The Cost Of Living Crisis Is Making It Even Harder For Same-Sex Couples To Access IVF

Katherine Fraioli-Harper and her wife Jayme would like a second child. But the rising cost of living means it’s now impossible for them to save for fertility treatment.

“I’ve broken down about about it a few times, because I just hate the fact that it’s money that is the only thing stopping us from growing our family,” says Katherine, a 38-year-old fitness instructor from Bristol. “That just is a horrible feeling.”

Same-sex couples already face more barriers in accessing IVF on the NHS than their straight counterparts. While heterosexual couples are expected to try to conceive for two years before accessing NHS-funded treatment, NICE guidance states that female same-sex couples must undergo six rounds of intrauterine insemination (IUI) from a private fertility unit before they’re considered. They’ll then be offered NHS IUI (usually another six rounds), before being offered IVF. The restrictions are even more complex for male same-sex couples, where a surrogate is needed.

The NICE guidance for same-sex fertility treatment is just that – guidance – and funding is ultimately decided by local CCGs, or clinical commissioning groups. Some CCGs require lesbian couples to demonstrate two rounds of IUI, but most request all six.

In the vast majority of cases, lesbian and gay couples have to pay for private treatment – and it does not come cheap.

Katherine and Jayme paid almost £18,000 to have their first son, Cillian, in December of last year. To foot the bill of multiple cycles, they moved home, lived frugally and put every penny of birthday and Christmas money into savings. They also travelled to Norway for some of their treatment, where IVF is cheaper than in the UK.

“That spanned over five years, because we had to do so much saving between every cycle to do the next one,” explains Katherine.

They’ve always imagined giving Cillian a sibling, but now, with food and utility bills through the roof, saving up again simply isn’t possible.

A cycle of treatment at a private clinic can vary from around £3,500 to upwards of £7,000, depending on the services and tests recommended.

“It’s always a kick in the teeth knowing that if we were a heterosexual couple that that wouldn’t be the case,” says Katherine. “It’s like, there’s definitely discrimination going on here, especially because I didn’t have any fertility issues other than not being with a male partner.”

Though Jayme has a stable job, working as a lighting and sound demonstrator in a university’s theatre department, like many of us, they’ve had to tighten purse strings further as bills go up. Self-employed Katherine is currently on maternity leave, but they’ll soon have to pay for Cillian’s childcare, too.

They’ve got enough money remaining for one single round of IVF, which they’ll be having at abc ivf, a fertility service marketed as the UK’s “most affordable”, because they cut out “unnecessary testing and unproven add-ons”.

“If it works, great,” says Katherine. “And if it doesn’t, then we have to put a lid on it, because after that financially, it will become completely non-viable for us.”

Professor Geeta Nargund, medical director of abc ivf, says the increase in cost of living is placing extra stress on couples like Katherine and Jayme, when fertility treatment is already “gruelling, both emotionally and physically”.

“When you consider the additional challenge of witnessing heterosexual contemporaries conceive naturally, without cost, it can feel isolating – particularly if more than one cycle is required,” she says.

Rising costs also impact the wellbeing of same-sex couples who aren’t currently seeking fertility treatment, but may want to in the future. Charlotte Summers, 25, and her girlfriend Aislinn, 26, are unsure if they’ll ever be able to afford a family.

“We have to ask ourselves, do we want a house, wedding or start a family – which is a common question for most couples, but we find ourselves at a disadvantage, as the costs for us are doubled with IVF processes,” says Summers, who runs Unite UK, a platform supporting LGBTQ+ writers.

“We’re not ready now, but even looking into the process of having a child scares us. It’s upsetting, but money is a factor in whether we start a family.”

Summers works as a social media manager while her partner is a quality engineer. After seven years together, she says they’re “about 40% ready to have children”. But the couple, who are based in Birmingham, have already had to move house to cope with cost of living increases.

“At the start of the year we were in a position where rent was too high, so we had to move, and whilst we’re super happy in our new apartment, it’s not a forever home,” says Summer. “I guess our main worry would be looking where we settle down, and if things keep going up, would we be able to afford the ideal ‘family home.’”

There are some organisations and individuals working to make things easier for same-sex couples. The digital health company Hertility, which offers at-home fertility testing in a bid to cut clinic costs, has launched an initiative calling out inequalities. Its campaign – #TheFertilityQUEERy – seeks to highlight the barriers faced by same-sex couples while providing information to help those in navigating the system.

And in November 2020, influencers Whitney and Megan Bacon-Evans (who go by @whatwegandidnext on social media) launched legal action against their local CCG to challenge discrimination regarding NHS fertility treatment.

Amid a cost of living crisis, they say it’s “even more pressing” for this to be addressed. “Couples were already having to choose between saving for a wedding, a house or having a baby, or being able to afford a family at all,” the couple tell HuffPost UK in a joint email.

“Now with the increase in the cost of living, it’ll be even harder and many will be having to scrimp even more on food, petrol and gas and electricity and even go without in order to save for creating a family or ultimately never have their dreams fulfilled.”

Whitney and Megan’s legal battle is ongoing and could mark a major test of the NHS’s provision for LGBTQ+ families. In the meantime, Professor Nargund says immediate action must be taken to help queer couples access treatment.

“In the first instance, there should be a conversation around workplace policy which enables same-sex couples to pursue fertility treatment affordably, without risking workplace stigma due to appointments and potential side effects,” she says.

“In order to make things better, the government can place a cap on IVF pricing and implement a national tariff in order to allow more cycles to be funded within the existing budget.”

HuffPost UK previously contacted the Department of Health and Social Care (DHSC) regarding the so-called ‘gay tax’ on fertility treatment. A spokesperson said the level of provision available is “a matter for local healthcare commissioners”.

But unless access policies change or treatment costs are reduced, some same-sex couples will be forced to change major life plans.

“I definitely always planned to have two children and I definitely would still love to have two children,” says Katherine. “But the cost of living increase will impact our ability to grow our family.

“If the one round of IVF that we’ve already got savings put aside for doesn’t work, it will then be exceptionally difficult for us to save the money required for further rounds. It makes me feel really, really sad.”