British couples who have difficulty starting a family are among the least likely in Europe to get the IVF treatment they need, according to a new league table published today.

Britain has come 12th out of 15 countries that provided data for 2003, with only Macedonia, Croatia and Austria performing fewer cycles of fertility treatment per head of population.

Clinics in Denmark, the top-rated country where most IVF is provided free by the state, conducted more than three times as many procedures as those in the UK, with 2,031 cycles per million inhabitants compared to just 633.

Even countries in the middle of the table, such as Germany in seventh place, perform twice as many cycles per million than the UK, while France, the country most comparable in size, comes ninth with 1,009.

A similar picture emerges in the first attempt to compare access to IVF around the world, with Britain finishing 16th out of 34 countries. Most of the lower ranked nations, with the exception of the USA which has no reimbursed provision of IVF, are from the former Soviet bloc, the Middle East or Latin America.

Israel headed the world table by a distance, with 3,263 cycles per million, reflecting its uniquely generous provision of IVF: it is available free, and without limits, to any couple that needs it.

Anders Nyboe Andersen of Copenhagen University Hospital in Denmark, who led the team that compiled the European data, said Britain’s lowly position came as no surprise given the low priority that is given to funding IVF by the NHS.

While the National Institute for Health and Clinical Excellence (Nice) has recommended that three cycles be provided free to most couples in which the woman is under 40, the Government has asked primary care trusts (PCT) to pay for just one and many do not even offer this limited service.

Last month, North Lincolnshire PCT became the latest to scrap free IVF treatment because of financial deficits, and Dame Suzi Leather, chair of the Human Fertilisation and Embryology Authority, recently described access to IVF as"the number one problem faced by patients" and called on the Government to implement the Nice guidelines.

"It’s grossly insufficient," Dr Andersen told the European Society of Human Reproduction and Embryology conference in Prague."In theory everyone should have one cycle reimbursed, but it doesn’t happen in practice. You hear of people having to wait a year or more for treatment.

"The main reason for Britain’s position is that it is not available from the state. In Israel, they have taken a political decision that it is important for society to have children, so IVF is completely free. You can see the impact that a policy like that has in the figures."

Most of the European countries that do better than Britain in the table have much more generous state funding for IVF. Denmark provides five free cycles, and Belgium has risen from fourth to second place in the rankings following its decision to fund six free cycles for every infertile couple that needs it. France provides four cycles of treatment free, and another four if the couple wants a second baby.

Clare Brown, chief executive of Infertility Network UK, a patient support group, said:"It is totally unacceptable that most other European countries have better service provision for infertility patients than the UK, where IVF was pioneered. Infertility treatment has for too long been seen as a low priority, failing couples who face the devastating impact this illness has on a daily basis. We hope the UK government feels a sense of shame at these figures, and takes immediate action to ensure that the Nice guideline is fully implemented as quickly as possible."

British clinics’ average pregnancy rates per treatment cycle were 30.1 per cent, close to the European average of 29.7 per cent. It is harder to compare success rates fairly across countries, as some, including Britain, restrict the number of embryos that can be transferred. This reduces the chances of damaging multiple births, but can also reduce success rates.

EUROPEAN LEAGUE TABLE

CYCLES OF IVF PER MILLION INHABITANTS (2003)

2002 place in brackets

1 Denmark 2,031 (1)

2 Belgium 1,682 (4=)

3 Finland 1,503 (2)

4 Iceland 1,434 (6)

5 Sweden 1,322 (4=)

6 Slovenia 1,288 (3)

7 Germany 1,242 (7)

8 Norway 1,172 (10)

9 Netherlands 1,093 (8)

10 France 1,009 (9)

11 Switzerland 785 (11)

12 UK 633 (12)

13 Croatia 611 (13)

14 Austria 602 (-)

15 Macedonia 186 (-)

WORLD LEAGUE TABLE

CYCLES OF IVF PER MILLION INHABITANTS (2002)

1 Israel 3,263

2 Denmark 2,040

3 Finland 1,599

4 Cyprus 1,374

5 Australia 1,291

6 Slovenia 1,288

7 Iceland 1,270

8 Sweden 1,225

9 Germany 1,073

10 France 1,052

11 Netherlands 997

12 Norway 909

13 Switzerland 719

14 Hungary 681

15 Bahrain 640

16 UK 611

17 Croatia 582