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Fertility: Assessment and treatment for people with fertility problems [CG156]

Measuring the use of this guidance

Recommendation: 1.9.1.1

Consider unstimulated intrauterine insemination as a treatment option in the following groups as an alternative to vaginal sexual intercourse: - people who are unable to, or would find it very difficult to, have vaginal intercourse because of a clinically diagnosed physical disability or psychosexual problem who are using partner or donor sperm - people with conditions that require specific consideration in relation to methods of conception (for example, after sperm washing where the man is HIV positive) - people in same-sex relationships. [new 2013]

What was measured: Proportion of fertility clinics that offer intrauterine insemination
Data collection end: April 2014
96%
Area covered: UK
Source: Dongah, K., Child, T. & Farquhar, C. (2015) Intrauterine insemination: a UK survey on the adherence to NICE clinical guidelines by fertility clinics. Reproductive medicine, 5.


Recommendation: 1.9.1.3

For people with unexplained infertility, mild endometriosis or 'mild male factor infertility', who are having regular unprotected sexual intercourse: • do not routinely offer intrauterine insemination, either with or without ovarian stimulation (exceptional circumstances include, for example, when people have social, cultural or religious objections to IVF) • advise them to try to conceive for a total of 2 years (this can include up to 1 year before their fertility investigations) before IVF will be considered. [new 2013]

What was measured: Proportion of clinics that had formally discussed the NICE guideline recommendation that intrauterine insemination should not be offered routinely
Data collection end: April 2015
78%
Number that met the criteria: 36 / 46
Area covered: UK
Source: Dongah, K., Child, T. & Farquhar, C. (2015) Intrauterine insemination: a UK survey on the adherence to NICE clinical guidelines by fertility clinics. Reproductive medicine, 5.

What was measured: Proportion of clinics that had made some changes to their practices in response to the the NICE guideline recommendation that intrauterine insemination should not be offered routinely
Data collection end: April 2015
37%
Number that met the criteria: 17 / 46
Area covered: UK
Source: Dongah, K., Child, T. & Farquhar, C. (2015) Intrauterine insemination: a UK survey on the adherence to NICE clinical guidelines by fertility clinics. Reproductive medicine, 5.


Recommendation: 1.11.1.3

In women aged under 40 years who have not conceived after 2 years of regular unprotected intercourse or 12 cycles of artificial insemination (where 6 or more are by intrauterine insemination), offer 3 full cycles of IVF, with or without ICSI. If the woman reaches the age of 40 during treatment, complete the current full cycle but do not offer further full cycles. [new 2013]

What was measured: Proportion of clinical commissioning groups offering 3 cycles of IVF
Data collection end: May 2014
18%
Number that met the criteria: 38 / 210
Area covered: England
Source: Fertility Fairness (FF) IVF data



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