The NHS is contributing to needless abortions and the avoidable birth of children with inherited diseases because of a postcode lottery in embryo screening, medical experts said today.

Couples who know they are at risk of passing on serious genetic diseases to their children are often refused funding for IVF tests that can detect affected embryos, according to doctors and nurses from Guy’s Hospital in London.

This has led to cases in which couples have terminated pregnancies following the results of prenatal tests and incidents where children have been born with a genetic disease that could have been picked up with embryo screening.

When prospective parents know they are at risk of having children with a serious heritable disease, they can use an embryo screening test known as pre-implantation genetic diagnosis (PGD) to ensure they have a healthy baby.

Though such couples are generally fertile, they conceive by IVF and a single cell is removed from each embryo for genetic analysis. Only embryos that do not carry the faulty gene carried by the family are then chosen for transfer to the womb.

The service, which costs about £7,000, is available for hundreds of genetic conditions, including cystic fibrosis, Huntington’s disease and muscular dystrophy, and several hundred PGD babies have been born in the UK.

The only alternatives are prenatal testing, in which a foetus is tested several months into pregnancy, offering the parents the opportunity to have an abortion if it is affected, or taking no tests at all.

All primary care trusts fund prenatal tests during pregnancy when there is a risk but many will not pay for PGD, even though this can prevent abortions.

Alison Lashwood, consultant nurse in genetics and PGD at Guy’s, said: “There are couples we have seen who have not been given funding, who have gone on to have affected children. Others have had to go down the prenatal testing route and some have had terminations.”

Speaking at the launch of Guy’s Hospital’s new Assisted Conception Unit and PGD centre, which opens tomorrow, she described one couple who had been refused PGD on the NHS, who had gone on to have a stillbirth and a baby with a severe inherited disease.

Some PCTs, Ms Lashwood said, apply the same eligibility criteria as they do to IVF for infertility even though it is not a fertility treatment. This means that couples can be refused on grounds of age or because they already have children. The latter is particularly unfair on couples who discover they need the procedure because they have already had a child with a genetic disease.

“They cannot get the idea that PGD is an early approach to prenatal diagnosis, not a type of fertility treatment,” Ms Lashwood said. She urged trusts to set up common rules, as are already operated by a consortium of PCTs in south east England.

Yacoub Khalaf, head of the Guy’s unit, said: “More trusts than not understand the need for PGD and that it is not to be mixed up with fertility treatment, but some trusts say they offer prenatal diagnosis, so why don’t you have that? It denies patients a choice.”

Professor Peter Braude, of King’s College, London, said: “Some PCTs regard PGD as a bolt-on to IVF, but it should not be seen that way. Most patients who have PGD are not infertile.”

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