There is a particular kind of absurdity reserved for fertility treatment in Britain.
You can have the same diagnosis, the same clinical need, and the same desire to become a parent as someone living a few miles away – and yet your chances of getting NHS-funded IVF can be completely different.
Why? Your postcode. And, let’s be honest, multiple other stipulations and eligibility criteria too.
For something as important as deciding who gets the chance to to try for a baby – it has always felt like a spectacularly blunt instrument.
But, finally, something is shifting.
Over the past few days, we have seen two developments that suggest fertility access is moving up the political agenda – and, importantly, moving towards a conversation about what fertility fairness should actually look like.
In Scotland, we’ve seen only days ago, the Government has announced a review of NHS-funded fertility treatment. It will look at access for solo parents and people whose partners have children from previous relationships, fertility preservation for people facing cancer treatment, donor-treatment waiting times, and whether the latest NICE guidance should be reflected in Scotland’s provision.
Then, almost immediately afterwards, came a significant moment here in England.
Last Thursday, our CEO, Katie Rollings, met with Sir Gavin Williamson to talk about the postcode lottery and the urgent need for fairer access to NHS-funded IVF.
He promised to act.
This afternoon, he did.
Sir Gavin asked the Secretary of State to support a proposed new clause requiring the Prime Minister to make regulations standardising NHS-funded IVF provision across all Integrated Care Boards in England, in accordance with existing NICE guidelines.
And crucially, that includes the things patients know all too well can vary depending on where they live: how many IVF rounds you can access and the age limits for treatment.
This is not a law yet. It is not the end of the postcode lottery.
But it is a big deal.
Because something that has spent years being treated as an unfortunate quirk of NHS commissioning is now being put firmly on the political table.
The problem with the postcode lottery
Infertility is already an experience defined by uncertainty.
Will treatment work? How long will it take? Can we afford another cycle? Will I still be eligible by the time I reach the front of the queue? Is my age, weight, identity, relationship status, egg-reserve, POSTCODE going to affect my chances?
The last thing anyone needs is to add: And I wonder what my local ICB thinks?
Yet that is the reality for many patients.
NICE guidelines can recommend a particular level of treatment, but access can vary considerably between areas. The result is a system in which the postcode on your driving licence can have an extraordinary influence on whether, and how, you become a parent.
It is difficult to think of a more personal example of inequality.
And that is why our campaign has been so determined to keep pushing. We aren’t asking for a lottery ticket – far from it. We’re asking for the rules to make sense, and to consider everyone who’s impacted.
Why this moment feels different
Campaigning can be a strange business.
You spend months explaining a problem that everyone insists they understand. You produce evidence. You tell stories. You have meetings. You have more meetings. You explain the same thing again, but this time with a graph.
And then, occasionally, something happens.
A conversation becomes a commitment.
A commitment becomes a proposal.
And suddenly the thing you’ve been campaigning about isn’t just something people are talking about – it is something sitting on a politician’s desk.
That is where we are now.
The Scottish review and the proposed new clause in England are not identical. But they are part of a much bigger shift: governments are being forced to look at whether fertility services reflect the realities of modern families, modern medicine and modern clinical guidance.
And frankly, it is about time.
Families don’t fit neatly into old assumptions anymore. People become parents in different ways. They face cancer diagnoses that can affect their fertility, or have children with previous partners. People choose to parent alone. Medicine moves forward.
Healthcare policy has to move with it.
A moment to celebrate – and then carry on
We are very conscious that a proposed clause is not the same thing as change on the ground.
There is still a process to go through. There is still work to do.
But after years of hearing that the postcode lottery was too complicated to solve, seeing a concrete proposal to standardise provision in England is a moment worth recognising.
So, yes, we’re celebrating this one.
For everyone who has shared their fertility story, spoken to their MP, supported our campaign, challenged the system or simply refused to accept that this is just how it is…. thank you.
You have helped move the conversation.
And perhaps the most encouraging thing about this week is that we are no longer simply asking whether fertility access needs to change.
We are beginning to have the much more interesting conversation:
What should fair fertility access actually look like?
That is a conversation we intend to keep having.
Loudly.
