Assisted conception funding

Infertility services in Bromley

Infertility is when a couple cannot get pregnant, despite having regular unprotected sex.  Around one in seven couples may have difficulty conceiving.

Some women get pregnant quickly, but for others it can take longer. It is a good idea for a couple to visit their GP if they have not conceived after a year of trying.   Women aged 36 and over and anyone who is already aware they may have fertility problems should see their GP sooner.  The GP can check for common causes of fertility problems and suggest lifestyle changes or treatments that could help. You can read more on www.nhs.uk

What treatment is available?

Investigations, diagnosis and conservative treatments for infertility are routinely available on the NHS. Types of fertility treatment available in primary or secondary care include:

  • Advice on lifestyle changes to aid a natural conception such as weight loss and smoking cessation.
  • Medical treatment for lack of regular ovulation.
  • Surgical procedures – such as treatment for endometriosis.

If infertility is diagnosed, or after all treatments and recommended lifestyle changes have been tried and infertility remains unexplained, a referral to an Assisted Conception Unit for IVF / ICSI may be considered for assisted conception such as:

Who can have IVF / ICSI on the NHS in Bromley?

NHS Bromley Clinical Commissioning Group has a Treatment Access Policy (TAP) which sets out the treatments funded by the local NHS.   This is a shared policy with other CCGs in south east London (SEL) and has been approved by our Governing Body.   Having a shared policy ensures that there is equality of treatment across south east London.

The SEL TAP includes the arrangements for funding treatment for infertility and states that one cycle of treatment (IVF/ICSI) is available for eligible couples.   You can read more in the policy and full list of eligibility criteria for NHS funding of infertility treatment here. The key criteria about eligibility for infertility treatments are as follows:

  • Couples should be living together and in a stable relationship. 
  • The partner who is to receive treatment must be aged between 23 and 39 years old (up to 39 years and 364 days) at the time of treatment. 
  • Couples who have been diagnosed as having male factor or female factor problems or have had unexplained infertility for at least 3 years, taking into consideration both age and waiting list times. 
  • Women will only be considered for treatment if their BMI is between 19 and 30 
  • Couples should be non-smoking at the time of treatment. 
  • Fertility treatment will only be offered to couples where the following two criteria are met: 
  • where there are no living children in the current relationship
  • Where neither partner has children from previous relationships. 
  • The female partner should not have had any previous NHS funded attempts at IVF or ICSI and not more than three NHS funded attempts at IUI. 
  • Eligible couples will be offered: 3 cycles of IUI, and / or 1 full cycle of IVF +/- ICSI. 

Where is infertility treatment delivered and how are referrals made?

Your GP may opt to refer you to a local NHS consultant for routine investigations, treatments, and surgery. For Bromley couples this secondary care is likely to be delivered at the Princess Royal University Hospital in Orpington. Once couples have gone through the primary and secondary care sub-fertility pathways appropriate to them and an NHS consultant has deemed them clinically ready for IVF / ICSI they will be discharged back to the care of their GP. This is because IVF / ICSI is not offered at the Princess Royal University Hospital and the GP is required to make a referral to an Assisted Conception Unit (ACU) where the couple will complete their treatment.

 Alternatively, you may wish to discuss with your GP the option of being referred directly to an ACU for your initial routine investigations and treatments. The benefits of this option is that if IVF / ICSI is indicated you would be able to complete your infertility treatment with clinicians you know and in an environment familiar to you. Staff at the Assisted Conception Unit will assess a couple’s eligibility for NHS funding and advise them on next steps.

Bromley couples have a choice between the ACU at Guy’s and St Thomas’ Hospital, at London Bridge, and the ACU at King’s College Hospital, at Denmark Hill. Couples are advised to research the relevant provider websites for outcome details and visit their preferred provider unit before making their informed choice.

Chances of success

The chance of a live birth following infertility treatment is consistent for the first three cycles of treatment, but the effectiveness after three cycles is less certain*

However, the most significant factor affecting the chances of a live birth following infertility treatment varies with female age and the optimal female age range for invitro fertilisation is 23-39 years.   Chances of a live birth per treatment cycle are:

  • greater than 20% for women aged 23-35 years
  • 15% for women aged 36-38 years
  • 10% for women aged 39 years
  • 6% for women aged 40 years or older* 

*NICE: Fertility: assessment and treatment for people with fertility problems, 2013

Where can I find out more?

If you are registered with a Bromley GP Practice and seek further advice about the eligibility criteria for NHS funding of infertility treatment and the South East London Treatment Access Policy contact Bromley CCG on 01689 866539 or email BROCCG.fertilityfundingrequests@nhs.net

There is more information on the NHS choices website at www.nhs.uk and at the UK Fertility Network at www.fertilitynetworkuk.org

NHS Bromley CCG, 1st Floor, Beckenham Beacon, 379 Croydon Road, Beckenham, BR3 3QL

© 2017 Bromley CCG