While making the decision to start a family is one that’s exciting, sometimes a little bit daunting, for same-sex couples it also comes with a huge financial hit.
A new report by Fertility Mapper has revealed the true cost of becoming parents for LGBTQ+ couples in the UK, shedding a light on a number of hidden costs incurred and hoops to jump through for those wanting to start a family.
Earlier this year, a survey of LGBTQ+ women and non-binary people conducted by Stonewall and DIVA magazine revealed 36% of respondents who had children had experienced barriers or challenges when starting their family.
This is echoed in Fertility Mapper’s latest report, which found NHS-funded fertility treatment is not only a postcode lottery, but a personal lottery too in terms of eligibility, wait times and generosity of offer.
How much it really costs same-sex couples to conceive
When it comes to accessing treatment, there are steps that couples must take to ‘prove’ infertility.
For heterosexual relationships, most integrated care boards (ICBs) require at least two years of unsuccessful, unprotected sex before being considered to be eligible for NHS-funded IVF treatment. For other areas, this rises to three years of trying.
However, for female same-sex couples, the picture is different. More than half of England’s ICBs require couples to have undergone at least 12 cycles of failed artificial insemination before being eligible for IVF – and almost all ICBs require those 12 cycles to be self-funded.
The average price of a round of intrauterine insemination (IUI) at a private clinic is £1,265 excluding donor sperm, meaning that many couples incur huge costs – we’re talking up to £25,000 – before even being considered for NHS-funded IVF.
The UK Government’s 2022 Women’s Health Strategy pledged to remove additional financial barriers to IVF for female same-sex couples in England, including the requirement to pay for artificial insemination to prove fertility status before accessing IVF services.
But earlier in the year, the charity Stonewall noted not much progress has been made and many regional ICBs in England still require female same-sex couples to self-fund at least six cycles of IUI.
“This lack of equitable access to NHS funding for IVF means that conceiving children isn’t an option for lots of people in our communities,” the charity warned.
For same-sex couples or those considering surrogacy, fertility experts TFP suggest that it can cost anywhere between £10-15,000 and that is just an estimate for a single baby. The organisation warns that the cost can increase for twins and potential parents should consider this.
Even once couples have gone through the process of ticking the many eligibility boxes, they might still find the NHS fertility services in their local area are limited.
Discrepancies across the country
The report found almost half (46%) of regional NHS boards in England will only offer IVF if the maternal partner is aged under 40.
What’s more, three-quarters (76%) of integrated care boards (ICBs) won’t fund IVF if either partner has any living children – even if they’re from previous relationships.
Fertility Mapper said that “when it comes to fertility treatment, the NHS is far from equal. Funding for services is determined at a local level – resulting in significant inequalities across the country”.
HuffPost UK reached out to NHS England for comment on this matter but received no reply.
In terms of funding, nearly three-quarters of ICBs will only fund one cycle of IVF. And following treatment, 40% of ICBs will only store surplus embryos for free for one year. Yet only 20-35% of IVF first rounds are successful.
The report adds: “It is perhaps unsurprising, then, that the proportion of fertility treatments that are funded by the NHS has fallen significantly in recent years. In 2021, just 27% of IVF cycles were funded by the NHS, compared to 40% in 2017.”
What happens when couples choose to go private?
There are many reasons why people choose to go private for their healthcare but, according to the report, many of those entering private treatment for fertility are likely paying for healthcare services for the first time – something that can be a new and daunting experience.
“Healthcare services, including fertility treatments, are expensive. They’re inherently complex to buy,” reads the report.
“There’s a huge number of clinics all offering packages at different price points, with different levels of coverage available. Until now, there was no comprehensive source to help people distil the good from the bad.”
In short: patients are having to make complex, not to mention costly, decisions during a time when they might also feel quite vulnerable or underprepared.
And unfortunately, even clinics that seem the most cost-effective at first can become the most expensive thanks to thousands of hidden costs added to the final bill.
The report includes a story from Frank who had twin boys through IVF with sperm injection, a treatment they funded privately with the help of family.
The couple were initially quoted a “ballpark” figure of around £9,000 for their treatment but the final bill came to £13,000 due to extra costs – mainly medication.
The couple paid the bill as they’d already committed to the clinic with pre-treatment tests and didn’t feel like they could switch at that point.
Frank said that “if they’d just said from the beginning how much it would be we would have been prepared, but it was so much more than they’d said”.
“It was really worrying and stressful, and added so much pressure for the pregnancy to be successful. But you’re not going to stop the treatment, so there’s nothing you can do,” Frank added.
What can happen now?
According to Fertility Mapper, “the key antidote” to all this complexity is greater transparency from clinics, which equips people with information they need to manage their money, plan and make the best choices for them.
“That is the core driver behind this report,” they said.
The fertility experts propose to tackle this with two methods of improving transparency for patients. Firstly, a fertility funding calculator where users can quickly and easily assess their personal eligibility for NHS-funded treatment.
And secondly, a clinic search. Here, users can search for fertility clinics’ pages containing pricing information and community reviews, complete with detailed scores and personal feedback, to help them pick the best one for them.
As for Stonewall, it urged people to email their local MP to call on the government to commit to a review of the inequality in access to NHS-funded fertility services in England.
“We must speak up together to bring an end to the ICB postcode lottery and ensure that lesbians, bi women, and other LGBTQ+ people who want to conceive have equal access to NHS-funded care,” the charity warned.
HuffPost reached out to the Department of Health and Social Care and their spokesperson said:
“NICE (The National Institute for Health and Care Excellence) is currently reviewing its fertility guidelines and will consider whether the current recommendations for access to NHS-funded treatment are still appropriate. We expect that this review will be published later in 2024.”
“NHS England is developing advice to assist Integrated Care Boards with implementing this advice and we intend that the guidance be available shortly.”
Background:
- Funding decisions for local health services in England are made by Integrated Care Boards (ICBs) and based on the clinical needs of their populations.
- The Women’s Health Strategy sets out our 10-year ambitions for boosting the health and wellbeing of women and girls, and for improving how the health and care system listens to women.
- The strategy contained a number of important changes and future ambitions to improve the variations in access to NHS-funded fertility services.
- The Minister for the Women’s Health Strategy, Minister Maria Caulfield recently announced a change in the law to benefit couples with fertility issues, including same-sex couples
- A new tool has been launched that allows people to look up information about NHS-funded IVF treatment in their area – giving more transparency about its provision. This will also be linked from the NHS website page on infertility to help people find this information as easily as possible. For more information, please see here: NHS-funded IVF in England