ICB Board approves improvements to local fertility treatment policy


Updated: 13 December 2022

Members of Bristol, North Somerset and South Gloucestershire’s Integrated Care Board (ICB) approved improvements to the area’s policy on fertility assessment, treatment, and preservation funding at their Board meeting on Thursday, 1 December.

The changes follow a comprehensive review process which began in March 2021 and gained the views from 438 people and organisations. The review involved consultation with local fertility specialists and a 12-week period of online public engagement which asked what the priorities should be in reviewing the local approach to funding infertility treatment.

Participants highlighted three common themes in their feedback:

  • The scope of people who can access fertility preservation should be broader
  • The number of cycles of in vitro fertilisation (IVF) should be increased from one to three
  • The length of time a person has not conceived should be considered more important than their relationship status.

As a result of the review, the ICB has refreshed its current policy on Fertility Assessment and Treatment, and has developed a new policy for Fertility Preservation.

Rosi Shepherd, Chief Nursing Officer for Bristol, North Somerset and South Gloucestershire ICB, said:

“We know fertility funding and treatment policies impact on the lives of many people. That’s why we are so pleased to have received such extensive and constructive feedback from the public, and experts in this field.

“The changes our Board have approved provide better equity of access for local people – which was important feedback we heard during the consultation – while staying within our limited resources.”

Reflecting public engagement feedback, the refreshed policy for Infertility Assessment and Treatment, and new policy for Fertility Preservation will:

  • Support heterosexual couples, same sex couples, and single women with demonstrated infertility problems. The current policy states that only people in a heterosexual or same sex couple are eligible.
  • Relieve some of the financial demands on those accessing treatment, by reducing the number of independently funded cycles of Intrauterine Insemination (IUI) required to demonstrate infertility, from ten to six.
  • Offer individuals, who will receive NHS-provided treatment that will have an adverse, long-term impact on their fertility (where there is no clear alternative) the opportunity to freeze their reproductive cells (egg cells or sperm) for a defined period. This includes, and is not limited to, support for people undergoing some cancer treatments, surgery on a second ovary or testes and transgender people who are on the transition pathway. The current policy only provides support for people undergoing some cancer treatments.
  • Support individuals with diagnosed therapy-resistant psychosexual issues that prevent them from having children without assistance.
  • Continue to offer individuals one fresh and one frozen cycle of IVF treatment.

While the changes enable a wider range of people to access support for infertility, the NHS is not able to provide further funding to meet the needs of an increased number of people seeking NHS funded treatment.

To address this, the ICB will be lowering the upper age limit for prospective mothers from 40 to 39 years. The change is based on evidence that indicates the success rate of IVF for women over the age of 40 is generally less than for women under 40 years.

Following approval from the ICB on 1 December, these new policies will be implemented from 1 April 2023.