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Summary of Results

Health Topic:   Gynaecology, pregnancy and birth
Guidance:   Fertility
Description:   The summary of the published clinical guideline on Fertility. It links to the published guidance and key documents.

NICE implementation uptake reports

Implementation uptake report Assessment Published Date Coverage

External literature

External literature Assessment Coverage

Abacus International (2005) A survey measuring the impact of NICE clinical guideline 11: Fertility treatment - fertility experts

Description: A survey of one fertility expert from each of the 75 HFEA registered clinics. The majority of respondents felt that they were already implementing 3 of the key priorities prior to guideline publication and demonstrated little change in practice in a further 3. 10% had seen a decrease in the number of IVF cycles offered since guideline publication.

Doubts about or mixed impact in practice National

Kennedy R, Kingsland C, Rutherford A et al. (2006) Implementation of the NICE guideline - recommendations from the British Fertility Society for national criteria for NHS funding of assisted conception Human Fertility 9: 181-189

Description: A survey of assisted conception providers in England. Results show an overall increase in the number of IVF cycles purchased. However implementation is stalled at one cycle in the majority of PCTs and there is little consensus about criteria for acceptance.

Doubts about or mixed impact in practice National

Abacus International (2005) A survey measuring the impact of NICE clinical guideline 11: Fertility treatment - PCT commissioning managers

Description: A survey of Commissioning Managers at 302 PCTs in England during July 2005. 75% of PCTs felt that the guideline had a moderate-high impact on the way in which fertility treatment was commissioned and 11% expressed a very high impact. All PCTs reported that they were taking steps to implement the guideline with only a small proportion of PCTs expecting to be fully implementing in less than 1 year.

Doubts about or mixed impact in practice National

Department of Health (2008) Primary Care Trust survey - provision of IVF in England 2007 London: Department of Health

Description: This survey presents the position in each PCT in England in relation to the number of cycles offered, number of patients treated and any access criteria. The survey makes no overall intepretation of the results.

Not graded National

Department of Health (2009) Primary Care Trust survey - provision of IVF in England 2008 London: Department of Health

Description: A survey looking at the provision of IVF treatment by PCTs. Each PCT provided information on the number of cycles funded for each patient (2008-09 & 2009-10) and the number of patients provided with IVF (2008-09). In some cases this information is for less than a full year. The survey showed that there was clear variation in the number of cycles of IVF offered to patients by PCTs in England

Not graded National

Grant Shapps MP (2009) All your eggs in one basket: A comprehensive study into the continuing postcode lottery in IVF provision through the NHS Grant Shapps MP

Description: The survey received an 80% response rate from PCT's. More than 8/10 PCT's are still failing to offer the full three cycles of IVF treatment as recommended by NICE. The survey found that 1/8 PCT's are failing to comply with NICE guidelines with regards to the age of the female partner.

Doubts about or mixed impact in practice National

All Party Parliamentary Group on Infertility (2005) Survey of PCTs for providing of full cycles of IVF to couples meeting agreed clinical criteria

Description: In February 2004, NICE published a clinical guidance on the treatment and management of people with fertility problems. Among recommendations, NICE stated that upto 3 full cycles of IVF should be made available to couples meeting agreed clinical criteria. Results show that the vast majority of PCT's have taken steps towards meeting the 1-cycle requirement and over 50% of PCT's are working towards full implementation.

Doubts about or mixed impact in practice National

All Party Parliamentary Group on Infertility (2011) Holding back the British IVF revolution? A report into NHS IVF provision in the UK today

Description: The information on which this report is based was collected through Freedom of Information (FoI) requests to Primary Care Trusts (PCTs) in March 2011. Of the 171 PCTs that information was obtained from, 166 confirmed they were currently offering IVF treatment to patients. Of the PCTs offering IVF to patients, 39% only offered one cycle of treatment. 26% of PCTs offered two and a further 27% offered three cycles. Therefore 73% PCTs are offering less than the three cycles recommended by NICE.

Practice appears not to be in line with guidance National

El-Talatini, M. et al (2012) Management of sub-fertility in secondary care: An audit. An International Journal of Obstetrics and Gynaecology. Conference Publication: (var.pagings). 119 (pp 144-145), 2012. Date of Publication: June 2012.

Description: This retrospective audit examined the management of women with respect to NICE guidelines on the management of sub-fertility. Hospital data was collected on 100 new referrals to the infertility clinic at Leicester Royal Infirmary between April 2010 and April 2011. Findings include that 93% of women had chlamydia screening, 83% had tubal patency tests and all had BMI <30 prior to fertility treatment.

Practice appears to be in line with guidance Local

Chamberlain, C. A. et al (2013) Trends in procedures for infertility and caesarean sections: was NICE disinvestment guidance implemented? NICE recommendation reminders BMC Public Health. 2013 13 PAGES 112-

Description: Routine inpatient HES data was extracted for 1 April 1998 to 31 March 2010 to identify any influence of the release of NICE guidance which recommends discontinuing two fertility procedures (varicocele operations in infertile men and endometrial biopsies in infertile women) and caesarean section in women with hepatitis. Results found no decline in use of the three studies procedures, contrary to guidance, and no change in uptake associated with the timing of the guidance.

Practice appears not to be in line with guidance National

Spungina, A. et al (2013) Chlamydia screening prior to hysterosalpingography BJOG: An International Journal of Obstetrics and Gynaecology. 2013 Conference (var.pagings) PAGES June -

Description: This audit measured the practice of offering chlamydia screening prior to uterine instrumentation and the use of hysterosalpingography (HSG). Retrospective audit of 58 consecutive cases showed chlamydia screening prior to HSG was achieved in all cases.

Practice appears to be in line with guidance Local

This page was last updated: 01 June 2013

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Selected, reliable information for health and social care in one place

Accessibility | Cymraeg | Freedom of information | Vision Impaired | Contact Us | Glossary | Data protection | Copyright | Disclaimer | Terms and conditions

Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.

Accessibility | Cymraeg | Freedom of information | Vision Impaired | Contact Us | Glossary | Data protection | Copyright | Disclaimer | Terms and conditions

Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.