New strategy to make fertility treatment more accessible

Isabelle James

In July 2022, the Department of Health for England released its strategy aimed at improving Women’s Health. While women represent 51% of the population, for decades the NHS has been accused of systemic and entrenched gender health inequality, with not enough focus placed on women-specific issues. Cases such as the Shrewsbury and Telford Hospital NHS Trust maternity scandal bear testament to this. The 2022 Strategy outlines the Government’s aims to remedy the disparity.

Women’s Health Strategy: some background

The call for evidence began in Spring 2021. Views of nearly 100,000 members of the public, academics, charities and health campaigners were collated to inform the Strategy.

According to Maria Caulfield, Minister for Women’s Health, 84% of respondents felt ignored when seeking help from the NHS. Respondents also perceived a lack of understanding or awareness among some medical professionals about health conditions that affect women.

Target areas

Areas for change outlined in the Strategy include menstrual health and gynaecological conditions, menopause, cancer and fertility. Tangible plans to instigate necessary change include:

• New research on women’s health issues
• Ensuring diagnoses and treatment work better for women
• Easier access to abortion pills and HRT
• Improved training on women’s health for all medical students and doctors

However, some of the plans are yet to receive targets or funding commitments so it remains to be seen if they will be followed through.

What about IVF?

Under the Strategy, access to fertility treatment in NHS England will change. Greater transparency will allow prospective parents to see how their local NHS provides IVF care. Non-clinical criteria will not be used to ration fertility treatment. This opens free treatment to those previously denied IVF, including couples denied it due to one partner having a child from a previous relationship. In addition, female same-sex couples will no longer be required to pay for private artificial insemination to prove fertility, before being given access to IVF on the NHS.

NICE has since published its updated guideline on fertility assessment and treatment (NG257, published 31 March 2026), which partially replaces its 2013 guideline. NHS England and the Human Fertilisation and Embryology Authority will collaborate to ensure that access to information on IVF will be improved, and referral for treatment will become quicker and easier.

Who qualifies for NHS IVF under the 2026 NICE guideline?

The NICE guideline NG257 recommends that IVF is offered to women, and to trans men and non-binary people with female reproductive organs, who have not yet reached their 42nd birthday and meet one of these conditions:

• there is a diagnosed cause of infertility for which other treatments are not suitable or have not been successful
• they have unexplained fertility problems and have not conceived after two years of regular unprotected vaginal intercourse, with or without intrauterine insemination (IUI)
• they have not conceived after 12 cycles of artificial insemination, where six or more of the cycles are by IUI

NICE guidelines are recommendations, so what you are offered can still depend on your local NHS area.

How many cycles of IVF does NICE recommend?

A full cycle of IVF normally means one episode of ovarian stimulation and the transfer of any resulting fresh and frozen embryos. The guideline recommends:

• Under 40: an initial three full cycles. If you have not conceived after three, your clinician should discuss the chances of success and consider up to three further full cycles.
• Aged 40 or 41: one full cycle, if you meet the criteria and have not had IVF before.
• Turning 40 during treatment: you complete the cycle you are in, but no more cycles are offered.

Having paid for IVF privately does not rule out NHS-funded treatment. However, any earlier full cycle, whether self-funded or NHS-funded, counts towards the total number the NHS offers.

More work required: postcode lottery continues

Over the years, funding to NHS fertility clinics has been cut by some Clinical Commissioning Groups, meaning service cancellations. Research has shown that since 2013, there has been a ‘quiet and sustained disinvestment’ in NHS fertility services. The alternative of course is private treatment, but costs can be prohibitive – between £5,000 and £7,000 per cycle and if unsuccessful, couples may decide to repeat the process for additional cost.

Sarah Norcross, the Director of Progress Educational Trust, a charity for people affected by infertility and genetic conditions, agreed the removal of some barriers to IVF was welcome, but felt it was ‘incredibly disappointing’ that the ‘postcode lottery’ of treatment across England remained unaddressed. She emphasised, ‘The commitment to improve transparency in relation to the availability of IVF does not equate to giving women the chance to try to have a baby’.

Politicians respond to the Strategy

Of the anticipated NHS England reforms, the then Health Secretary Steve Barclay said, ‘It is not right that 51% of our population is disadvantaged in accessing the care they need simply because of their sex.’ The ‘Strategy is a landmark moment in addressing entrenched inequalities and improving the health and wellbeing of women across the country’.

Minister for Women’s Health, Maria Caulfield said, ‘Tackling the gender health gap will not be easy – there are deep-seated, systemic issues we must address to ensure women receive the same standards of care as men, universally and by default. This strategy is the start of that journey, but eradicating the gender health gap can’t be done through health services alone. I am calling on everyone who has the power to positively impact women’s health – from employers to doctors and teachers to industry – to join us in our journey’.

How we can help

If you are embarking on your own fertility journey and seeking advice, please speak to our specialist team of fertility lawyers.

The team, including Isabelle James, offers advice to intended birth parents, co-parents or donors on how the law applies and on what legal rights they will acquire on the birth of a baby or by subsequent agreement or court application, advice about parental responsibility, parentage and any dispute that may have arisen between parties.

Osbornes Law are one of the only law firms in London to specialise and advise families on different pathways to parenthood including in fertility law, surrogacy and adoption. Our team is happy to discuss these with you, to help you decide what is the best way for you to grow your family.