, so you should shop around to compare costs and the services they provide.
Why do costs of IVF treatment vary so much?
IVF treatment costs vary because clinics are allowed to charge whatever they wish, and some add high premiums due to state of the art facilities, and success rates. However, what can look like two wildly different quotes at the outset can often end up a lot more similar than might appear at first glance.
One clinic’s quote may include all kinds of optional ‘extras,’ such as intracytoplasmic sperm injection [ICSI] and embryo glue, as well as including their admin fees, scans, general anaesthetic fees, and freezing costs. They might even include your very costly fertility medications. While on the other hand, the second, seemingly ‘cheaper’ clinic might only include egg retrieval, embryo cultivation, transfer, and consultations, with everything else charged piecemeal along the way.
What seems like an excellent ‘too good to be true’ price at the outset is often just that. Once you add all of the costs and fees, you soon find that the seemingly more expensive clinics are a better value. That’s why it’s so important to ensure you’re comparing like for like when you look at different clinic’s quotes.
Is it worth having the clinic’s recommended ‘extras’?
Your clinic might start offering all kinds of treatment add-ons, the cost of which can add up quite quickly. The most common is intracytoplasmic sperm injection [ICSI], which is a standard procedure in other countries as it offers higher success rates than standard IVF.
As the NHS offers publicly funded services, they have to act with extreme caution. As a result, common add-ons and additional tests in private clinics and abroad are not available on the NHS. At private clinics, they are often willing to ‘throw everything at the procedure’ to increase the chances of success, while the NHS takes a far more cautious approach because they are spending public funds.
The NHS uses a ‘traffic light system’ to assess the efficacy of different IVF add-ons in the UK. However, it is crucial to remember that these grades are based on a population level. So, for instance, add-ons such as PICSI and PGT-A have a ‘red traffic light’ for their use on the general population, but they can reduce the chances of miscarriage and improve outcomes for women over 35.
Speak to your GP and fertility specialist about each add-on to find out if it could benefit your chances of conception, increase chances of a healthy delivery, or reduce your likelihood of OHSS (ovarian hyperstimulation syndrome). What doesn’t ‘work’ on a population level could still help in your unique situation, so even if an add-on has a ‘red traffic light’ designation, don’t rule it out.
That said, the Human Fertility and Embryology Authority advises that “having routine cycles of proven fertility treatment are effective without using any treatment add-ons.
If you are paying directly for your own treatment… it might be more effective and/or affordable to pay for multiple routine proven treatment cycles” than more add-ons that haven’t been tested.
Some of the most common IVF add-ons include:
- Artificial egg activation calcium ionophore – Amber
- Assisted hatching – Red
- Elective freeze all cycles – Amber
- Endometrial scratching – Amber
- Hyaluronate enriched medium (EmbryoGlue) – Amber
- Immunological tests and treatments for fertility – Red
- Intracytoplasmic morphologic sperm injection (IMSI) – Red
- Intrauterine culture – Red
- Physiological intracytoplasmic sperm injection (PICSI) – Red
- Pre-implantation genetic testing for aneuploidy (PGT-A) – Red
- Time-lapse imaging – Amber
Payment plans and refund packages
Payment plans are a relatively recent development in the world of IVF financing. In the past, you could seek a personal loan or borrow money from loved ones, but you can now purchase IVF treatments with different financing options. With not all insurance companies covering IVF and in the UK, the NHS waitlists longer than ever, these financing options are very attractive to those seeking treatment.
IVF financing allows you to spread the cost of your treatments over a set period, usually between two and ten years. The longer your repayment period, the higher your interest will be.
Some clinics work with financing companies with better conditions and may even offer an interest-free period of a year or more.
If you would prefer to pay for the cost of your treatment over time, this is a great option. However, it’s crucial to go over the payment terms with a fine-toothed comb to look for hidden terms, outrageous penalties, and the nitty gritty details.
To stay competitive and attract new patients, some private fertility clinics now offer ‘refund packages’ that offer a certain percentage of money back in the case of failed IVF. You usually need to sign on for a minimum of three cycles and commit to paying for the entire package. But, of course, some people get pregnant on their first cycle, and they forfeit the rest of the pre-paid package.
However, if you fail to have a live birth, you will receive a refund of all or most of what you paid. Most of these packages offer unlimited cycles for women under age 38, three cycles for women aged 39, and two cycles for women under aged 44. It covers all scans, bloodwork, consultation and embryo freezing. Medication costs are never included.
A refund scheme is becoming increasingly popular because fertility patients can budget IVF costs from the beginning, eliminating any financial uncertainty. Furthermore, they have the assurance that they are going to get their money back in case of failure. As more than half of IVF patients do not succeed first time, a refund scheme can prove to be a good option.
Paying for IVF
Whether you choose to finance your IVF with a clinic’s payment plan, use credit cards or personal loans, or simply take money out of your pension or savings, paying for IVF is always a complex choice. While you may be eligible for NHS-funded treatment, remember that those treatments often come with long waitlists and may lack the additional testing of private clinics. Of course, some people choose to travel for treatment to cut costs, which might also be an option.
No matter how you choose to pay for your IVF, we wish you all the luck in the world. Never hesitate to get in touch with questions!
find out more about financing your IVF in the UK and overseas here
When planning your budget for your fertility treatment, there is a lot to take in to consideration You need to think about the cost of
The world is full of uncertainty at the moment, with millions of people worldwide affected by job cuts and financial devastation due to the coronavirus