Lesbian couple win fight for IVF on the NHS

A Lesbian couple have won the right to IVF on the NHS after a legal tussle, ahead of laws that will put same-sex patients on an equal footing with heterosexuals.

The couple, who remain anonymous, had to go through a legal fight to push the NHS to fund IVF because, at the moment, individual trusts decide whether they wish to pay for treatment for lesbians.

The couple were initially refused IVF by their primary care trust because they were of the same sex. One of the women had polycystic ovarian syndrome, which disrupts ovulation, and is one of the most common causes of infertility.

From October, clinics will no longer be able to block lesbians by referring to a child’s “need for a father”. Instead, same-sex couples will need to demonstrate only that they can offer “supportive parenting”.

If NHS trusts continue to deny lesbians fertility treatment after this date they face possible legal action.

Ruth Hunt, head of policy at Stonewall, the lesbian, gay and bisexual charity, said: “The changes in the law should mean that no infertile lesbian is refused NHS fertility treatment on the grounds of her sexual orientation.

“We have just published a guide on how to get pregnant for lesbians in response to lots of queries. This is a hot topic for us at the moment.”

While same-sex couples have won new rights, many heterosexual couples continue to be denied IVF on the NHS. Only 27% of trusts offer heterosexual couples three cycles of treatment as recommended by the National Institute for Health and Clinical Excellence, the NHS guidance body.

If lesbians are fertile they can usually conceive by intrauterine insemination (IUI), the medical name for donor insemination. This is less complicated than IVF, which involves fertilising eggs in a test tube. IUI is also cheaper,at about £700 per attempt compared with £3,000 per cycle of IVF.

The lesbian couple enlisted David Herbert, a partner at the law firm Lester Aldridge, when they were denied IVF on the grounds that they were of the same sex. The trust reversed its decision in June.

Herbert said: “Discrimination on the grounds of sexual orientation is contrary to the Human Rights Act and the Equality Act. There is an element of conflict in the Human Fertilisation and Embryology Act 1990 which requires clinics to consider a child’s ‘need for a father’.

“This was used historically to justify denying treatment to same-sex couples. The ‘need for a father’ element is just about to be removed on the grounds that it is discriminatory. The assessment will be for ‘supportive parenting’, which will come into force in October.”

The government’s equality watchdog, the Equality and Human Rights Commission, took an interest and offered its support to the couple.

This is the second known case in which lesbians have been given fertility treatment after a legal fight. In February a Scottish couple forced Greater Glasgow and Clyde NHS health board to offer them treatment.

Sperm Washing

If you are having difficulties becoming pregnant, you may have decided to try certain fertility treatments in order to increase your chances of conceiving. Intrauterine insemination (IUI) is often the first type of fertility treatment attempted by couples. In order to get sperm ready for the IUI procedure, it must first be washed. Sperm washing may sound strange, but it actually works to ensure that only the healthiest sperm are used during the procedure. Sperm washing can increase your chances of conception and may help you to welcome a new addition to your family. Sperm washing is a procedure used to prepare sperm for use in IUI. It allows your partner’s sperm a better chance for survival and fertilization. Sperm washing separates sperm cells from a man’s semen, helping to get rid of dead or slow-moving sperm as well as additional chemicals that may impair fertilization. Once sperm has been washed at your fertility clinic’s laboratory, it can be used during IUI to help achieve pregnancy. There are a variety of different sperm washing procedures.

Sperm must be washed in order to be used with IUI. Raw semen cannot be inserted directly into a woman’s uterus. This is because semen contains chemicals called prostaglandins. Prostaglandins cause muscular contractions and are responsible for cramps during menstruation and pregnancy. If raw semen is inserted directly into your uterus, rather than going through the cervix first, it could cause severe pain and cramping. It could also cause your uterus to collapse, causing severe complications.
Sperm is also washed in order to increase your chances of becoming pregnant. Sperm washing can remove dead sperm and those sperm with poor motility. This leaves behind sperm that can swim faster and that are more likely to fertilize your egg. Sperm washing can also get rid of the white blood cells, mucous and seminal fluid surrounding the sperm, which can also interfere with fertility.

Anyone who pursues IUI will receive the sperm washing procedure. However, the procedure can also benefit others, especially those with:

-unexplained infertility
-male-factor infertility
-women with endometriosis
-men with antisperm antibodies


The sperm wash procedure is actually relatively easy to prepare for. Your semen will be collected after you masturbate, or from a sample taken during surgical sperm retrieval. It is important to refrain from sexual intercourse for two days before your sperm is collected. However, do not go more than five days without intercourse. Certain antibiotics may also affect the quality of your sperm, so speak with your fertility physician if you are taking any medications.

There are three commonly-used sperm washing techniques:

Simple Sperm Wash
The simple sperm wash technique is the most basic way of washing and preparing sperm for IUI. Semen is diluted in a test tube with a special solution of antibiotics and protein supplements. It is then placed in a centrifuge, a machine that spins around at extremely high speeds. As the sperm mixture is spun, sperm cells fall to the bottom of the test tube, producing a mass of dense, highly active sperm. These sperm can then be removed from the test tube and used in IUI. A simple sperm wash takes about 20 to 40 minutes.

Density Gradient Sperm Wash
The density gradient sperm wash is one of the most popular sperm washing methods. This is because it also works to separate dead sperm cells, white blood cells, and other waste products from the sperm. A test tube is filled with multiple layers of liquids of different densities. Semen is then placed on the top layer of liquid and the test tube is spun in a centrifuge. After it is spun, active, healthy sperm will make their way to the very bottom layer of liquid in the test tube, while debris and dead sperm will get caught in the top two layers. These layers can be siphoned off in order to remove the active sperm from the test tube. This sperm is then used in the IUI procedure. Density gradient sperm washes take approximately 60 minutes.

Swim Up Technique
The swim up technique is rapidly becoming more and more popular throughout Indian fertility clinics. This technique revolves around the fact that sperm need to swim forwards and up in order to reach the uterus. Only the most powerful sperm will be able to do this. In order to retrieve this powerful sperm, semen is placed in a culture dish with a layer of media culture. Sperm are attracted to this culture, and will swim up to it. As the sperm swim up to the culture, they are collected. This technique takes about an hour in order to harvest enough sperm for use in IUI.

Success Rates
Success rates do increase when sperm washing is used with IUI. Because sperm washing ensures that only the most healthy and active sperm are used for fertilization, there is an increased chance that you will become pregnant when using washed sperm. However, success rates do depend on your partner’s overall sperm count. Typically, the lowest sperm count to be used with sperm washing is one million, however, success rates are significantly lower if your sperm count falls beneath five to ten million. The best sperm counts for use with sperm washing are those between 20 and 30 million.

Cost of the Procedure
The cost of sperm washing in itself is relatively low. A basic sperm wash typically costs only Rs.3000 or so. If you opt for one of the more advanced forms of sperm washing, it could cost you up to Rs.10000. However, sperm washing is only of use when combined with other fertility treatment procedures. One session of natural IUI typically costs under Rs.3000 while IUI with the use of fertility drugs and monitoring can cost anywhere between Rs 8000 and Rs 10,000.