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New guide ranks success of IVF treatment centres
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     Couples seeking fertility treatment in the United Kingdom will be able to compare the success rates of different centres by using statistics published in a new directory from the Human Fertilisation and Embryology Authority (HFEA). The figures will also be available in an online database.

    "This is the most comprehensive and detailed information published about UK infertility services, and we believe it抯 unique globally," said Suzi Leather, the HFEA抯 chairwoman.

    Infertility represents a considerable proportion of the workload in general practice, and aside from pregnancy it is the most common reason among women aged between 18 and 45 for consulting a GP.

    Many of these women are not receiving help early enough, the HFEA抯 data indicate. The chances of infertile women conceiving successfully after in vitro fertilisation (IVF) declines steeply after the age of 35 (figure). The average success rate for IVF treatment using fresh eggs (rather than frozen embryos) is 27.6% for women under 35; this figure falls to 18.3% for women aged 38 or 39 and to 10% for women between 40 and 42.

    The data also highlight regional differences in access to services. London and the north west of England have roughly the same number of couples with fertility problems, but the capital has 22 licensed treatment centres while the north west has four. Waiting times for an initial NHS consultation vary from just a few weeks at some centres to more than a year at others.

    One aim of the guide is to promote choice for patients, but the HFEA hopes that the directory will also help GPs and primary care trusts as they get to grips with new guidance that is likely to increase demand among patients for publicly funded NHS infertility treatment.

    Currently about 25% of IVF treatment is provided by the NHS, but that figure is expected to rise rapidly over the next year.

    In 2004, guidelines from the National Institute for Clinical Excellence (NICE) said that the NHS should fund three cycles of IVF treatment for women aged between 23 and 39 years. Health ministers, however, baulked at the potential cost and directed the health service to move gradually towards this target. Department of Health guidelines say that the NHS in England must offer couples at least one cycle of IVF treatment and that those without children living at home should receive priority.

    The NICE guidelines are certain to increase waiting times for services that are already overstretched, confirmed Bill Ledger, professor of obstetrics and gynaecology at the University of Sheffield and a spokesman for the Royal College of Obstetricians and Gynaecologists.

    However, he does not believe that the HFEA has hit on the best formula for helping patients and the NHS make best use of limited resources and time. The guide is too complex and detailed, he said. "If you put too much information in, it makes it hard to see the forest for the trees." Professor Ledger would prefer to see a straightforward league table, listing each centre抯 live birth rate after IVF for women aged 35.(Colleen Shannon)