Funding for NHS fertility treatment does not meet current demand, leading to the rationing of fertility care through access criteria such as age, body mass index (BMI), and hormone levels.  However, many women feel that restrictions are unfair and that the impact of these restrictions on their lives is underestimated and misunderstood. Additionally, there is a lack of understanding about how rationing decisions are made in practice, as there is significant regional variability in treatment restrictions.

Women and others assigned female at birth from socially and/or racially minoritised backgrounds are disadvantaged when seeking help for fertility issues and this may be made worse by policies limiting access. Underlying social values, beliefs and systemic forms of discrimination may underpin and influence policy decision-making. 

Rebecca’s research will take an Interpretive Policy Analysis approach to untangle this issue, through mapping the perspectives of different stakeholders involved in IVF treatment decision-making. This includes women seeking fertility care, doctors charged with implementing restrictions in their practice, commissioners tasked with deciding about the scope of treatment restrictions, and other stakeholders who have an interest in this issue. 

Women and others  assigned female at birth affected by restrictions will be interviewed about their experiences of seeking fertility care, to explore how IVF access criteria have shaped reproductive choices and lives. Additionally, doctors will be interviewed to understand how IVF access is implemented in practice. Stakeholders such as advocates for policy change will be interviewed to understand critical views on restrictions. 

This study will elevate the voices of women affected by restrictions and uncover new perspectives on this issue, as well as generating evidence for future policy reviews. 

Rebecca’s research is funded through a Wellcome Trust Doctoral Training Programme Fellowship.