Accessing Fertility Care as an LGBTQ+ Couple or Individual
It’s incredibly exciting if you have made the decision to start a family, but it can be difficult to know where to start especially if you are an LGBTQ+ couple or individual. Here are some things you may want to know to start making it happen. One of the first steps you can take is to visit your GP, who can give you advice on what fertility care and treatments you can access in your area. The fertility treatment options available via the NHS vary depending on the area you live in with some requiring you to have to tried to conceive six times using artificial insemination before being considered for NHS-funded treatment, unless subfertility is proven by clinical investigation. Your GP should discuss your fertility care options with you and give you an idea of what the NHS allowance is in your area, as set out by your local integrated care board (ICB, this was previously known as clinical commissioning group, CCG). Keep reading for more information on how to access fertility care on the NHS as an LGBTQ+ couple or individual.
What can I expect from my GP?
As well as discussing fertility treatment options, your GP may also ask questions related to your reproductive health and if you have any known medical conditions that may have an impact on your fertility. You may be able to access some initial investigations, which could include a blood test during your cycle to check if you are ovulating and an ultrasound scan to assess your ovaries, fallopian tubes and uterus if you were assigned female at birth.
Unfortunately and frustratingly the NHS doesn’t routinely offer treatment for those that need a surrogate in order to conceive, which is particularly troubling for many LGBTQ+ patients. However it may be worth still discussing this with your GP as some area guidelines say surrogacy is ‘not normally’ funded – hence there may be room for exceptions to be made.
What fertility treatments are available on the NHS for LGBTQ+ couples or individuals?
In a number of areas in order to access funded fertility care on the NHS, you would need to complete six cycles of self-funded intrauterine insemination (IUI)1. Females who have not become pregnant after 6 cycles of IUI undertaken in a clinical setting should be referred for further assessment and possible treatment, if eligible in your area. Some ICBs fund up to 6 cycles of artificial insemination. However, some areas require 12 cycles of self-funded IUI before any access to fertility treatment on the NHS. This can be a large financial expense – so it’s very important to know the requirements and eligibility criteria in your area. If you’ve completed 12 cycles of IUI without achieving a pregnancy, in-vitro fertilisation (IVF) could be considered the next treatment option. ICBs will not routinely fund the cost of donor sperm, but can fund the associated treatment at the clinic.
Eligibility for care as an LGBTQ+ couple or individual
In order to be referred for treatment, an assessment must be made by your GP or fertility specialist which specifies certain criteria set out by the ICB. The criteria may include:
- Age
- Body Mass Index (BMI)
- Length of time trying to conceive
- Previous children
- Lifestyle factors
- Sterilisation – if you’ve had any procedures to permanently prevent you from having children
What are you entitled to as an LGBTQ+ couple or individual?
Once it’s established if you are eligible for treatment funded by the NHS, there may be limitations on how many cycles you are entitled to. The British Pregnancy Advisory Service (BPAS) conducted a report on the provision of fertility services and concluded that only 17% of the previous CCGs2 funded the full 3 cycles of IVF as recommended by the NICE guidelines, and 3 of the CCGs didn’t offer IVF on the NHS at all. Your GP should explain what’s available in your area, as there can be large financial implications if you would need to fund treatment yourself.
Private fertility treatment
When you attend a private fertility clinic, you will have a consultation with a fertility doctor who will discuss what treatment options are available and may request additional investigations. This can include a blood test to measure antimüllerian hormone (AMH) and an ultrasound scan to assess the follicles in your ovaries or a semen analysis. The cost of fertility treatments and donor sperm can be vary so be sure to check why a particular treatment type may be most suitable for you.
