IVF treatment is free on the NHS but inconsistencies in availability mean many couples end up having to finance their own private treatment. Emma Lunn looks at the options.

Fertility treatment offers a real glimmer of hope for the one-in-seven couples who struggle to conceive. However, couples who undertake such treatment need to prepare for an emotional - and often expensive - journey.

While treatment is theoretically available free of charge from the NHS, the reality is often very different. Eligibility for free IVF varies so much across England and Wales that couples are effectively facing a postcode lottery.

According to a survey by Conservative MP Grant Shapps, many of the primary care trusts (PCTs) that run local health services are not following guidelines on the provision of IVF set by the National Institute for Clinical Excellence (NICE), the body which decides the treatments available on the NHS.

NICE guidelines say that women aged between 23 and 39 should be offered up to three cycles of treatment. However,eligibility varies depending on the rules of the PCT operating in each region.

Shapps' report, The Messy Business of Conception, says PCTs vary over factors such as the eligible age of patients and number of IVF cycles offered. Grant Shapps says: "Inconsistencies in the implementation of the guideline have created 'baby boundaries' where couples are effectively being told that they cannot have a baby while their friends on the other side of the street, who have a similar set of circumstances are able to obtain three cycles of IVF provided for them by the NHS."

Your GP should be able to give you details of what you're entitled to on the NHS but, be warned - if you are accepted for treatment the waiting list can be very long. Also, unless you are exempt from paying prescription charges, you will still have to pay for fertility drugs which cost between £800 and £1,600 per course of treatment.

NHS treatment can either be in an NHS facility or a private clinic that has a deal with the PCT.

Going private

If your local PCT won't pay for IVF then it's time to think about going private. The NHS will normally bear the costs of tests to ascertain the problem - albeit with a waiting list - but when it comes to treatment you will have to pay for it yourself.

The Human Fertilisation and Embryology Authority (HFEA) is the watchdog responsible for licensing clinics in the UK. Its website has an interactive tool to help you search for 85 clinics around the country.

To be treated privately, you will still need to meet the clinic's eligibility criteria, which will consider factors such as your age and circumstances. But the good news is that many will treat older women than the NHS can. Clinics vary in what they offer, who they will treat and at what price, so shop around for the one that meets your needs and budget.

The HFEA puts the cost of a cycle of IVF at between £4,000 and £8,000, but it's more if you have ICSI (intracytoplasmic sperm injection) at the same time. Whether or not this price includes initial consultations, counselling and drugs depends on the clinic. Some will offer a reduced rate if you sign up for more than one.

Additional expenses you need to consider include time off work and the cost of travelling to and from hospital appointments. At the moment, there is no legal right to time off work for fertility treatment.

Counting the cost

If you have been confirmed as having fertility problems, you might be tempted to start treatment straightaway, but it is a good idea to work out how you will pay for it first. While private medical insurance (PMI) may cover the cost of diagnosing a fertility problem it doesn't cover the cost of treating it.

Paul Lynes, spokesperson of Standard Life Healthcare says: "We don't cover it on our policies, although we do pay for investigations into the cause of infertility (after two years of continuous cover) on many of our policies. This is standard in the PMI industry."

Diagnostic tests are usually paid for by the NHS but waiting times vary; patients with a long wait ahead might choose to claim on their PMI policy or pay for the tests themselves.

Funding options

There are several options for funding treatment. But the reality for many couples is that they will have to borrow. Traditional wisdom says its best to save for large expenses using tax-free ISAs and high interest rate savings accounts. But as treatment can become less successful with age, planning ahead and saving up is unlikely to be an option for couples who are desperate to start a family.

Credit cards will often be your first port of call. Many cards have longer 0% introductory on purchases.

Finances might not be at the forefront of your mind, but with expenses likely to rack up it pays to get the best value deal.

If you need to borrow larger sums or need more time to pay the debt off, personal loans are an option. Rates tend to be lower the more you borrow, so it might be a good idea to borrow the potential total cost of IVF treatment in one go rather than taking out a new loan for each cycle.

However, remortgaging might be the cheapest ways of raising extra cash.

Talk to your lender about a further advance, whereby you make a separate payment each month on the loan. Whether this is cost-effective or not depends on your lender; while some will let you have a cheap rate of interest, or at least match the interest charged on your existing mortgage, others will insist the loan is on their standard variable rate, which is inevitably higher. Shopping around for the best rate on further advances isn't straightforward.

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