Fertility treatment delays ‘will impact older women’

Dr John Waterstone, medical director of Waterstone Clinic, says many patients are still unclear on how to access the State-funded fertility treatment scheme.




A leading fertility specialist has warned any delays in referrals to the State-funded fertility treatment scheme could further reduce older women’s chances of conceiving.

Dr John Waterstone, medical director of Waterstone Clinic, says many patients are still unclear on how to access the scheme.

And he cautioned that any potential “bottlenecks” could impact women in their late 30s or early 40s for whom fertility treatment is less likely to work.

“Patients probably still aren’t aware how the mechanism works,” he said.

“We don’t send patients to the fertility hubs, the GP has to make a referral for the patient concerned.”

There are six such hubs including in Cork University Maternity Hospital and Nenagh Hospital.

Hubs can then refer eligible couples to a private clinic of their choice, from a list of HSE-approved providers of which Waterstone Clinic is one.

“If [a woman] is 38 or 39, the passage of time means her chances are going to reduce because the chance of success is very much related to the woman’s age,” he said.

“If there is a big delay in getting through the bottleneck of the hub, it could be significant for them.”

The new scheme funds one cycle of IVF among other options, and he said while some women do get pregnant after one cycle, this is not certain.

“It’s not even guaranteed to work. Some couples will have several cycles and still not end up with a baby,” he cautioned.

Women aged up to 40 years and 364 days are eligible for funding.

Dr Waterstone said this is because “the treatment is less likely to work for women who are in their 40s. Is that fair on women in their 40s? Probably not but it is pragmatic”.

However, he is worried that the impact of age on fertility may not be fully understood.

“Some do [know], some don’t,” he said, describing a clinic where “every single patient I saw was 41, 42, 43, 44. I didn’t see anybody who was in their 30s. It was thoroughly depressing [for them].”

He explained how the chances of success vary with age.

“If you are in a good unit with good success rates and you are, say, under 35 the chance of a baby out of one IVF cycle is 50%-ish,” he said.

“Then as the woman gets older, that chance goes down.

“By the time she is 40, it’s gone down to 25% to 30%, and as a woman gets older still into her 40s, their chance gets lower still.

“By the time you get up to age 42, 43, the chances have gone to 5% or 10% maximum.”

It is not yet clear for how long the Government will involve private clinics in this system, he said.

“The fact there has been a huge over-run on the Department of Health budget this year means it all depends on how much money and how they are going to dole it out, and is IVF going to be seen as a high priority or not so high priority,” he said.

The HSE and Department of Health fertility treatment scheme opened for GP referrals on September 25 in the first phase of a process expected to include further treatment options after legislative changes.