Decommissioning of IVF and other NHS fertility services

Difficulty conceiving is a problem that affects around one in seven couples in the UK. According to NHS Choices, 84% of couples will conceive naturally within a year if they have regular unprotected sex, while 92% will conceive within two years.

The National Institute for Clinical Excellence (NICE) recommends that couples who have been unsuccessful in conceiving after two years should be offered three full cycles of in vitro fertilisation (IVF) for women under 40, and one cycle for women between 40 and 42. However, these are guidelines, and Clinical Commissioning Groups (CCGs) are not legally required to implement them. There is substantial variation between CCGs in England in terms of what fertility treatments are routinely funded.

According to Fertility Fairness, 35 CCGs offer three cycles of IVF to women under 40, but just four CCGs out of 209) offer funding for fertility treatment which is fully in line with the NICE guidelines, all of which are in Greater Manchester. Four CCGs currently do not routinely fund any fertility treatment: Mid Essex, North East Essex, Basildon & Brentwood and South Norfolk. A number of other CCGs are currently consulting on reducing or decommissioning existing services.

There is variation between the devolved administrations regarding funding for IVF, but there is no variation within Scotland, Wales or Northern Ireland.

• Scotland – eligible women under 40 are entitled to two cycles. The Scottish Government is due to begin consultations with health boards on increasing this to three cycles in April 2017.
• Wales – eligible under 40 are entitled to two cycles.
• Northern Ireland – women under 40 are entitled to one cycle.