Quality statement 6: IVF for women, trans men and non-binary people with female reproductive organs aged 40 or 41 years
Quality statement
Women, trans men and non-binary people with female reproductive organs aged 40 or 41 years who meet the criteria for in vitro fertilisation (IVF) are offered 1 full cycle of IVF. [2014, updated 2026]
Rationale
The overall chance of having a live birth after IVF treatment falls as the age of the woman, trans man or non-binary person with female reproductive organs rises and it also decreases as the number of unsuccessful cycles increases.
Quality measures
The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.
Structure
Evidence of local arrangements to provide 1 full cycle of IVF for women, trans men and non-binary people with female reproductive organs aged 40 or 41 years who meet the criteria for IVF.
Data source: The Department for Health and Social Care publishes NHS IVF provision criteria for areas across England. Data can also be collected from local service delivery plans.
Process
Proportion of women, trans men and non-binary people with female reproductive organs aged 40 or 41 years who meet the criteria for IVF who are offered 1 full cycle of IVF.
Numerator – the number in the denominator who receive 1 full cycle of IVF.
Denominator – the number of women, trans men and non-binary people with female reproductive organs aged 40 or 41 years who meet the criteria for IVF.
Data source: The Human Fertilisation and Embryology Authority (HFEA) collects data on NHS-funded IVF cycles across England. Data can also be collected from information recorded locally by healthcare professionals and provider organisations, for example, from patient records.
What the quality statement means for different audiences
Service providers (specialist fertility services) ensure that policies are in place to provide 1 full cycle of IVF for women, trans men and non-binary people with female reproductive organs aged 40 or 41 years who meet the criteria for IVF.
Healthcare professionals (in specialist fertility services) adhere to policies on providing 1 full cycle of IVF for women, trans men and non-binary people with female reproductive organs aged 40 or 41 years who meet the criteria for IVF.
Commissioners should commission sufficient capacity within specialist fertility services to provide 1 full cycle of IVF for women, trans men and non-binary people with female reproductive organs aged 40 or 41 years who meet the criteria for IVF.
Women, trans men and non-binary people with female reproductive organs aged 40 or 41 finding it difficult to get pregnant who have a diagnosed cause of infertility and other treatments are not suitable or have not been successful, or who have unexplained fertility problems and have been trying for 2 years or longer, or have had 12 cycles of artificial insemination (which is the direct insertion of sperm into the womb or the neck of the womb), are offered 1 full cycle of IVF. A full cycle of IVF involves collecting eggs and sperm, fertilising the eggs outside the body, and placing 1 or 2 fertilised eggs (embryos) into the womb to start a pregnancy.
Source guidance
Fertility problems: assessment and treatment. NICE guideline NG257 (2026), recommendations 1.39.3 and 1.39.9
Definitions of terms used in this quality statement
Criteria for IVF for women, trans men and non-binary people with female reproductive organs aged 40 or 41 years
Women, trans men and non-binary people with female reproductive organs aged 40 or 41 years should be offered 1 full cycle of IVF if there is a diagnosed cause of infertility for which other treatments are not suitable or have not been successful, or they have unexplained fertility problems and they have not conceived after 2 years of regular unprotected vaginal intercourse (with or without IUI), or they have not conceived after 12 cycles of artificial insemination (where 6 or more cycles are by IUI). [NICE's guideline on fertility problems, recommendations 1.39.3 and 1.39.9].
Full cycle of IVF
A full cycle should include 1 episode of ovarian stimulation and the transfer of any resultant fresh and frozen embryo(s). [NICE's guideline on fertility problems, terms used in this guideline]
Equality and diversity considerations
The existence of living children should not be a factor that precludes the provision of fertility treatment.
The statements include reference to specific age groups. This is to promote effective care because age was found to be the only robust factor in determining IVF success.
The statement includes women, trans men and non-binary people with female reproductive organs who are in same‑sex relationships and women, trans men and non-binary people with female reproductive organs with or without a partner having artificial insemination.