22 May 2012

Standing by IVF and HRT?

Women’s fertility, hormones and reproductive abilities are high on the news agenda today. 

In no particular order, there is the recommendation from the National Institute for Health and Clinical Excellence (Nice) that some women should be able to have IVF on the NHS up to the age of 42.

The interesting point about this is not so much the value of raising the age.  The question is whether primary care trusts will actually agree to the funding.

There is growing evidence that IVF is on a number of PCTs ‘cuts’ list and that no matter what Nice says, they will not pay for any couple to receive fertility treatment, let alone someone over the age of 39.

The second story today is about hormone replacement therapy.  It is from a paper published in Climateric, the journal of the International Menopause Society.  It is criticising the massive trials in the US and here 10 years ago, which showed an increased incidence of breast cancer, heart attacks and strokes and which led to a dramatic drop in the number of women being given HRT.

I have had a word with an international expert in this area who says the evidence has not changed and who did not place any great value in this latest publication.

This expert, who I respect and trust, also pointed out that the FDA in the US and the Medicines and Healthcare Products Regulatory Agency (MHRA) here continue to recommend that women should take the lowest feasible dose of HRT for the shortest possible time to minimize the risks.

So for the time being we will stick by what were the two largest ever trials into HRT anywhere in the world.

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