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Let’s end the “postcode lottery” of fertility treatment


Coping with trying for a baby and the agonising realisation that you may need fertility treatment can be a very emotional time and for some couples devastating news. Once you come to terms that you need assistance, the last thing you will want to hear is that you can’t have treatment you need because you live in the wrong part of the country.

The National Institute for Health and Care Excellence (NICE) has published a set of  statements to help the NHS eliminate the so-called ‘postcode lottery’ of treatment in the UK and support for people with fertility problems.

NICE published updated guidance in 2013 for the NHS on the diagnosis, treatment and care of people with fertility problems.  The recommendations included offering 3 full cycles of IVF treatment to women aged under 40 who have failed to get pregnant after 2 years of trying or 12 cycles of artificial insemination. It also recommended that women aged 40-42 should receive 1 full cycle if certain criteria were met.

However, not all areas offer the full number of cycles and some women are only being offered 1 cycle of IVF treatment up to the age of 35.

“Infertility is a recognised medical condition that can affect people of any age and has a potentially devastating effect on people’s lives. It can cause significant distress, depression and can possibly lead to the breakdown of relationships.”

“Our updated guidance which published last year provides clear recommendations on the most clinically and cost effective way to treat people with fertility problems. Unfortunately, we know that not all areas are following our guidance to the letter. This creates variations in treatment within the NHS, which is disappointing and goes against the fundamental aims of the NHS.

”The quality standard that we are currently developing should help healthcare services to focus on the key areas of care that need to be addressed most urgently and ensure that the right support and treatment is available to those who need it.”

“When published, this standard will complement our guidance on the treatment and support of people with fertility problems, creating a comprehensive guide to help the NHS provide and maintain consistent and high-quality care for all.”

Professor Gillian Leng, Deputy Chief Executive and Director of Health and Social Care at NICE

In addition to the statements on access to IVF treatment, the quality standard also says that Clinical Commissioning Groups (CCGs) should offer cryopreservation to people of reproductive age who are preparing to have treatment for cancer that is likely to give them fertility problems.

The full, quality standard is available to view on the NICE website, but includes other statements such as:

  • GPs referring people for specialist consultation if they have not conceived after 1 year of unprotected vaginal intercourse, or earlier if there is a known clinical cause, a history of predisposing factors for infertility or the woman is at least 36-years-old.
  • Offering counselling to people before, during and after investigations and treatment for fertility problems, irrespective of the outcome.
  • Women having IVF should have the appropriate number of embryos transferred according to the age of the woman whose eggs are used, the cycle number and quality of embryo.



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