Fertility problems: assessment and treatment

Fertility problems are common and can affect people of all backgrounds. Whether you're in a relationship or you’re single, you have the right to safe, fair and compassionate care. This guideline helps to ensure that everyone receives support based on the latest medical evidence.

Throughout your fertility journey, you should be supported with clear information and respectful care. You have the right to understand your options, ask questions, and be involved in decisions about your treatment.

We want this guideline to make a difference in the following ways:

• Improving the way fertility problems are investigated and managed – so you get the right support and treatment at the right time.
• Making IVF (in vitro fertilisation) more accessible: NICE continues to recommend 3 NHS-funded IVF cycles for eligible people under 40, and it now suggests that healthcare professionals consider offering up to 3 additional cycles if the first 3 are unsuccessful.
• Ensuring fair treatment for everyone – whether you're in a same-sex relationship or single, the guideline supports more inclusive access to fertility care.
• Clinics will be asked to avoid offering ‘add-on’ treatments that do not have strong evidence, helping you focus on what’s most likely to work.
• Reducing variation in care across regions and providers, promoting consistent, high-quality treatment regardless of location.

Making decisions together

Decisions about treatment and care are best when they are made together. Your healthcare professionals should give you clear information, talk with you about your options and listen carefully to your views and concerns.

To help you make decisions, you may want to ask:

• How long should I try to conceive before seeking help? 
• Can I be referred to a specialist even if I have not been trying for a full year? 
• What if I’m single or in a same-sex relationship? 
• What tests will I be offered?
• Will my partner be tested, and what do those tests involve?
• Am I eligible for NHS-funded fertility treatment?
• What are the risks and success rates of treatments like IUI (intrauterine insemination) or IVF?
• Are donor sperm, eggs or embryos an option for me?
• Can I preserve my fertility if I need medical treatment or I have a condition that could make me infertile?

If you need more support to understand the information you are given, tell your healthcare professional.

Read more about making decisions about your care.

Where can I find out more?

The organisations below can give you more advice and support.

• Cancer Research UK, 0808 800 4040
• Fertility Friends
• Fertility Network UK(also includes ACeBabes and More to Life), 0121 323 5025
• Stonewall (the lesbian, gay and bisexual charity), 0800 050 2020
• Terrence Higgins Trust (HIV and sexual health charity), 0808 802 1221

The NHS infertility and Human Fertilisation and Embryology Authority (HFEA) websites may also be good starting points for finding out more.

To share an experience of care you have received, contact your local Healthwatch.

NICE is not responsible for the content of these websites.

We wrote this guideline with people who have been affected by fertility problems and staff who treat and support them. All the decisions are based on the best research available.

ISBN: 978-1-4731-9361-1