Doctors press fertility rights

October 11, 1996

Helping mothers to conceive their babies through in-vitro fertilisation is an economically viable medical treatment when used accurately and appropriately, according to Alan Templeton, professor of obstetrics and gynaecology at the Aberdeen University.

Professor Templeton, speaking at last week's Assisted Fertilisation conference at the Royal Society of Medicine in London, revealed his model for predicting the success of fertility treatment. It takes account of a woman's age, the duration of infertility and previous pregnancies in predicting the likelihood of her becoming "spontaneously" pregnant and pregnant through IVF treatment.

Infertility treatment on the National Health Service is limited. People often pay privately for more sophisticated medical options, such as tubal surgery, laparoscopy or IVF.

But Professor Templeton says his evaluation criteria, devised after studying 2,000 women who produced 250 pregnancies, should be used by private and NHS clinics.

"We have always known that these three factors were important in the prognosis for pregnancy," he said. "What might come as a surprise is that you can take two or three of these factors together and there is a considerable multiplication of effect."

Gillian Lockwood, clinical research fellow in infertility at the Oxford IVF unit, told the conference that older women should not be deprived of the chance to conceive using modern fertilisation techniques. She urged the audience not to make moral judgements.

"There is an aesthetic problem for many people. Their image of motherhood is of the smooth-skinned Madonna with a baby at her breast," she said. "A wrinkled mother causes disquiet.

"But as a young woman you have so much to cram into such a short time and probably more of us should take advantage of the technology available to make our fertile life as long as men have enjoyed."

Dr Lockwood also stressed that a comprehensive IVF programme on the NHS makes economic sense.

"Health providers should try to maximise the number of QALYs [quality adjusted life years] per pound spent. The relative low cost and high success of assisted fertility techniques means they can produce lots and lots of QALYs very cheaply. There are QALYs for the parents and grandparents whose lives will be enhanced and enriched with a baby and QALYs for the babies who are badly wanted."

Dr Lockwood calculates the cost of providing assisted fertilisation in Oxfordshire would be Pounds 1.7 million, the same as providing cars for senior NHS staff. A course of IVF treatment for women under 38 costs around Pounds 6,200 per baby with a success rate of 25 per cent per cycle. Over 40, the cost rises to an average of Pounds 31,000 and the success rate plummets to 5 per cent per cycle, she said.

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