Fertility inequality: How single women are facing IVF discrimination and financial strain
Nicole Collarbone never thought she would be a single mother, but as she neared her 40th birthday, she knew she no longer wanted to wait to meet a partner to have a baby.
She decided to have IVF with a sperm donor, but with the steep price of fertility treatment, and no one to share the costs with, Nicole hoped she could get at least part of it on the NHS.
But she was told that because she was single, she didn’t qualify for any fertility treatment on the health service.
“I was gutted,” she said. “It was just such a definitive no. And I had expected maybe something, you know, that we’d explore it a little bit more. There’d be more explanation around the funding, but it was just a no.”
Nicole borrowed money from her family and is now pregnant with her first child.
“I was so dependent on them being able to contribute that if they couldn’t, then I wouldn’t have been able to go down this route.”
Nicole Collarbone
She is among a rising number of single women choosing solo motherhood, with a 44% increase in women with no partner doing IVF between 2019 and 2021 according to the Human Fertilisation and Embryology Authority.
But those who cannot afford private treatment have to tackle barriers in the health service which, according to one legal expert, discriminate against them.
Over half of NHS England integrated care boards, which decide on who can get fertility treatment locally, don’t include single women in IVF policies at all.
The rest require them to spend thousands of pounds to prove infertility, by paying privately for between three and 12 cycles of artificial insemination.
It is a less invasive fertility treatment that is about a third as effective as IVF, where a cycle costs between £700 and £1,600.
If that fails, a single woman can be considered for IVF on the NHS.
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Has anything changed for single women?
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In comparison, heterosexual couples are asked if they have been trying to conceive for two years.
Female same sex couples also have to prove infertility, but the government has committed to fund artificial insemination for them as part of the Women’s Health Strategy, created in part to level up access to IVF.
There’s no such commitment for single women though, who will still have to pay, creating an unlevel playing field according Atina Krajewska, professor in human rights law at Birmingham University.
“In my view, single women should be treated similarly to same sex couples, because inevitably they are in a similar situation when it comes to their ability to conceive,” she said.
“I would see this as a discriminatory treatment based on international human rights provisions.
“Those who can afford private treatment will be affected, but not to the same extent, eventually they might just decide that they want to self-fund the treatment and then try to get access to IVF.
“For women who are from more economically disadvantaged backgrounds, this is impossible. It’s a question of equity.”
Georgie
For Georgie, the issue wasn’t just the cost, but also the time it would take to do six rounds of artificial insemination in order to qualify for just one round of IVF on the NHS in her area.
She was 38 when she decided to try for a baby alone, so she spent much of her savings to go straight to the most effective treatment.
“It is quite daunting in many ways to find out how much I ended up spending but in total with six rounds of IVF I spent in the region of £40,000.
“If you’d told me that at the start, I mean who knows what I would have actually said, but I think there’s a big part of me that would have said that there’s no way I can find that sort of money. I don’t see how I can start this journey.”
Her treatment worked and she recently gave birth to a daughter, though the spiralling cost nearly made her give up.
She considered adoption but her desire to carry and give birth to a baby was overwhelming.
Campaigners acknowledge that NHS finances are under pressure, but say single women are a fraction of those doing IVF, totalling just over 2,800 in 2021 according to the Human Fertilisation and Embryology Authority, so funding them wouldn’t break the bank.
“Single women who want to become parents and haven’t got any other options but to seek help from fertility services, are as deserving of help as anybody else,” said Dr Catherine Hill, CEO of Fertility Network UK.
“If you’re funding six or 12 cycles (of artificial insemination) you’re talking about thousands and thousands of pounds.
“And that’s just financially crippling, it’s a massive financial hurdle. That means it’s practically impossible for most single women to access NHS fertility treatment.”
In exceptional cases the NHS can refer single women to IVF without artificial insemination.
Jennifer Lon-Ho-Kee
This is what happened to Jennifer Lon-Ho-Kee, after a long and confusing journey navigating the system.
