8. Fertility Services

  • Investigations into infertility and local fertility services for any patient who may benefit from them will be commissioned. It may be inappropriate to investigate patients who would be ineligible for definitive treatments.
  • Surgical fertility services and assisted conception services (usually amounting to 2 cycles of treatment) will be commissioned for patients who satisfy each of the following criteria at the start of any cycle or episode of treatment:
  1. They are in a stable partnership AND:
  2. have been attempting unsuccessfully to conceive naturally within that partnership for a period of at least two years,
  3. OR have a clinically diagnosed illness or abnormality that would make natural conception impossible or extremely unlikely,
  4. OR have a diagnosed genetic status that would appropriately lead to consideration of preimplantation diagnostic testing.
  5. There is no live child resulting from that relationship.
  6. Neither partner has previously been sterilised.
  7. The age of the female partner is not more than 39 years at the start of the treatment cycle.
  8. The treatment is provided within the portfolio of service agreements (except when the purpose of the treatment is other than to address a fertility problem, e.g. preimplantation diagnostic testing).
  9. The female partner has a body mass index within the range 19-30 at the time of commencement of a treatment cycle.
  10. The requirements of the Human Fertilisation and Embryology Authority (HFEA) have been satisfied.
  11. There is no clinical advice that treatment is unlikely to succeed or that the treatment, resulting pregnancy or parental responsibility would be medically inadvisable.
  12. The couple have not previously received NHS funding for the maximum amount of treatment commissioned for an individual couple.
  • Surrogacy may be considered by prior authorisation of the Commissioning Panel
  • Uterine transplantation may be commissioned within strict guidelines by prior authorisation of the Commissioning Panel
  • Other surgical procedures may be commissioned when the above criteria are satisfied and where there is consultant medical advice that the surgery is more likely to be effective than assisted conception in the circumstances of the patient in question by prior authorisation of the Commissioning Panel.
  • Re-implantation of any frozen embryos produced by NHS funding from the gametes of one or both partners may be commissioned.

[Fertility Services Continued…]

  • Services including pre-implantation genetic testing may be commissioned when the couple have a clear risk of having a child with an important genetic condition, and otherwise satisfy the provisions of this policy.
  • General Practitioners should not issue NHS prescriptions for the drug component of private sector assisted conception treatment. If a patient wishes to return to NHS care for all components of assisted conception treatment, then the prescribing of the drug component must be in line with the body of this policy regarding eligibility for NHS funded treatment. Any such prescriptions issued will be funded in the usual way through drug budgets.