Updated NICE Fertility Guideline recommends three extra IVF cycles

The National Institute for Health and Care Excellence (NICE) has published an updated version of its Fertility Guideline, recommending that up to three further NHS-funded IVF cycles should be considered if the initial three cycles are unsuccessful.

As in a draft version of the updated Guideline published last year (see BioNews 1306), the final version retains NICE's longstanding recommendation that eligible women under 40 should be offered three full cycles of NHS-funded IVF, while also revising age-specific criteria to state that women aged 40-41 should be offered one cycle, narrowing the previous eligibility range of 40-42.

Peter Thompson, chief executive of the Human Fertilisation and Embryology Authority (HFEA), said: 'We are particularly pleased to see the recommendations that three full cycles of IVF should be offered to women under 40 if they have fertility problems and meet certain criteria, as it not only improves options for people looking to create much longed-for families but also represents value for money for the NHS, and that add-ons without sufficient evidence shouldn't be offered to patients.'

The HFEA has highlighted that NHS-funded fertility treatment continues to decline, with only 27 percent of cycles funded in 2023, despite improvements in success rates (see BioNews 1195 and 1295). The HFEA and other organisations have also found persistent inequalities in access – female same-sex couples, single patients and black patients are less likely to receive NHS funding (see BioNews 1220, 1248, 1262, 1327 and 1334), and this gap is widened further by many integrated care boards (ICBs) in England not implementing NICE guidance consistently (see 1326).

'We hope that England's ICBs will now implement the Guideline, so that people affected by infertility can receive evidence-based care,' said Sarah Norcross, director of PET (the Progress Educational Trust, the charity that publishes BioNews.) 'The PET NHS Fertility Funding Tracker shows that that only two out of 42 ICBs in England currently comply with the NICE Guideline, which is an abysmally low number. The Government needs to act, to ensure that the NICE Fertility Guideline is put into practice.'

The NICE independent committee reviewed feedback from patients, clinicians and professional bodies between September and October last year, alongside a public consultation, before introducing a dedicated section on endometriosis to the updated Fertility Guideline. The change marks the first time endometriosis has been formally recognised as requiring a distinct, tailored approach to fertility care, rather than being managed alongside other causes of infertility.

The new guidance has been criticised over differences in how same-sex and heterosexual couples access fertility support. Under the new recommendations, same-sex couples may only be eligible for IVF support for a 'health-related fertility problem' after completing six cycles of artificial insemination, which could cost thousands of pounds. The issue was raised as part of the Women's Health Strategy, but many ICBs are still not funding these treatments (see BioNews 1153).

'It is an absolute disgrace that same-sex couples and LGBTQ+ people are not even mentioned in the initial scope of the guidance, and it fails to offer any support for same-sex couples and LGBTQ+ people,' South Tyneside MP Kate Osborne told The Chronicle.

The updated NICE Fertility Guideline will be discussed by leading patient advocates and fertility professionals at the PET event 'What Does the NICE Fertility Guideline Update Mean for You?', taking place online this coming Wednesday (15 April 2026).

Find out more and register here.