Transgender patients should benefit from the proposed changes to the egg and sperm freezing policy adopted by the local NHS.
The policy exists to ensure that patients who undergo medical or surgical treatment on the NHS that could cause permanent infertility are able to freeze their eggs or sperm for future use.
Some transgender patients are already eligible for surgery due to the current policy, but a Leicestershire healthcare boss called it “confusing.”
The new version, which is expected to be adopted throughout the East Midlands, is an attempt to reduce the risk of postal code lottery situations.
A lot of confusion
Clinical commissioning groups (CCGs) – health budget boards – across the East Midlands are set to launch a consultation on the changes this month.
Ket Chudasama reported on changes to a meeting of the three GCCs in Leicester and Leicestershire. He said: “The point of having an East Midlands approach is to start building some consistency.”
What’s going on in your area
One participant said, “There was a lot of confusion as to who was included in the process. The old policy stipulated that urological procedures, which would include sex change, met the criteria, but because there was some confusion and there were a lot of people who were not included in the original part of the process. “
He asked questions about the possibility of retrospective complaints by people who were eligible for treatment but who were not offered to him and therefore went in private.
Mr. Chudasama said it would be considered during the consultation process.
In a draft of the new version of the document to clarify who is eligible for treatment, examples include people undergoing chemotherapy, irradiation or radiotherapy that could affect the reproductive organs, conditions requiring urological or gynecological surgery and people who have mitrochondrial conditions.
Change of age limit
The new policy also states: “The policy includes the recovery and storage of transgender patients who are receiving treatment for gender dysphoria that can cause permanent infertility (hormone therapy, reconstructive surgery, etc.). Cryopreservation will be funded for patients on a transgender route provided the criteria are met. “
In the previous policy, there was no upper age limit for men, but that will change and men will have to be 55 or younger to receive treatment. The age limit for women will remain at 42.
The report states that the consultants will make recommendations on behalf of patients who meet the criteria. Patients will receive a treatment cycle – multiple attempts will not be funded by the NHS.
The eggs will be kept for a maximum of 10 years and patients will be able to self-finance after this period.
Data provided in the CCG report estimates that 55 men and nine women in Leicestershire would be eligible for the procedure per year.
A policy report provides a breakdown of the figures collected in the East Midlands. The data show that from 2013/14 to 2016/17, the vast majority of referrals were for patients undergoing cancer treatment – 93% men and 97% women.
One percent of men and no women were referred for other medical / surgical treatment and demand for privately funded cryopreservation from transgender patients during the same period was “relatively low” – six percent of men and three percent of women.
The report adds that “there will likely be an unmet residual demand in the (transgender) population”.
Across the region, costs are expected to be around £ 230,000 per year.
What is happening in Leicester hospitals
Recovering and freezing eggs (eggs or embryos) costs around £ 3,000 per patient.
Treatment costs for freezing sperm are around £ 250 per patient per year. If surgical recovery of sperm is necessary, it will cost an additional £ 850 per patient. Storage costs are around £ 200 per year for men and women.
The background to the report says: “The demand for health care is greater than what can be funded from this fixed budget.
“Unfortunately, this means that certain health care that patients may wish to receive and that professionals may wish to offer cannot be funded. CCGs prioritize what they spend, so that their local people have access to the health care they need most. ”