Help shape the way fertility services are delivered
NHS organisations in the East Midlands are currently reviewing how people can access fertility treatments. The aim is to create a fairer approach to fertility treatment across the region.
This is your opportunity to share your thoughts and help shape the future of fertility services in the East Midlands to ensure that our population’s needs are met.
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What is the fertility policy review?
Integrated Care Boards (ICBs) across the East Midlands are seeking feedback from residents on proposed guidelines for a unified East Midlands Fertility Policy. This region includes the counties of Derbyshire, Leicestershire, Lincolnshire, Northamptonshire, and Nottinghamshire, along with the authorities of Derby, Leicester, Rutland, and Nottingham. A fertility policy outlines the NHS-supported treatments available to people looking to access fertility services within their area.
Currently, fertility policies vary across the East Midlands, with differences in factors like age, BMI requirements, the number of NHS-funded treatment cycles, and eligibility for same-sex couples, and single individuals. This review aims to create a consistent fertility policy for the entire East Midlands, ensuring equal access to fertility treatments based on unified criteria.
The Case for Change document outlines the proposed guidelines, available in a summary and full version.
Feedback from this engagement will be instrumental in shaping the final East Midlands Fertility Policy. Updates on the engagement process, including how your feedback is being used, will be posted on our website.
How can I share my views?
You’re invited to share your views on the proposed guidelines by completing a survey open until Friday 10 January 2025.
Complete a survey online: East Midlands Fertility Policy Review Survey
NHS Derby and Derbyshire Integrated Care Board (ICB) will collect responses to this survey on behalf of the NHS Integrated Care Boards in the East Midlands. They will also facilitate any questions submitted through the platform and ensure they reach the relevant area for a response.
For alternative formats, such as large print or postal surveys, please contact NHS Derby and Derbyshire ICB by calling 01332 981 601 or emailing ddicb.engagement@nhs.net.
You can also submit question on the NHS Derby and Derbyshire ICB involvement website: https://derbyshireinvolvement.co.uk/fertilityreview
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Questions and answers
There are currently differences between Fertility Policies in the East Midlands, in terms of access to treatment, in relation to age, BMI and number of IVF cycles available. The review aims to develop a consistent and equitable Fertility Policy across the East Midlands.
The timeline for completing the East Midlands Fertility Policy will be informed by the engagement feedback and key milestones be set taking into account local actions and in collaboration with the East Midlands Integrated Care Boards:
- NHS Derby and Derbyshire Integrated Care Board
- NHS Leicester, Leicestershire, and Rutland Integrated Care Board
- NHS Lincolnshire Integrated Care Board
- NHS Northamptonshire Integrated Care Board
- NHS Nottingham and Nottinghamshire Integrated Care Board
What if I have children from a previous relationship?
The policy proposes that both partners should have no living children to qualify for NHS-funded treatment.
Can same-sex female couples apply for treatment?
Same-sex female couples are proposed to be eligible if they meet all other criteria.
Will transgender individuals be eligible for funding?
The policy includes access for individuals and couples with fertility issues, regardless of orientation, identity, or relationship status.
Will single women be eligible for treatment?
Single women meeting the proposed criteria will be eligible for treatment.
For more information view the Case for Change document.
Will surrogacy be covered?
Surrogacy will not be funded, as it is outside NHS England’s scope for fertility services.
Will gamete storage be included?
Gamete storage for patients undergoing fertility-impairing treatments, such as cancer treatment, will be funded for up to three years.
Why is only one cycle of IVF proposed, when NICE guidelines recommend three?
Although NICE recommends up to three cycles, local policies vary based on clinical need and available resources.
Can I reapply if I was previously denied treatment?
If your clinical situation has changed, you may reapply. If not, you can appeal, although this does not guarantee funding.
What happens if I turn 43 while waiting for a donor egg?
Egg retrieval must begin before turning 43. If you turn 43 during treatment, you may still complete the full IVF cycle.
