Infertility Treatments on the NHS

The National Health Service offers funding for fertility treatments to citizens in the UK. What this means is that if you are diagnosed with infertility, you will be supported by the NHS through your treatments, provided you are eligible of course. There are advantages to having the NHS fund your treatment, but there are, of course, also distinct disadvantages to using public health services, all of which will be discussed in this article.

Am I eligible for NHS infertility treatment?

What NHS treatments are offered where depends on which trust you go to and how their Primary Care Trust (PCT) operates their services. PCTs are responsible for managing how a trust’s money is spent and on what treatments, so there is some variation across the country. There is also a great deal of variety in terms of the waiting lists at different NHS institutions.

If a diagnosis of infertility has been made, which in the NHS is usually after 2 years of regular intercourse with no successful conception, then you can talk to either your GP or local PCT about your eligibility for infertility treatment. Every patient’s initial infertility tests and investigations are funded by the NHS, it just depends on the PCT which treatments you will receive and when.

The NHS offers treatments under three broad categories of fertility treatment: Assisted conception, fertility drug treatments, and surgeries.

Fertility drug treatments

Fertility drugs can be used to treat infertility, particularly in women, effectively provided that the causes of that infertility fit under the drug’s action. Some of these drugs can be effective when used on men, but typically speaking they are only about a third as effective.

Examples of medications involved in treating infertility include:

  • Gonadotropins which stimulate ovulation in women and can increase sperm production in men.
  • Clomifene which enhances ovulation if the cause of infertility is irregular or absent ovulation.
  • Metformin is used after Clomifene has been used and has failed to the same end, and is effective in treating a common infertility disorder called polycystic ovary syndrome (PCOS).
  • Tamoxifen is another alternative to Clomifene that is used if the response to the first drug is poor.

As you can see these drugs tend to target ovulation as the cause of infertility. Ovulation is the monthly release of eggs that allows them to be fertilized, and if that is the problem then these drugs provided an effective treatment. However if ovulation isn’t the problem, then drug treatments won’t achieve much.

Surgical fertility treatments on the NHS

The NHS does offer different surgical options to treat infertility, each of which can be effective in their own right or at least provide an insight into the cause of infertility. Fallopian tube surgery is one such example. The fallopian tubes are structures that link your womb to the ovaries in which your eggs are stored. If these tubes are damaged, blocked, or scarred, which can be caused by using IUD contraception or suffering from pelvic inflammatory diseases (PID), surgery can restore fertility by repairing them. Unfortunately this kind of surgery does increase the risk of ectopic pregnancy, where rather than implanting and growing in the uterus, an embryo does so in the fallopian tubes (amongst other potential location).

Another kind of surgery available under the NHS is laparoscopy, where a specialized thin microscope is passed through a small surgical incision to provide a view of your internal organs and perform small procedures. This treatment is particularly suited to women who suffer from small cysts (usually benign liquid filled growths), fibroids, or endometriosis, a condition where the endometrium (lining of the uterus/womb) grows in places where it doesn’t belong. These are some potential causes of infertility which, when treated, can yield remarkable results.

Surgical options are also available for men under the NHS, and include, for example, a procedure that clears blockages of a structure called the epididymis. This is within the testicles and is responsible for the storage and transport of the male sex cells, sperm. Epididymal blockage is often a cause of male infertility, and where applicable the surgery is very effective at treating infertility.

Assisted conception on the NHS

A number of different assisted conception techniques are available on the NHS, including intrauterine insemination (IUI), IVF, and egg and sperm donations. Each of these is provided where appropriate and usually after other treatments have failed to solve the infertility problem. To what extent and which form assisted conception can vary from PCT to PCT, as this form of treatment, and in particular IVF, can be very costly and time consuming.

Other options for infertility treatment

If you find that the treatment available for infertility at your local trust doesn’t meet your needs, then you can always investigate private treatment, which has the advantages of speedier treatment at specialist clinics, but the disadvantage of expense. Your GP and the HFEA are great sources for advice on which clinics are best for your treatment.

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