NHS-funded IVF: consequences of NICE implementation

The UK National Institute for Health and Clinical Excellence (NICE) recommends that all subfertile women of < 40 years should be entitled to up to three IVF treatment cycles funded by the NHS. The full criteria have been implemented at The Newcastle Fertility Centre at Life since August 2009. The aim of this study was to evaluate the clinical outcome in terms of analysing the cumulative pregnancy rates. A retrospective analysis of data from 812 couples who started their first NHS-funded treatment after August 2009 was undertaken until there were 100 couples who had completed the three treatments. Cumulative pregnancy rates were calculated using life table analysis, and time intervals between treatments were recorded. The number of couples having first, second and third treatment cycles was 812, 298 and 100, respectively. The cumulative clinical pregnancy rates per each fresh cycle were 30.1%, 50.2% and 60.2%, and when frozen embryo transfers were included, they were 33.5%, 53.4% and 62.7%. The median + 2SD time interval between treatments was 11 and 10 months; 90.2% of the women were likely to complete up to three NHS-funded treatment cycles until they achieved a pregnancy. The NICE criteria offer most couples a chance of pregnancy, and the majority will take up the opportunity of undergoing three treatment cycles if required. The time interval between treatments indicated that it will take < 2 years for couples to complete the full course of NHS-funded treatment.