Current restrictions on access to NHS-funded fertility treatment exclude
the majority of those trying to conceive: a retrospective cohort
analysis
Abstract
Objective: Evaluate NHS-funded fertility treatment policies
across England, Scotland, and Wales, assessing their alignment with the
needs of those trying to conceive and comparing eligibility against NICE
guidance. Design: Review of current NHS-funded fertility
treatment policies and retrospective analysis of participant data.
Setting: Not applicable. Population: Reproductive-age
UK-based women using Hertility Health services from 2021-2023, focusing
on those actively trying to conceive (TTC) or planning future
pregnancies. Methods: Policy evaluation and data review without
interventions. Main Outcome Measures: Eligibility for
NHS-funded fertility treatment under UK regional policies versus NICE
guidance. Results: In total, out of 2980 individuals actively
trying to conceive and 6282 individuals planning for future pregnancies,
1700 (57.0%) and 2750 (43.8%) respectively would be ineligible for
state-funded treatment under current regional policies: 1551 (57.7%) in
England, 123 (53.2%) in Scotland, and 26 (41.9%) in Wales for those
actively trying to conceive, and 2558 (43.9%), 146 (41.7%), and 46
(44.2%) for those planning future pregnancies respectively. In
contrast, only 248 (8.3%) of those actively trying to conceive and 149
(2.4%) of those planning for future pregnancies would be ineligible if
the NICE guidance were universally applied. Conclusions: By
imposing outdated clinical and non-clinical qualifying criteria, the
current NHS-funded fertility treatment policies exclude a substantial
number of individuals requiring treatment. This necessitates a swift
policy overhaul, as promised in the 2022 UK Women’s Health Strategy, to
avoid further age-related fertility loss in women who require treatment
imminently.