In England, decisions about local NHS fertility services are determined locally, taking account of National Institute for Health and Care Excellence (NICE) fertility guidelines. Local NHS bodies are expected to commission fertility services in line with the NICE guidelines so that there is equal access across England.
The existing NICE fertility guidelines include provisions for same-sex couples who have demonstrated their clinical infertility through six failed cycles of artificial insemination. If this is the case, these couples are offered a further six cycles of unstimulated intrauterine insemination before proceeding to IVF. The criteria in the guidelines were developed as a way of achieving equivalence between opposite-sex and same-sex couples in establishing clinical infertility and accessing NHS fertility treatment services. However, NICE has begun a review of these guidelines which will consider whether the current recommendations for access to NHS-funded treatment are still appropriate. This is expected to be ready in 2024.
I wholeheartedly agree that no couple should face disproportionate or unequal costs in their efforts to overcome fertility issues. I am glad that NICE is reviewing the existing guidelines. The Department for Health and Social Care also undertook an internal review of access to NHS fertility services last year. The review informed the Government's Women’s Health Strategy published in July 2022.
In this, the Government committed to removing additional barriers to IVF for female same-sex couples. The Government committed to removing the requirement for them to pay for artificial insemination to prove their fertility status and NHS treatment for female same-sex couples will start with six cycles of artificial insemination, prior to accessing IVF services, if necessary. The Department is currently working with NHS England to implement this through local Integrated Care Boards, which is expected shortly.
The Women’s Health Strategy also outlined several ten-year ambitions including a commitment to work with NHS England to address the current geographical variation in access to NHS-funded fertility services across England. it also committed to ensuring that same-sex couples are able to access NHS-funded fertility services in a more equitable way.