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Science has developed on from the now relatively basic and clumsy process of in vitro fertilisation (IVF) simply mixing gametes together outside the body and re-implanting them. When National Institute for Health and Clinical Excellence (NICE) examined the question of infertility, it used a fairly basic estimate of cost effectiveness related to the numbers of cycles performed and their cost and likely success rates in various age bands. Criteria with regard to secondary infertility inadvertently discriminate against older people, since these are more likely to be in second or third relationships. Denying a couple the chance of treatment if there is a pre-existing child from any previous relationship seems especially harsh but is frequently applied. Good evidence exists on the Human Fertilisation and Embryology Authority (HFEA) database as to the value of the treatment, and success rates have continued to rise over the past 10 years.
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