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Ministers have begun seeking views over inequalities in access to fertility treatment across Scotland.

Average waiting times range from two months in Shetland to five years in Grampian, and the same guidelines do not apply in all health board areas.

Opinions on a range of issues would be sought, such as whether the age limit for women receiving fertility treatment on the NHS should be increased. Only those aged under 38 are currently eligible for treatment. The Scottish Executive consultation also intends to ask whether couples without any children should receive priority and examine the impact of widening the access criteria.

About 75,000 couples in Scotland are affected by infertility, which is defined as a failure to conceive after trying for two years. The executive said that the problem had not become more prevalent, but there was evidence that more couples were seeking treatment.

Deputy Health Minister Lewis Macdonald said there had to be equal access for all, regardless of location. “We have national criteria for accessing infertility treatment provided by the NHS, and boards are expected to follow this guidance,” he said. “However, I am aware there is still some variation among boards regarding the provision of infertility treatment, and that not all boards are following this guidance as they should.

WAITING TIMES IN APRIL 2005
Argyll & Clyde - seven months
Ayrshire & Arran - eight months
Borders - three months
Dumfries & Gall. - 19 months
Fife - 24 months
Forth Valley - 10 months
Grampian - 60 months
Greater Glasgow - 7 months
Highland - six months
Lanarkshire - 11 months
Lothian - 24 months
Orkney - eight months
Shetland - two months
Tayside - 24 months
Western Isles - n/a

“I also know there are differences in criteria and waiting times for the most specialist treatments within the four specialist centres in Scotland.” These centres, which carry out procedures like in-vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI), are based in Aberdeen, Dundee, Glasgow and Edinburgh.
Five years ago health boards were urged to adopt a national criteria which was proposed by the Expert Group on Infertility Services in Scotland (EAGISS). It specifies that women, who must be under 38, will be eligible for up to three assisted conception cycles.
Last year the National Institute of Clinical Excellence (Nice) produced guidelines for England and Wales which set an age limit of 40. It also said that women should receive five treatment cycles on the NHS.

Nine Scottish NHS boards now comply with the EAGISS criteria, and the consultation document said most of the others had guidelines which were either more generous or only slightly different. Currently Lanarkshire offer treatment up to age 40 although referral must be by age 38. At present not all areas offer 3 cycles, some are just 2 but waiting times may be less

Average wait

However, the document also highlighted considerable differences between waiting times across the country.
The average wait in the Borders fell from five years in 1998 to just three months in April this year, a figure beaten only by Shetland.

However, couples in Tayside, Lothian and Fife faced a two-year wait - and in Grampian the figure rose from 24 months in 1998 to 60 months this year. Mr Macdonald said he hoped to discover why there were discrepancies across different parts of Scotland. “We are consulting widely in the hope that we can secure an equal service for all in Scotland,” he said

source news.bbc.co.uk