In addition to “dogs”, “men” and “young children” (I imagine), some women will struggle to get fertility treatment on the NHS. Here’s the lowdown.

What do the NICEish people at NICE say?

The National Institute for Health and Care Excellence (NICE) publishes guidelines for the English and Welsh NHS on a wide assortment of medical issues – one of which is the appropriate treatment and care of people with certain medical conditions.

When it comes to fertility treatment, it advises the following:

  • “In women aged under 40 years who have not conceived after 2 years of regular unprotected intercourse or 12 cycles of artificial insemination (where 6 or more are by intrauterine insemination), offer 3 full cycles of IVF, with or without ICSI. If the woman reaches the age of 40 during treatment, complete the current full cycle but do not offer further full cycles.”

    (According to NICE, “A full cycle of IVF/ICSI has been clearly defined as one in which 1 or 2 embryos are replaced into the womb as fresh embryos (where possible) with any remaining good-quality embryos frozen for use later. When these frozen embryos are used, this is still considered to be part of the same cycle.”)

  • “In women aged 40–42 years who have not conceived after 2 years of regular unprotected intercourse or 12 cycles of artificial insemination (where 6 or more are by intrauterine insemination), offer 1 full cycle of IVF, with or without ICSI, provided the following 3 criteria are fulfilled:
    • they have never previously had IVF treatment
    • there is no evidence of low ovarian reserve (as measured by an AMH level test, an FSH level test, or an antral follicle count)
    • there has been a discussion of the additional implications of IVF and pregnancy at this age.”
  • “Where investigations show there is no chance of pregnancy with expectant management (that is, through offering advice and support about timings and lifestyle changes for natural conception) and where IVF is the only effective treatment, refer the woman directly to a specialist team for IVF treatment.”
  • “In women aged under 40 years any previous full IVF cycle, whether self- or NHS-funded, should count towards the total of 3 full cycles that should be offered by the NHS.”
  • “Take into account the outcome of previous IVF treatment when assessing the likely effectiveness and safety of any further IVF treatment.”
  • “Healthcare providers should define a cancelled IVF cycle as one where an egg collection procedure is not undertaken. However, cancelled cycles due to low ovarian reserve should be taken into account when considering suitability for further IVF treatment.”

Keep reading… there's more below.

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Do all NHS fertility units have to do what NICE says?  

No: the NICE guidelines are just guidelines – and the local clinical commissioning groups (CCGs) that make the final decision often have stricter criteria than those recommended by NICE. Not only that, but many of them also use their own, stricter definition of what a “full cycle” is.

To find out what your local CCG offers, visit the Fertility Fairness website. Under “NHS fertility services”, select your region and click on the link to download a spreadsheet of all the CCGs in that region.

Not sure which CCG you’re with? The simplest “CCG postcode lookup” tool I could find is this one from Stephen Keable.

Does the NHS pay for the fertility medication as well as the treatment?

No. Unless you’re exempt from paying prescription charges, you’ll have to fork out for your fertility drugs. (You’ll be getting a LOT of drugs, so do yourself a favour and buy a three-month or yearly prescription prepayment: it will save you an absolute fortune.)

Is it possible to have IVF on the NHS after having tried private treatment?

You’ll need to speak to your CCG: they each have different rules when it comes to this question.

Any more questions about NHS-funded IVF treatment?

The Fertility Fairness website has tons of information.

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