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In Vitro Fertilisation Eligibility Criteria

Couples will be assessed for referral using the following criteria:

  1. Test for ovarian reserve using Anti-MÜllerian Hormone (AMH) level
    To be eligible, the patient should have an AMH level of more than 5.4pmol/l within three months of referral from secondary care to the specialist IVF provider*.
    *During the transition to AMH testing it is anticipated that some Trusts may not be able to offer AMH immediately. During this period, to be eligible the patient should have an FSH of <9IU/L on day two of any menstrual cycle done within three months of referral from secondary care to a specialist IVF provider.
  2. Maternal age and number of cycles:
    Women aged 23 to less than 40 years at the start of treatment – Two fresh cycles. Where a woman reaches the age of 40 years during treatment they will complete that cycle in the 40th year and will not be entitled to commence further cycles. Women aged 40 to less than 43 years may be entitled to ONE cycle of IVF where:
    • They have never previously had IVF treatment
    • There is no evidence of low ovarian reserve
    • There has been a discussion of the additional implications of IVF and pregnancy at this stage
  3. Embryo transfers:
    Women aged 23 to 39 years – ONE embryo will be transferred during each cycle to reduce the risk of multiple pregnancies. A maximum of six embryo transfers (fresh plus frozen) will be funded. All frozen embryos should be used before a new fresh cycle is funded. Women aged between 40 to less than 43 years – Up to TWO embryos may be transferred during each cycle. A maximum of two embryo transfers (fresh plus frozen) will be funded.
  4. Age of male partner
    None specified
  5. Minimum / Maximum BMI
    Women must have a BMI of between at least 19 and up to 30 and less than 35 for a male. Patients outside of this range will not be added to the waiting list and should be referred back to their referring clinician and/or general practitioner for weight management, advice and support if required. In female same sex couples, BMI criteria should only apply to the partner undergoing fertility treatment. .
  6. Duration of sub-fertility

    Couples with unexplained infertility must have infertility of at least three years’ duration or 36 cycles, despite regular unprotected vaginal sexual intercourse with the partner seeking treatment. Of these 3 years, at least twelve months of the management should take place in primary care where appropriate.

    If the woman has a miscarriage, the couple will wait for a further 3 years of unexplained infertility from the date of the miscarriage to be eligible for NHS funded IVF.

    Couples with a diagnosed cause of absolute infertility which precludes any possibility of natural conception, and who meet all the other eligibility criteria, will have immediate access to NHS funded assisted reproduction services

  7. Previous Fertility treatment
    Previous privately or NHS funded cycles and embryo transfers will count towards the total number of fresh cycles and embryo transfers funded by the NHS. To ensure equality of access between two genders, if a male partner in the relationship has received the full entitlement of IVF treatment (as per CCG policy) for his infertility either in current relationship or previous relationship, the couple are not eligible for additional IVF treatment..
  8. Smoking Status
    Couples who smoke will not be eligible for NHS-funded specialist assisted reproduction assessment or treatment, and should be informed of this criterion at the earliest possible opportunity in their progress through infertility investigations in primary care and secondary care. Couples presenting with fertility problems in primary care should be provided with information about the impact of smoking on their ability to conceive naturally, the adverse health impacts of passible smoking on any children and smoking cessation support should be provided as necessary. Both partners must be non-smoking at the time of referral from secondary care to specialist IVF services and maintained during treatment. This applies equally for same-sex couples as passive smoking may affect the fertility of the partner undergoing fertility treatment. Smoking status should be ascertained by carbon monoxide testing in secondary care and specialist IVF services.
  9. Parental Status
    Couples are ineligible for treatment if there are any living children from the current or any previous relationships, regardless of whether the child resides with them. This includes any adopted child within their current or previous relationships; this will apply to adoptions either in or out of the current or previous relationships.
  10. Previous sterilisation
    Couples are ineligible if previous sterilisation has taken place (either partner), even if it has been reversed.
  11. Child Welfare
    Providers must meet the statutory requirements to ensure the welfare of the child. This includes HFEA’s Code of Practice which considers the ‘welfare of the child which may be born’ and takes into account the importance of a stable and supportive environment for children as well as the pre-existing health status of the parents.
  12. Medical Conditions
    Treatment may be denied on other medical grounds not explicitly covered in this document.
  13. Residential Status
    The couple should either be registered with a GP in the CCG for 12+ months, or if their GP registration is less than 12 month, they can be eligible if they can demonstrate residency of 12+ months in HVCCG area
  14. The minimum investigations required prior to referral to the Tertiary centre are:
    Female: Laparoscopy and/or hysteroscopy and/or hysterosalpingogram or ultrasound scan where appropriate
    Rubella antibodies
    Chlamydia screening
    Hep B including core antibodies and Hep C and HIV status and core, within the last 3 months of treatment and repeated every 2 years.
    Male: Preliminary Semen Analysis and appropriate investigations where abnormal (including genetics)
    Hep B including core antibodies and Hep C, within the last 3 months and repeated after 2 years.
    HIV status
  15. Pre-implantation Genetic Diagnosis
    PGD and associated specialist fertility treatment is the commissioning responsibility of NHS England and is excluded from the CCG commissioned service.
  16. Rubella Status
    The woman must be rubella immune
  17. IUI (Unstimulated)
    Due to poor clinical evidence, IUI will only be offered under exceptional circumstances.

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