Major breakthrough on fertility treatment for lesbian couples

Lesbian couples will no longer have to face financial barriers to accessing NHS fertility treatment, in a major breakthrough in IVF funding.

Until now, female same-sex couples in England were forced to go through several rounds of expensive intrauterine insemination that can cost thousands of pounds, before being considered for NHS-funded IVF.

In comparison, heterosexual couples just have to say they’ve been trying to conceive for two years.

As part of its new Women’s Health Strategy, the government has announced that “there will no longer be a requirement for [female same-sex couples] to pay for artificial insemination to prove their fertility status”.

Now, NHS fertility treatment will begin with six rounds of funded IUI, before moving on to IVF if necessary.

An investigation into NHS-funded fertility care by BPAS Fertility found that the majority (76%) of Clinical Commissioning Groups (CCGs) require same-sex female couples to self-fund a minimum of three self-funded artificial insemination cycles and frequently up to 12 cycles, which can cost as much as £1,600 per cycle, or almost £20,000 in total.

BPAS Fertility has led the campaign to overturn what it describes as "unfair policies".

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Commenting on the announcement, BPAS fertility’s director of embryology, Marta Jansa Perez, said: “We are absolutely delighted that the government has committed to removing discriminatory barriers to IVF for female same-sex couples.

“Fertility services are crucial in supporting the development of different family structures. However, our research has found that female same-sex couples and single women are disproportionately impacted by policies which require that they self-finance costly, and less effective, artificial insemination, in some cases for at least two years, before becoming eligible for funded IVF.

"These restrictions amount to a tax on LGBT+ families, and the impact can be truly devastating. One same-sex couple told us that their experience of trying to access NHS-funded fertility treatment caused them to feel, for the first time in their life, a 'deep sadness at being gay'. The need for reform is urgent and overdue."

The announcement was also welcomed by Stonewall. The charity’s CEO, Nancy Kelley, told Yahoo UK: "We are delighted that the UK Government has listened to our call for fair and equal access to IVF treatment.

"For years, lesbians, bi women and trans people have been forced to pay for up to £25,000 of private healthcare before they can access IVF on the NHS, or face giving up their dream of becoming parents.

"This is a giant step towards a world where LGBTQ+ people have the same opportunity as everyone else to build a loving, thriving family of their own."

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So what does the change mean for same-sex couples trying to conceive?

Following the breakthrough many lesbian couples will be evaluating their options to begin building their own family.

Yahoo UK spoke to Terry Sullivan, founder of www.fertilityfamily.co.uk, who has specialised in reproductive health for almost 40 years, about the fertility options for lesbian couples.

What are the fertility options for lesbian couples?

The most straightforward way for lesbians to have a child is through the insemination of donated sperm, which can come from a male friend or anonymous donor.

For lesbian couples struggling to conceive a baby with donated sperm, in vitro fertilisation (IVF) is usually the next step. IVF involves fertilising eggs in a lab and then placing the resulting embryo into the womb. Of course, if neither of the partners has a womb that can carry a baby, a surrogate may be needed.

For lesbian partners, something called reciprocal IVF is another option. It involves one partner’s eggs being inseminated into the other partner’s womb, meaning one woman is the biological mother and the other woman carries the child to term.

What costs are involved in treatment?

Since it involves two partners, reciprocal IVF (or co-IVF) between two lesbians costs more.

For lesbians, choosing informal sperm donation – with the process performed at home – might save money, but undergoing insemination through a clinic is a much safer option.

Donor sperm from a clinic is guaranteed to be free of any sexually transmitted infections or genetic disorders. Plus, going through a clinic gives both women immediate parental rights, regardless of whether they’re in a civil partnership or not.

For prospective partners needing a surrogate and thinking of having more than one child, it might be worth considering trying for twins, if that fits with your parenting plans. Overall, the cost of transferring two embryos to a surrogate isn’t that much more than it is for one embryo. And it’s certainly less expensive than going through the whole process again after having a first child.

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What are the misconceptions about IVF for same-sex couples?

