Dear Lord Winston,
I am interested in your views on the availability of artificial insemination (with or without IVF) for older women without a male partner. I am a single woman in my mid forties, my menstrual cycle is still regular and hormone tests indicate I am ovulating normally. I have never ever tried to conceive and am potentially still fertile.
UK policy does not support assisted reproduction for me because statistically I am too old. Statistics reflect populations but don’t account for individual differences. I am forbidden from even attempting to conceive using my own genetic material, something I would happily pay privately for and an option not denied to women in a relationship with a male partner. My options seem to be to travel to Europe for private treatment (and probably be encouraged to take a donor egg so as not to skew commercial clinic ‘success rates’) or to risk unprotected sex with a stranger. The latter is not an option.
I accept policy thresholds need to be set somewhere for assisted reproduction but I wonder is there room for consideration of an individual’s circumstances. Is age too blunt an instrument when an individual is ostensibly still fertile?
I’m most grateful for your time and attention. N

Reply…

Dear N,

I think we may have to recognise that where health service resources are limited, treatments for non-life threatening conditions will be increasingly difficult to obtain. And frankly, if you are genuinely in your mid-forties (what age 45 or older?) your chances of conception with treatment and without intercourse are extremely slim – with artificial insemination or IVF less that 5% per cycle and with a high risk of miscarriage and a slightly increased risk of a child with a genetic defect of some kind. Added to this, in Britain due to regulatory restrictions now in place, there is a massive shortage of donor sperm and I suspect that under the NHS, there will be very little donor sperm available. Even private clinics are finding it extremely difficult to meet the demand.

Of course there must be room for consideration of an individual’s circumstances and I also agree statistics reflect populations not individuals, But what makes you believe that you are outside the normal curve? The vast majority of women continue to ovulate till 50 plus are having normal periods, but in general they do not produce eggs which are capable of giving rise to a healthy pregnancy. The mean age of menopause in Britain is 52 and the mean age for cessation of fertility ten years earlier, probably around 42.

I am sorry not to be more hopeful and positive, but I think what I have written reflects something often very difficult to accept.

My best wishes
Robert Winston

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