The effect of government funding on IVF (in-vitro fertilisation) demand: Evidence from regional data in the UK

Lay summary

In the UK and in high-income countries more generally, many people are now waiting longer until they start a family. Since it is harder to conceive naturally at older ages, in-vitro fertilisation (IVF) is becoming more and more important in helping people have the number of children they want. This study explores whether the level of NHS funding for IVF has any impact on birth rates in the UK and whether IVF should be funded more generously than it currently is. The aim of the research is to determine how NHS funding criteria for IVF affect how many people use it. That means looking at how the supply (funding for IVF) interacts with the demand (how many people access IVF). The main source of data for this research is records of IVF treatments undertaken in all licensed clinics in the UK, submitted to the Human Fertilisation and Embryology Authority (HFEA). Additionally, information about the number of women and birth rates in the UK is used. While funding for IVF set nationally in Scotland, Wales and Northern Ireland, this depends on the local integrated care board in England. This is often called the ‘postcode lottery’ by patients. The study uses these differences in funding to estimate how demand for IVF changes with the funding level. Firstly, the study looks at the current situation: How many IVF treatments are done in different areas, how successful are they, and how do they contribute to overall birth rates? Then, the main part of the research is about understanding how changes in funding affect whether people use IVF as well as how many cycles they try for. It uses several statistical techniques to compare areas with different funding rules to see if more generous funding leads to more people using IVF as well as completing more cycles. Finally, the research will use these findings to predict what might happen if IVF funding is changed. This includes an estimate of how cost-effective it would be to increase funding for IVF in the UK to the level recommended by the National Institute of Health and Care Excellence.

Public benefit statement

There has been a long debate on the so-called “postcode lottery” that patients face when accessing IVF in the UK. Patients feel they are being treated unfairly when they are denied funding based on where they happen to live. On the other hand, local integrated care boards may be in a difficult position to prioritise funding for IVF due to limited resources. This research project will be the first to quantify how many patients likely forego treatment each year due to the limited amount of NHS funding available. Given the psychological burden from the unrealised desire to have a child, it is of great public importance to highlight the scale of this problem. The project will also highlight impacts of higher IVF funding on birth rates. Ultimately, it hopes to offer compelling evidence on how increased IVF funding could benefit future IVF patients.