HEALTH & WELLBEING
trouble conceiving and so may lose the continuity of medical care and treatment that is preferable.”
“Couples experiencing problems conceiving should, after 6 to 12 months of trying, see their GP for a chat and some basic tests. These include a sperm test for the man, plus an ovulation blood test and a pelvic ultrasound scan for the woman. If the tests are normal the couple may be encouraged to continue trying for longer, but if the tests are abnormal, or the woman is in her late 30’s or beyond, then referral to a fertility specialist is appropriate. A test for patency of the fallopian tubes may be arranged and, if the woman is not ovulating, drugs given to stimulate this or surgery suggested to improve the pelvis.
“However, for many couples, IVF is the most appropriate treatment, usually because the chance of natural conception is low due to either an underlying untreatable problem or because the couple have been trying to conceive for two or more years. During an IVF cycle the woman will need to take a programme of drugs to help produce eggs, these will be collected by a minor surgical procedure in the clinic. At the same time the man will provide a sperm sample and then eggs and sperm are brought together in the clinic laboratory to fertilise either naturally (In-Vitro Fertilisation) or by Intra-Cytoplasmic Sperm Injection (ICSI). ICSI is when sperm is injected into the egg assisting couples where a low sperm count or quality is the issue. The fertilised eggs, known as embryos, are carefully stored and monitored in incubators over two to five days. One or two embryos are then transferred back into the woman’s uterus via a procedure similar to a smear test. The couple then have to wait for two
weeks before taking a pregnancy test, if this is positive then it is followed up by a pregnancy scan three weeks later. The chance of success is mainly dependent on the age of the woman. For a woman aged 35 years each IVF cycle will roughly have a live birth rate of 33%. This is why funding for up to three cycles is so important as not every cycle is successful.”
A three cycle entitlement is made up of three fresh cycles, where fresh eggs and sperm are used each time. A cycle may result in several viable embryos but no more than two may be implanted, the remainder can be frozen. Should a pregnancy not result from the first embryo(s), any remaining embryos can be implanted over time within that one cycle before a fresh cycle would be required. Understandably, as this process will take time, the MOD is revising its stability policy for couples accessing Assisted Conception Services (ACS) in the UK. In order to provide continuity of care for Service personnel and their partners, up to three years (previously six months) geographical stability in the UK can be requested for those undergoing ACS.
National Health Services in England and the Devolved Administrations provide ACS to different levels and with a variety of different qualification criteria. In England for example, the authority on what services will be provided is delegated to a local commissioning group which then decides whether or not they will provide IVF and also how many treatment cycles. This could result in a disparity in the number of funded treatment cycles provided which has naturally caused some uncertainty for Armed Forces personnel when moving every few years.
NHS England and the Devolved Administrations have committed under the Armed Forces Covenant to provide fair treatment to the Armed Forces Community and special consideration to those who have given the most. Part of this commitment has been an agreement, where possible and practicable, to enable military personnel and their partners to access IVF provided they meet set criteria2. NHS England and the Devolved Administrations fund the same services for military couples, including all consultations, tests, drugs, procedures and pregnancy scans up to seven weeks if successful. However, the number of funded IVF cycles for entitled couples currently differs3. The MOD is working with NHS England and the Devolved Administrations to improve this provision where possible.
To qualify for IVF, couples must meet the following criteria: • Women must be under the age of 40 and have been trying to get pregnant for 2 years, unless tests show a diagnosed absolute cause of infertility meaning that there is no chance of the woman getting pregnant naturally (for example blocked tubes or absent sperm).
• The woman must also have a BMI of between 19 and 29.9 and be a non- smoker (for at least six months).
• The partner/sperm donor must also be a non-smoker and have a BMI of 30 or below.
• Women aged 40-42 years can access funding for one cycle of IVF if: they have been trying for two years; have never had IVF treatment before; the fertility tests show that their ovaries should respond to fertility drugs and they meet the same BMI and smoking criteria.
www.raf-ff.org.uk
Envoy Summer 2015
39
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56