This guideline covers diagnosing and treating fertility problems. It aims to reduce variation in practice and improve the way fertility problems are investigated and managed.
The Royal College of Obstetricians and Gynaecologists has produced guidance for gynaecological services during the COVID-19 pandemic.
In September 2017, we stood down section 1.7 in this guideline as it has been superseded by publication of the NICE guideline on endometriosis.
This guideline includes recommendations on:
- advice about delays in conception and defining infertility
- investigating and managing fertility problems, including reducing the risk of viral transmission of HIV or hepatitis
- managing male factor fertility problems, ovulation disorders and unexplained infertility
- intrauterine insemination
- access criteria and procedures for IVF treatment
- intracytoplasmic sperm injection, donor insemination and oocyte donation
- people with cancer who wish to preserve their fertility
- long-term safety of assisted reproductive technologies.
Who is it for?
- Healthcare professionals
- People with fertility problems, their families and carers
Is this guideline up to date?
We checked this guideline in June 2015 and concluded that new evidence was available that may affect some of the recommendations. In August 2016 we reviewed the evidence for recommendation 188.8.131.52 on intrauterine insemination. The evidence reviewed did not justify a change to the recommendation. For more information see the addendum.
As outlined in our responses to stakeholder comments (for example response to comment 5) we will review the evidence for intrauterine insemination compared with IVF in a future update.
Guideline development process
This guideline updates and replaces NICE guideline CG11 (February 2004)
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.
All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.
Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.