Point one
Is fertility treatment cover by the NHS
What is an ICB?
What are eligibility criteria?
Heterosexual couples
Same sex couples
What is service generosity?
What does my ICB cover?
How do I get started with NHS funded fertility treatment?
How long will I wait for NHS funded fertility treatment?
Is egg freezing available on the NHS?
Is sperm freezing available on the NHS?
For many of us in the UK struggling to build a family, the NHS is the natural place we turn to for treatment and support. What we soon find, however, isn't clearcut: instead, we quickly realise that getting fertility treatment on the NHS isn't guaranteed - and getting started means first of all understanding if you're eligible for treatment.
In this straightforward guide, we explain the fundamentals of NHS eligibility to help you decide whether NHS fertility treatment is the right option for you.
We get this question a lot from those beginning to explore assisted fertility options. The short answer is yes - you can get fertility treatment on the NHS in the UK. Most commonly, this involves assisted fertility techniques like IVF, but in some circumstances, may also include fertility preservation, such as egg or sperm freezing.
But there's a problem, because getting NHS-funded treatment is actually more complicated than many people realise.
To understand why, it's first important to understand that the healthcare services you receive - including fertility treatment - are funded and determined at a regional level, by bodies like integrated care boards (ICBs).
An integrated care board (ICB) works in partnership with other NHS organisations (like NHS hospitals and GPs) in your area to deliver health services that meet the needs of your local community.
But the most important thing to know about ICBs is that they manage the NHS budget in your region - deciding what services, including fertility treatment, should be funded and to what extent. Currently, there are 42 ICBs across England.
In this guide, we're primarily focused on the process as it relates to NHS England - but we hope to expand it further with information about Scotland, Wales and Northern Ireland soon.
According to GOV.UK, ICBs should ensure 'equal access' to fertility treatment across England, in accordance with National Institute for Health and Care Excellence (NICE) guidelines.
In reality, though, ICBs set their own local policies and priorities. That means NHS-funded fertility treatment varies significantly across England, with ICBs deciding independently:
The 'NHS Postcode Lottery' is a popular phrase you might hear that describes the inequalities and regional differences in NHS-funded fertility care across England. This is the result of ICBs setting their own policies for fertility treatment.
Eligibility criteria are the requirements, set by your local ICB, that must be met in order for you to receive NHS-funded fertility treatment.
As we've explored above, there's no nationally consistent set of eligibility criteria for heterosexual couples seeking NHS-funded fertility treatment. Each ICB sets its own criteria - and that can make things really confusing.
However, there are some common factors and requirements that most ICBs take into account:
As a female same-sex couple, one of the key differences in eligibility criteria is that you'll need to provide evidence of infertility by first going through a number of rounds of unsuccessful artificial insemination (such as IUI).
It's important to be aware that ICBs have different or additional requirements regarding:
Self-funded artificial insemination can cost between £900 - £1250 per treatment package and it's not uncommon for an ICB to require a female same-sex couple to have undergone 12 rounds of artificial insemination. This makes it a really important budgeting factor to be aware of, and the basis for important campaigns about equality in the fertility sector.
Another thing to make sure you understand is your ICB's 'service generosity'. This is the term we use here at Fertility Mapper to describe how comprehensive the fertility treatment on offer is. In particular, we look at three elements:
Service generosity varies widely across ICBs. For example, not all ICBs offer the same number of rounds of IVF - in fact, 68% only offer one round.
It's also important to know how many embryo transfers are included, and how long you can store surplus embryos free of charge (41% of ICBs will only store embryos for one year - after which, you'll need to find alternative private storage).
If you've reached this point in the guide, your brain is probably hurting. We get it - navigating your NHS fertility options is downright confusing. That's why we built our NHS Fertility Funding calculator. All you need to do is add in some basic information, and we'll send you a personalised look at whether you're likely to be covered by NHS-funded fertility treatment.
We recommend first using our NHS Fertility Funding calculator above to understand what may, or may not, be available to you. While the results are only an estimate, it can save you hours of thankless research online, helping you feel more in control and informed about what your ICB offers.
It's essential you speak with your GP, who can advise you further on what you may or may not be eligible for. They may also refer you to a specialist for preliminary tests.
Waiting lists for NHS-funded fertility treatment like IVF vary depending on where you live. You may wait just a few months, or up to three years for treatment on the NHS.
It's best to speak to your GP. If you're likely to be waiting for a long time, it's important to keep any eligibility criteria like age limits in mind - so that you don't find yourself ineligible when the time comes.
So far, we've talked primarily about fertility treatments - but what about fertility preservation techniques, like egg freezing?
Well, there are certain situations in which the NHS will fund egg freezing. One example is when undergoing treatment for a medical condition - like cancer - that could negatively impact your fertility.
However, even if you are covered by the NHS, funding might not be available for the full length of time you wish to store your eggs - so always double check the length of time funding will cover.
Social egg freezing - when a woman chooses to freeze her eggs to keep her family-building options open - is not covered by the NHS, but is available privately.
The rules for sperm freezing are broadly the same as egg freezing: only in certain situations, like when your fertility may be negatively impacted by a medical condition, will sperm freezing be covered by the NHS.
Just like egg freezing, even if you are covered by the NHS, you should always double check how long you can store your sperm.
We want to make sure this guide is genuinely useful. So, if you have a question on NHS fertility eligibility that we can help answer, or you think something is missing from this guide, drop us a line: hello@fertilitymapper.com