Same-sex couples are facing barriers to accessing NHS fertility treatment, with some forced to pay up to £20,000 before they can access care, according to a study.
BPAS Fertility, which intends to launch its own not-for-profit fertility service in the autumn, found that more than a quarter of NHS clinical commissioning groups (29%) will not fund the cost of donor sperm to be used in IVF treatments.
Most (76%) of the 106 CCGs in England require a minimum of three artificial insemination cycles to be paid for by female same-sex couples, with more than a quarter (29 CCGs) saying 10-12 cycles were needed, creating a bill of up to £20,000.
This, according to BPAS, which requested the data under the Freedom of Information Act, may be in breach of equality legislation.
While the NHS will fund care for heterosexual couples who say they have been trying to conceive naturally, female same-sex couples are told to prove their “fertility status” through rounds of artificial insemination, paid for privately.
The BPAS study also found that 57% of CCGs will fund one cycle of IVF, less than 20% will fund the three rounds recommended by the National Institute for Health and Care Excellence (Nice), and in some areas no care is provided at all.
The findings come despite Nice guidance stating that intrauterine insemination (IUI) should be considered as a treatment option for people in same-sex relationships.
BPAS also found that three CCGs (Brighton and Hove, East Sussex and West Sussex) do not fund procedures involving donor sperm or eggs for any patient group.
BPAS said this has a disproportionate impact on female same-sex couples, since it effectively bans them from accessing NHS-funded care.
Some 31 CCGs (29%) also said they do not fund the cost of donor sperm to be used in IVF treatments for female same-sex couples.
One fertility patient told BPAS: “The requirement of our CCG to self-fund 12 attempts to conceive means that we have ruled this out as a viable option.
“We would likely have spent tens of thousands of pounds and be a few years down the line by the point we are eligible for support.
“Our heterosexual friends who have required fertility support from the NHS have had a very different experience.
“It has made me and my partner feel unsupported and discriminated against by the NHS for which we both work, and at times had made us seriously consider whether we will be able to start a family at all.
“This has inevitably put our relationship under pressure. I generally feel quite comfortable with my sexuality, but the fertility process is the first time in my life that I have felt deep sadness at being gay.”
Marta Jansa Perez, director of embryology at BPAS Fertility, said: “This report lays bare the harsh reality of access to NHS-funded treatment for female same-sex couples. The barriers faced by these patients are striking and amount to a tax on LGBT+ families.
“Going through fertility treatment can be a vulnerable experience, and even more so for patients funding their own treatment at great personal cost.
“As a society we are not used to paying for healthcare, and an already complex process can be complicated further by unfair gate-keeping and red tape.”
Eloise Stonborough, associate director of policy and research at Stonewall, said: “All lesbian, gay, bi, trans and queer people who want to, should be able to start their own families.
“While accessible, inclusive, and fair fertility services should be available to everyone who needs them, in reality, there are many barriers to LGBTQ+ people accessing NHS-funded care and causing obstacles to LGBTQ+ people forming a family of their own.
“BPAS’s vital report shines a light on the inequalities that still exist for female same-sex couples looking to start their family, from lack of funding to a postcode lottery.”
A spokeswoman for the NHS said: “While these decisions are legally for CCGs, who have to balance the various competing demands on the NHS locally, it is absolutely right that they should provide equal access to services according to need for people within their areas.”