Getting fertility treatments on the NHS can be a complicated process and it is not a routine type of treatment offered by the NHS, in the same way other treatments such as orthopaedics or oncology are. The first step is to find out what is available and if you are eligible, but unfortunately, this is not always a straightforward process and such are the pressures on and backlog within the NHS that getting to the front of a queue for fertility treatment in the UK can be incredibly tricky.
Does The NHS Offer Free Fertility Treatment in the UK?
This is not a simple question to answer, as the treatments for infertility that are offered will vary depending on where in the UK you live and which NHS trust you are under the care of. England, Scotland, Wales and Northern Ireland all have different practices and rules for fertility treatment and the funding of the treatment in question. To understand what is available to you, it is best to talk to your GP who will usually be your first port of call and the first medical professional with whom you address the problems relating to fertility and infertility.
Your GP will have a good understanding of fertility treatments covered by the NHS in your local area and will also be able to help you find out if you are eligible. Furthermore, your GP will be able to talk you through the general processes you may be likely to expect with regards to fertility treatment. For example, the tests you may need to undergo, lifestyle factors to be aware and conscious of any any risks you should consider before proceeding with treatment.
Fertility Testing on the NHS
The NHS states that: "All patients have the right to be referred to an NHS clinic for the initial investigation. If the GP refers you to a specialist for further tests, the NHS will pay for this."
In most circumstances, fertility testing can be funded and delivered by the NHS. Same-sex couples and single women without pre-existing fertility issues however, may first need to have self-funded IUI (intrauterine insemination). If IUI is unsuccessful, you may well be eligible for NHS fertility testing, but will need to consult your GP in advance.
What Fertility Treatments Do the NHS Offer?
There are many different forms of fertility treatment in the UK and around the world. With regards to the NHS however, there are three main types of fertility treatments which will be available in the right circumstances:
- Fertility medication
- Surgical procedures
- Assisted conception - including intrauterine insemination (IUI) and in vitro fertilisation (IVF)
There are many types of medicine prescribed to promote ovulation in women. Common fertility drugs include:
- Clomifene or tamoxifen to encourage ovulation
- Metformin for women with polycystic ovary syndrome
- Gonadotrophins to improve fertility in women and men
Fertility drugs may be available to you on the NHS, but you will as is routine, have to pay prescription charges unless exempt.
Several types of surgical procedures may be used to help with fertility. The NHS can provide fallopian tube surgery, surgery for endometriosis, fibroids and PCOS (polycystic ovary syndrome), epididymal blockage correction and surgery to retrieve sperm. Whether the NHS covers your treatment will depend on several factors, including your age and location.
Assisted conception is done through IUI, and is also known as 'artificial insemination' or IVF (in vitro fertilisation.)
Can I Get IVF Treatment Through the NHS?
IVF is offered on the NHS, but only if you meet specific eligibility criteria. If you are not eligible, you may need to pay to go private for your treatment. Guidelines from the National Institute for Health and Care Excellence (NICE) recommends fertility criteria to determine who can access IVF through the NHS in England and Wales. However, individual and independent NHS clinical commissioning groups (CCGs) will ultimately decide how to provide IVF in their local area.
Unfortunately, your local CCG may have stricter criteria than those recommended by NICE. For example, they may have rules that you must be a non-smoker, a healthy weight or have no previous children to get IVF. As a result, it can be unclear when checking if you are eligible for IVF through the NHS and it is always recommend you seek advice from your GP prior to any IVF or other fertility treatment.
What Are The NICE Recommended Criteria for Fertility and IVF?
The criteria recommended by NICE for IVF on the NHS depend on your age (more information).
Under 40: NICE says women under 40 should be offered three cycles of IVF treatment if:
- They have been trying to get pregnant through regular unprotected sex for two years
- They have been unable to get pregnant after twelve cycles of artificial insemination, with at least six of the cycles using IUI
However, if tests indicate that IVF is the only treatment suitable, you should be referred directly and do not have to meet these criteria.
Aged 40 to 42: NICE recommends that women aged 40 to 42 should have one cycle of IVF funded by the NHS if they meet the same criteria as under 40s and:
- Have never had IVF treatment before
- Show no evidence of low ovarian reserve
- Understand the additional implications of IVF and pregnancy for over 40s
Again, if tests indicate that IVF is the only treatment suitable, you do not have to meet all of the criteria.
What If I Am Not Eligible For IVF Through The NHS?
If you are not eligible for IVF treatment on the NHS, you may need to go to a private clinic for your IVF treatment, which particularly with potentially repeated rounds of treatment can be expensive. Some clinics will ask for a referral from your GP in advance of starting any course of treatment. Private fertility treatment options vary in their costs, but one cycle of IVF can cost more than £5,000 and there may be further charges for prescriptions, consultations and testing.
If you are struggling to decide between private healthcare and the NHS, take a look at our guide Private Healthcare vs NHS; Which Is Better?