For lesbian couples, seeing a fertility specialist is nearly always a necessary step, regardless of whether or not either have fertility issues. This is in order to ensure support through proper channels regarding legality and medical risk.

Whether the requirement is a sperm donor, an egg donor and/or surrogacy, assistance is usually needed on the path to parenthood.

In the end, it’s up to you how you want to define your family and there’s no right or wrong answer.

Regardless of what you choose, it’s important to know that there are many different options available, should you choose to seek assistance to have a baby.

Watch: 11 celebrities who have opened up about having IVF

What is the success rate for same-sex couples?

The good news is the success rate for same-sex couples is just the same as heterosexual couples, if not better. According to the latest reports from the HFEA (Human Fertilisation and Embryology Authority), the average birth rates per embryo transferred were recorded for patients in female same-sex relationships at 31%, followed by patients in heterosexual relationships at 23%.

It is important to understand that these figures are averages and that the data varies widely across different clinics in the UK.

Part of the reason for this apparent disparity in success is that the number of heterosexual couples seeking help are mainly patients suffering from some form of sub-fertility, whereas the majority of same sex couples probably do not have a specific fertility problem.

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How can women prepare themselves so they are fit and healthy for IVF?

When you make the decision to go through IVF to try for a baby, you have to accept there are many things out of your control and that success is not guaranteed.

According to the NHS website, between 2014 and 2016 the percentage of IVF treatments that resulted in a live birth was: 29% for women under 35, 23% for women aged 35 to 37, 15% for women aged 38 to 39 and 9% for women aged 40 to 42.

The Mediterranean diet is recommended by many fertility nutritionists because it includes so many of the foods that are known to boost fertility.

The basis of a Mediterranean diet is fresh food such as fruit, vegetables, whole grains, nuts, spices, legumes and olive oil.

Extra virgin olive oil has the added benefit of being rich in healthy fats and helping to absorb fat-soluble vitamins.

The focus of this diet is on whole, single-ingredient foods, rather than processed foods.

You could supplement these foods with seafood, white meat, eggs, cheese and yoghurt a couple of times a week.

The MedDiet is relatively low in animal foods, but it is recommended that you eat fish at least twice a week because it is high in protein and healthy omega-3 fatty acids — essential nutrients for pre-conception health.

Furthermore, you should look to be eating red meat only once a week at most.

Some of the best foods to help your chances of conception include:

• Tomatoes – cooked tomatoes contain lycopene, an antioxidant that can improve sperm morphology.

• Olive oil – increased intake of olive oil has been shown to improve sperm quality.

• Sunflower seeds – high in vitamin E, shown to boost sperm count and sperm motility, as well as omega 6 fatty acids.

• Fish – the omega 3s in fish have been shown to have a positive effect on ovulation and healthy progesterone production.

• Oysters – Oysters are rich in fertility-boosting nutrients and often hailed as the best fertility food.

• Walnuts – walnuts contain high amounts of both omega-3 and omega-6 fatty acids that support fertility.

Foods to avoid in your IVF diet plan:

• Fizzy drinks.

• Ice cream - refined sugar.

• High GI carbohydrates eg: potatoes, white bread, rice.

• Trans fats – these are found in margarine and baked foods (e.g. cakes and pies).

• Processed meat e.g. sausages.

• Highly processed foods e.g. ready meals.

The basis of a Mediterranean diet is fresh food such as fruit, vegetables, whole grains, nuts, spices, legumes and olive oil. Extra virgin olive oil has the added benefit of being rich in healthy fats and helping to absorb fat-soluble vitamins. The focus of this diet is on whole, single-ingredient foods, rather than processed foods.

You should supplement these foods with seafood, white meat, eggs, cheese and yoghurt a couple of times a week. The MedDiet is relatively low in animal foods, but it is recommended that you eat fish at least twice a week because it is high in protein and healthy omega-3 fatty acids — essential nutrients for pre-conception health. Furthermore, you should look to be eating red meat only once a week at most.

For further information and support visit the Fertility Family LGBTQ+ Fertility hub