This week marks 40 years since the birth of the first test tube baby, Louise Brown, but if rules then had been what they are today, she may not have been born.

Couples in the UK face what campaigners call "social rationing" of fertility treatment on the NHS, meaning its availability to would-be parents varies dramatically depending on where they live.

It is up to each local NHS provider - the Clinical Commissioning Group - to decide which treatments to fund.

The charity Fertility Network UK says if Louise Brown's parents were seeking IVF on the NHS today, they would be turned down by over 80% of England's clinical commissioning groups, because her father already had a child from a previous relationship, one of many rules that make it more difficult for couples to get IVF.

The National Institute for Health and Care Excellence (NICE) guidelines say women under 40 who have been trying for more than two years to get pregnant should have access to three full cycles of IVF on the NHS - but crucially those are not binding.


Image: The availability of IVF depends on where people live

Campaign group Fertility Fairness says the number of CCGs in England meeting those guidelines has gone down, from 24% in 2013 to 12% in 2017, and only four offer what Fertility Network UK calls the "gold standard" of three full IVF cycles, even for couples who have children from previous relationships.

Aileen Feeney, the chief executive of Fertility Network UK, said: "We believe that there should be fair access.

"NICE guidelines are there because financially and medically they are the best way to achieve the outcome that you want.

"So, therefore, we believe that everywhere in the UK should be offering those in line with the NICE guidelines, so three full cycles of IVF."

Emma Edey and her husband Lee say they are victims of these geographical differences.

Both have health problems that doctors agree would make natural conception difficult, but they live in north east Essex, one of seven areas in England where all NHS IVF treatment has been removed or suspended - and they cannot afford to pay for private treatment.

Image: Emma Edey is fighting to get IVF treatment

When Mrs Edey appealed to her local CCG last year, saying that her bowel disease means she is in "exceptional circumstances", she was refused.

She said: "They've just completely taken away everything - all of both of our dreams.

"We just want to be given the opportunity to have what all our friends have got, to be able to celebrate Christmases and stuff like a family, as families do.

"And it doesn't seem fair that my friends a few miles down the road can have it but I can't."

The cost of IVF varies but one cycle at a private clinic can come to more than £5,000.

NHS clinical commissioners told Sky News: "Unfortunately the NHS does not have unlimited resources and ensuring patients get the best possible care against a backdrop of spiralling demands, competing priorities and increasing financial pressures is one of the biggest issues CCGs face.

"As a result there are some tough choices that have to be made, which we appreciate can be difficult for some patients."

After more than two years of letters and phone calls to her MP, CCG and local hospital, Mrs Edey was told last month that her subsequent appeal has been upheld, and she can receive treatment.

But she says she'll keep fighting for others in the same situation.

"I won't stop," she said.

"I've said it all along, I won't stop until it's brought back.

"It's really not a luxury to have a baby - it's so important, it's from the heart."