IVF stands for In Vitro Fertilisation and it is one of the several techniques available to allow people with fertility problems to have children. NICE guidelines recommend that IVF should be offered to women under 43 years of age who have been trying to get pregnant for two years. However, the final decision about who can have NHS-funded IVF in England is made by local Clinical Commissioning Groups (CCGs), and their criteria may be stricter than those recommended by NICE. 

Women under the age of 40 can be given up to 3 cycles and women between the ages of 40-42 should be offered  1 cycle according to NICE guidelines providing they fulfill the other criteria. They are also required by law to carry out a Welfare of the Child assessment before starting any treatment. This looks at factors which are likely to cause serious harm, either to the child to be born or to any existing children in the family, possibly including the eventuality that a mother might die before her child reaches adulthood or become unable to care
for the child. If a person is not eligible for NHS treatment they can pay decide to pay for IVF privately, but one cycle can cost up to £5000 or more.There are many arguments as to whether this treatment should be available on the NHS. 

One of the main concerns is the expensive nature of the treatment and the drastic reduction in the success rate of the procedure as the woman becomes older. The statistics imply that it isn’t a cost effective intervention to allow women over the age of forty t go ahead with the treatment. The 2010 statistics show the percentage success rate after IVF:

  • 32.2% for women under 35
  • 27.7% for women aged 35-37
  • 20.8% for women aged 38-39
  • 13.6% for women aged 40-42
  • 5% for women aged 43-44 
  • 1.9% for women aged over 44

Arguments AGAINST Providing Older Women with IVF:

  •  Some medics have raised concerns about the more general societal trend for women having children later, and the associated risks this carries for both mothers and their babies. E.g. whilst the risk of giving birth to a baby with Down’s Syndrome is about 1 in 1,000 for a woman in her late 20s, this risk rises to around 1 in 100 for women giving birth at the age of 40.
  • There’s an increased likelihood of older mothers falling seriously ill and being unable to care for their young child. There is the case of a single woman who had became the oldest mother in the world at 66 and then died after having cancer less than three years after the birth of her twins.
  • Becoming pregnant at an older age can have a physical and psychological strain on the mother. A minority of older women face the risk of serious adverse effects such as developing diabetes in pregnancy.
  • The negative side effects of IVF will have a greater impact the older the woman is. 
  • Women above a certain age could be encouraged to adopt a child instead.
  • The ethical principle of justice wouldn’t be served as this treatment is so expensive and could take away funding from other life-threatening areas such as cancer treatment. 

Arguments FOR Providing Older Women with IVF:

  • It should be the woman’s choice when they went to have a child and the NHS should respect that autonomy.
  • No parent, whatever their age, can guarantee that they will
    not become ill or die before their children are grown up, and some women are healthier in their 60s than others in their 20s.
  • A London fertlity clinic recently used the fact that women are living longer lives to justify providing IVF to women over 50.
  • The welfare of the child  is taken into account including how fit the mother will be to take of the child at her age so we should not use age as a way to absolutely discriminate older women from having IVF.

I feel a though IVF is an area that is regulated across the country so the access is the same for all women irregardless of where they live. I also do agree that the mother does have a right to autonomy and it is possible for an older mother to have and bring up a happy and healthy child…we should not discriminate in the basis of she. However, the cost-effectiveness of providing this treatment is a concern especially as the success rate significantly decreases the older you become. Overall, I believe the decision should be made on a case by case basis considering the chances of success that individual has, discussing alternative ways of bringing up a child such as adoption and also considering the health risks to the mother themselves.

Posted by:Life of a Medic


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