Fertility Treatment Costs across East Midlands ICBs (2019/20 – 2022/23)
IVF/ICSI Cost | |||||
|---|---|---|---|---|---|
| ICB | 2019/20 | 2020/21 | 2021/22 | 2022/23 | Total |
| NHS Derby and Derbyshire ICB | £584,800 | £479,600 | £472,800 | £542,000 | £2,079,200 |
| NHS Leicester, Leicestershire, and Rutland ICB | £417,600 | £523,400 | £522,800 | £515,400 | £1,979,200 |
| NHS Lincolnshire ICB | £281,000 | £260,400 | £254,600 | £251,200 | £1,047,200 |
| NHS Northamptonshire ICB | £472,000 | £218,200 | £352,000 | £372,200 | £1,414,400 |
| NHS Nottingham and Nottinghamshire ICB | £596,800 | £473,200 | £571,200 | £441,000 | £2,082,200 |
| Total for 5 East Midlands ICBs | £2,352,200 | £1,954,800 | £2,173,400 | £2,121,800 | £8,602,200 |
| AI/DI/IUI Cost | |||||
| ICB | 2019/20 | 2020/21 | 2021/22 | 2022/23 | Total |
| NHS Derby and Derbyshire ICB | £825 | £2,475 | £825 | £1,650 | £5,775 |
| NHS Leicester, Leicestershire, and Rutland ICB | £172,425 | £94,875 | £141,900 | £112,200 | £521,400 |
| NHS Lincolnshire ICB | £14,025 | £16,500 | £14,025 | £10,725 | £55,275 |
| NHS Northamptonshire ICB | £1,650 | £1,650 | £2,475 | £2,475 | £6,600 |
| NHS Nottingham and Nottinghamshire ICB | £0 | £0 | £0 | £0 | £0 |
| Total for 5 East Midlands ICBs | £188,925 | £115,500 | £159,225 | £125,400 | £589,050 |
A single cycle of IVF includes egg collection and allows for both fresh and frozen embryo transfers, but only until a pregnancy results in a live birth. Currently, the policy permits a maximum of 6 embryo transfer attempts, which we propose to maintain.
This table provides definitions of essential terms related to the fertility policy, helping to clarify commonly used terms and concepts in the context of fertility treatments and NHS policy.
| Term | Definition |
|---|---|
| Fertility policies | ICBs are responsible for commissioning most fertility treatments; most therefore have policies in place specifying which interventions are funded and eligibility criteria for access to these. These policies typically explain when the ICB will fund fertility treatments for people experiencing infertility and assisted conception treatments for patients who require interventions for other reasons. |
| Infertility | Infertility is the period of time people have been trying to get pregnant (conceive) without success after which formal investigation is justified and possibly treatment implemented. |
| In vitro fertilisation (IVF) | IVF involves ovarian stimulation and then collection of a woman’s eggs. They are then fertilised with sperm in a lab. If fertilisation is successful, the embryo is allowed to develop for between two and six days and is then transferred back to the woman’s womb to hopefully continue to a pregnancy. Ideally one embryo is transferred to minimise the risk of multiple pregnancy. In older women, or those with poor quality embryos, two may be transferred. It is best practice to freeze any remaining good quality embryos to use later or in a frozen embryo transfer if the first transfer is unsuccessful. |
| Integrated Care Board | NHS organisations responsible for planning health services for their local population. There is one ICB in each ICS area. They manage the NHS budget and work with local providers of NHS services, such as hospitals and GP practices. |
| Intrauterine insemination (IUI) | IUI is a type of fertility treatment in which the best quality sperm are separated from sperm that are sluggish or non-motile. This sperm is then placed directly in the womb. This can either be performed with the woman’s partner’s sperm or donor sperm (known as donor insemination or DI). Sometimes ovarian stimulation is used in conjunction with IUI. |
| National Institute for Health and Care Excellence (NICE) | NICE provide national guidance and advice to improve health and social care. NICE guidelines are evidence-based recommendations for health and care in England. Organisations commissioning and delivering services are expected to take the recommendations contained within NICE clinical guidelines into account when planning and delivering services. |
| Surrogacy | Surrogacy is when a woman agrees to carry and give birth to a baby for someone else who cannot have a baby on their own. After the baby is born, the child is given to the person or couple who arranged the surrogacy. |
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