National Infertility Group Report January 2013

Appendix A Waiting times modelling scenarios

Discrete events simulation modelling led by Glasgow University

Key model assumptions

• The time between consecutive referrals follows an exponential distribution.
• Each unit operates for 46 weeks per year
• Pregnancy/treatment success is age-dependent, based on HFEA data.
• Treatment can only commence when there is sufficient capacity within the unit
• Patients are treated on a first-come, first served basis.
• Given sufficient funding, NHS-funded patients take precedence over self-funded patients.
• Reducing the NHS waiting time results in fewer people choosing to self fund.

Selection of scenarios considered by the Group

Scenario 1: 2013: Three cycles, re-enter at front, BMI / smoking, age < 40.
Scenario 2: 2013: Two cycles, re-enter at front, BMI / smoking, age < 40.
Scenario 3: 2013: Three cycles, re-enter at front, BMI / smoking, age < 38.
Scenario 4: 2013: Three cycles, re-enter at front, BMI / smoking, age < 40, 2015: One partner has no genetic child.
Scenario 5: 2013: Three cycles, re-enter at back, BMI / smoking, age < 40.
Scenario 6: 2013: Three cycles, re-enter at front, BMI / smoking (no purging), age < 40.
Scenario 7: 2013: Two cycles, re-enter at front, BMI / smoking (no purging), age < 40.
Scenario 8: 2013: Two cycles, re-enter at front, BMI / smoking, age < 40, 2015: Three cycles.

Scenarios considered in more detail by the Group

Scenario recommended from 1 April 2013

Scenario 2 - waiting time upper limits

Scenario 8 - waiting time upper limits

All modelling will be available to view, from 10 May 2013, at: http://www.scotland.gov.uk/infertility