“From the time when I went to my GP initially, just to get some exploratory tests, it’s actually been eight years to the point of getting IVF, which is a hell of a long time. And it was like pulling teeth at every stage,” she said.
She was initially told she could not get fertility treatment because she was single, but when she asked again a few years later she was put on the waiting list.
Because of delays to appointments, she was nearing the age cut-off for fertility treatment in her area and was given IVF just days before breaching it.
The round did not result in a pregnancy, and Jennifer is now spending thousands on fertility treatment abroad.
The financial strain for single women should not be harder than for couples, according to Mel Johnson, a solo motherhood coach.
“Some people spend all their savings, even go into debt to pay for the treatment, which makes the starting point of becoming a parent challenging from a financial point of view,” she said.
“For me the main thing is it will be equitable with everybody else.”
The government told Sky News that local health services in England follow guidelines from the National Institute for Health and Care Excellence (NICE), and a review of those guidelines is expected to be published in 2024.
It’s like The Godfather, one reformed drug trafficker tells me.
The mythical gangster film centred on an organised crime dynasty locked in a transfer of power.
Communities in Scotland currently have a front row seat to a new war of violence, torture, and taunts as feuding drug lords and notorious families grapple for control of Glasgow and Edinburgh.
There have been more than a dozen brutal attacks over the past six weeks – ranging from fire bombings to attacks on children and gun violence.
A firebomb attack in Scotland
Victims left for dead, businesses up in flames
Gangsters have filmed themselves setting fire to buildings and homes connected to the associates and relatives of their bitter rivals.
The main aim, they boast, is to “exterminate” the opposition.
The taunting footage, accompanied by the song Keep On Running by The Spencer Davis Group, has been plastered over social media as part of a deliberate game of goading.
A 12-year-old boy and 72-year-old woman were left for dead when teenagers wearing balaclavas burst into a home in north Glasgow.
Garages and businesses have gone up in flames. Shots were fired at an Edinburgh house.
Signals are being sent of who wants control of Scotland’s dark criminal underworld.
A firebomb attack that saw a man throw an incendiary device through a building window
The fire attack set to the song Keep On Running by The Spencer Davis Group
What’s caused the gang war?
The former director of the Scottish Crime and Drug Enforcement Agency, Graeme Pearson, explains how a “vacuum of leadership” is playing a part.
Last October, Glasgow-based cocaine kingpin Jamie Stevenson, known as The Iceman, was jailed after orchestrating a £100m cocaine shipment stashed in banana boxes from South America.
The mob leader was one of Britain’s most wanted, running his business like another on-screen criminal enterprise: The Sopranos.
The 59-year-old fugitive went on the run before eventually being hunted and apprehended by police while out jogging in the Netherlands.
Jamie Stevenson. Pic: Police Scotland
Pic: Crown Office
‘Old scores to settle’
But paranoia was running rife about how this notorious gangster could be brought down. Was there a grass? Was it one of their own?
It further fuelled divisions and forced new alliances to be forged across Scotland’s organised criminal networks.
It wasn’t until The Iceman case came to court that it was revealed an encrypted messaging platform, known as EncroChat, had been infiltrated by law enforcement.
It ultimately led to Stevenson pleading guilty.
Ex-senior drug enforcement officer Mr Pearson told Sky News: “It is a complex picture because you have got people who are in prison who still want to have influence outside and look after what was their business.
“On the outside you’ve got wannabes who are coming forward, and they think this is an opportunity for them, and you have got others have old scores to settle that they could not settle when crime bosses were around.”
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Graeme Pearson
Mr Pearson describes a toxic mix swirling to create outbursts of violence unfolding in Scotland.
He concluded: “All that mixes together – and the greed for the money that comes from drugs, and from the kudos that comes from being a ‘main man’, and you end up with competition, violence, and the kind of incidents we have seen over the past four to six weeks.”
New wave of violence ‘barbaric’
Glasgow man Mark Dempster is a former addict, dealer, and drug smuggler who is now an author and respected counsellor helping people quit drinking and drugs.
