Potential changes to NHS IVF in England and Scotland

The UK and Scottish Governments have both proposed changes to NHS funding for IVF.

An amendment to the Health Bill (NHS Modernisation Bill), which is entering its report stage in the House of Commons today, has been put forward regarding NHS-funded IVF. The proposed clause would require NHS-funded IVF provision to be standardised across all integrated care boards in England, ensuring that everyone has access to at least the basic level of treatment recommended by the National Institute for Health and Care Excellence (NICE) including the number of IVF cycles and age limits for treatment. The Fertility Guideline published by NICE has long recommended that women under 40 should be offered three cycles of IVF, and now additionally recommends that an offer of a further three cycles should be considered if treatment is unsuccessful (see BioNews 1334 and 1335).

Responding to a question from Sir Gavin Williamson (the MP who tabled the amendment), the Prime Minister said that he will direct the Health Secretary to consider this amendment and 'there should be an expectation that services available anywhere should be available everywhere, particularly when it comes to an issue as important as this.'

Sarah Norcross, director of PET (the Progress Educational Trust), said: 'PET welcomes this amendment and the Prime Minister's commitment to look into this issue. The NICE guideline has been in place for more than 20 years, has and never been fully implemented in England. It is time for change.'

Scotland currently has the most generous provision of NHS-funded IVF in the UK. Subject to eligibility criteria, patients can access up to three full cycles of treatment. Scotland is also the only UK nation where more IVF cycles are funded by the NHS than privately.

However, the Scottish Government has separately launched a review into expanding its IVF eligibility criteria. The work will consider consistency of access to fertility preservation, including for women who have undergone cancer treatment, as well as ways to reduce waiting times for patients requiring donor eggs or sperm. It will also assess whether NHS funding should be offered to single women and to patients who have children from previous relationships.

Cabinet Secretary for Health and Care Angela Constance commented on the initiative, saying: 'Access to NHS IVF treatment should be fair, timely and reflect the way people's lives and families look today.'

Yet Professor Sarah Martins Da Silva, an NHS consultant and chair of reproduction and fertility medicine at Dundee University, questioned the stretching of NHS resources.

'As a fertility specialist I'm never going to be disappointed if the criteria is widened... but with single people, as an NHS clinician looking at the competing demands we have, I'd ask the question about whether being single is a health condition that needs to be funded.'

Professor Martins Da Silva added that NHS waiting lists were already full of couples who needed IVF treatment, including those requiring donor gametes due to medical conditions such as cancer, and warned that they could face longer waits.

'It's slightly a disservice to them,' she told BBC News. 'There would need to be a real investment and resource without making everybody wait an extraordinary long time', she added: 'With the current financial environment we work in, if you're talking about new money, where would that come from?'

Scotland's National Fertility Group, which includes representatives of organisations including PET, will lead the review and make 'costed, demand-modelled recommendations', which are expected to be published in summer 2027.