He describes the “jostle for power” as not a new concept among Glasgow’s high profile gangland families.
Mark Dempster
“There is always going to be someone new who wants to control the markets. It is like The Godfather. There is no difference between Scotland, Albania, or India,” he said.
Mr Dempster suggests a shift in tactics in Glasgow and Edinburgh in recent weeks, with 12-year-olds being viciously attacked in the middle of the night.
“It is barbaric. When young people, children, get pulled into the cross fire. It takes it to a different level.
“At least with the old mafiosa they had an unwritten rule that no children, no other family members. You would deal directly with the main people that were your opposition.”
Police Scotland is racing to get control of the situation, but declined to speak to Sky News about its ongoing operation.
It has been suggested 100 officers are working on this case, with “arrests imminent”.
But this is at the very sharp end of sophisticated criminal empires where the police are not feared, there are fierce vendettas and, clearly, power is up for grabs.
UK
Laws may need to be bolstered to crack down on exploitation of child ‘influencers’, senior MP suggests
Laws may need to be strengthened to crack down on the exploitation of child “influencers”, a senior Labour MP has warned.
Chi Onwurah, chair of the science, technology and innovation committee, said parts of the Online Safety Act – passed in October 2023 – may already be “obsolete or inadequate”.
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Experts have raised concerns that there is a lack of provision in industry laws for children who earn money through brand collaborations on social media when compared to child actors and models.
This has led to some children advertising in their underwear on social media, one expert has claimed.
Those working in more traditional entertainment fields are safeguarded by performance laws, which strictly govern the hours a minor can work, the money they earn and who they are accompanied by.
The Child Influencer Project, which has curated the world’s first industry guidelines for the group, has warned of a “large gap in UK law” which is not sufficiently filled by new online safety legislation.
Official portrait of Chi Onwurah.
Pic: UK Parlimeant
The group’s research found that child influencers could be exposed to as many as 20 different risks of harm, including to dignity, identity, family life, education, and their health and safety.
Ms Onwurah told Sky News there needs to be a “much clearer understanding of the nature of child influencers ‘work’ and the legal and regulatory framework around it”.
She said: “The safety and welfare of children are at the heart of the Online Safety Act and rightly so.
“However, as we know in a number of areas the act may already be obsolete or inadequate due to the lack of foresight and rigour of the last government.”
Victoria Collins, the Liberal Democrat spokesperson for science, innovation and technology, agreed that regulations “need to keep pace with the times”, with child influencers on social media “protected in the same way” as child actors or models.
“Liberal Democrats would welcome steps to strengthen the Online Safety Act on this front,” she added.
‘Something has to be done’
MPs warned in 2022 that the government should “urgently address the gap in UK child labour and performance regulation that is leaving child influencers without protection”.
They asked for new laws on working hours and conditions, a mandate for the protection of the child’s earnings, a right to erasure and to bring child labour arrangements under the oversight of local authorities.
However, Dr Francis Rees, the principal investigator for the Child Influencer Project, told Sky News that even after the implementation of the Online Safety Act, “there’s still a lot wanting”.
“Something has to be done to make brands more aware of their own duty of care towards kids in this arena,” she said.
Dr Rees added that achieving performances from children on social media “can involve extremely coercive and disruptive practices”.
“We simply have to do more to protect these children who have very little say or understanding of what is really happening. Most are left without a voice and without a choice.”
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The researcher pointed to one particular instance, in which children were advertising an underwear brand on social media.
She said: “The kids in the company’s own marketing material or their own media campaigns are either pulling up the band of the underwear underneath their clothing, or they’re holding the underwear up while they’re fully clothed.
“But whenever you look at any of the sponsored content produced by families with children – mum, dad, and child are in their underwear.”
Dr Rees said it is “night and day” in terms of how companies are behaving when they have responsibility for the material, versus “the lack of responsibility once they hand it over to parents with kids”.
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