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Fertility Services

Infertility is when an individual cannot get pregnant, despite having regular unprotected sex or artificial insemination. You can read more about infertility at nhs.uk.

Some people get pregnant quickly, but for others it can take longer. It’s a good idea to see a GP for advice if you have not conceived after a year of trying or after 6 cycles of artificial insemination.

Women aged 36 and over, and anyone who’s already aware they may have fertility problems, should see their GP sooner. They will go through your history (medical, social, family etc.) and fertility journey so far and may need to examine you. If you are in a couple, you should go together for the consultation.

Because most people will get pregnant in the first year of trying, your GP will usually only advise tests and investigations sooner if any of the below applies to you:

  • your GP has already diagnosed you with a fertility problem or think you are at risk of fertility problems
  • you have not got pregnant after one year of trying through regular (3 times per week), unprotected sex or after six cycles of self-initiated artificial insemination, which is where sperm is inserted into the vagina, cervix or womb with the aim of getting pregnant, or
  • the woman or person trying to get pregnant is aged 36 or over.

We have developed an information leaflet for people or couples living in north central London who are worried about their ability to get pregnant, download NCL Fertility Policy Patient Leaflet. This leaflet is also available to read in easy read format.  It contains information about the NHS-funded assisted conception (fertility) treatments that are available in north central London, which ones are not and what the eligibility criteria are for accessing these services. We also have a frequently asked questions document which covers some common scenarios.

 

 

What kinds of NHS-funded assisted conception treatments are available in north central London?

The type of treatment you receive will depend on the cause of the fertility problems. There are three main types of fertility treatments:

  • medicines
  • surgery
  • assisted conception treatments

The assisted conception treatments below are funded by the NHS in north central London for eligible patients. Only a small group of people experiencing problems getting pregnant will need this kind of fertility treatment.

In vitro fertilisation (IVF)
During IVF, eggs are removed from the ovaries and fertilised with sperm in a laboratory. One or two fertilised eggs (embryos) are then put into the womb to try to grow and develop (embryo transfer). This is called a ‘fresh’ IVF cycle. If there are any remaining good quality embryos these will be frozen to use later in a frozen embryo transfer if the first transfer is not successful.

Intra-uterine insemination (IUI)
IUI is where the better-quality sperm are separated and injected directly into the womb when the woman or person is ovulating (when an egg is released from one of the ovaries). Sometimes fertility drugs are used to start ovulation or release more eggs. In NCL IUI is provided ‘unstimulated’, which means that fertility drugs are not used.

Assisted conception treatments using donated sperm
Some people may need to use donated sperm which is not from a partner to try to get pregnant. Currently the NHS in NCL will fund the cost of IUI or IVF for eligible patients, but the patient will need to source and pay for the donated sperm.

IVF using donated eggs
Some people who have certain medical conditions may need to use eggs from someone else to try to get pregnant. Currently the NHS in NCL will fund the cost of IVF for eligible patients, but the patient will need to source and pay for the donated egg.

You can find out more about using donated sperm and eggs on the HFEA website.

Sperm washing
Sperm washing may sometimes be used where the woman or person trying to get pregnant is not living with HIV, but the sperm is from a partner who is living with HIV.

Sperm washing is where the healthy sperm is separated from the semen where the HIV cells are located, preventing them being passed on to the woman or person trying to get pregnant and the baby. The washed sperm can then be transferred to the womb using IUI, or used to fertilise eggs in IVF.

Fertility preservation
Fertility preservation usually involves freezing sperm, eggs, or embryos to use in assisted conception treatments at a later date. In NCL, this is available to people with conditions or need treatment which is likely to make them infertile

Who can access assisted conception treatments?

Assisted conception treatments are funded for eligible individuals and couples with fertility problems. This is regardless of sexual orientation, gender identity or relationship status.

To be eligible for NHS-funded assisted conception treatments most people who live in north central London will need to meet the criteria listed below:

  • Age: The woman or person trying to get pregnant must be aged under 43. Assisted conception treatments are not funded for people aged 43 and over because the chances of a successful pregnancy are low. You can see more information about IVF success rates  on the HFEA webpage: In vitro fertilisation (IVF)

    If the woman or person trying to get pregnant is aged under 40 they must not have already had three IVF cycles. If the woman or person trying to get pregnant is aged 40-42 they must not have already had any IVF cycles. This includes cycles paid for privately. This is because the likelihood of getting pregnant decreases with the number of unsuccessful IVF cycles a person has had.

  • Ovarian reserve: The woman or person trying to get pregnant should have an adequate number of good quality eggs in their ovaries (ovarian reserve). Ovarian reserve is a good indicator of a woman or person’s ability to get pregnant. A woman’s ovarian reserve declines with age. There are several blood tests and a scan that can help predict ovarian reserve. In NCL assisted conception treatments are not funded for people who have abnormal ovarian reserve tests because they are less likely to get pregnant using assisted conception treatments.
  • Weight: The woman or person trying to get pregnant must have a healthy weight. This is measured by working out a person’s body mass index (BMI), which divides weight in kilograms by height in metres squared. The person trying to get pregnant must have a BMI between 19 and 30. This is because people who are either underweight or obese are less likely to get pregnant using assisted conception treatments.
  • Smoking: The women or the person trying to become pregnant and the man or person providing sperm for treatment must not smoke. If you give up smoking you will become eligible. This is because people who smoke are less likely to get pregnant using assisted conception treatments.
  • Sterilisation: People in a couple or individuals must not have been sterilised. This is because sterilisation is offered in the NHS as an irreversible method of contraception.
  • Existing children: Couples cannot already have a child together and at least one person in the couple must not have a living child from a previous relationship. Single people cannot already have a child. This is because the NHS needs to focus its budget on patients who have the most need.
North Central London Integrated Care Board’s Fertility Policy

From 25 July 2022, there will be a new single fertility policy for North Central London. This policy was agreed by the former CCG in May 2022 and explains which assisted conception treatments are funded by the NHS in NCL and who can access them.

The policy increases the provision of specialist fertility treatments in several boroughs and to a large extent, is more closely aligned with NICE guidance compared to the existing policies. It has been developed using a robust, clinically-led and evidence-based approach, involving engagement with residents and a range of stakeholders.

From 25 July, if you are an NCL resident who is eligible for fertility treatment, you can expect to benefit from:

  • fairer access to specialist fertility treatments across all five boroughs
  • greater clarity and consistency about which specialist fertility treatments are NHS-funded in NCL and who is eligible
  • an increased number of in vitro fertilisation (IVF) cycles available to eligible people trying to conceive who are aged under 40 in four boroughs and the same provision in the other borough
  • funding of up to six cycles of intrauterine insemination (IUI) for eligible female same sex couples, single women, and other couples trying to conceive through artificial insemination who have not conceived after six self-funded cycles of IUI.

If you are already undergoing or have already been referred for NHS-funded fertility treatment, you will not be disadvantaged by the transition to the new policy. You can view our frequently asked questions which cover some common scenarios.

Fertility information document library

 

Specialist Fertility Service Providers in north central London

Anyone registered with a north central London general practice who needs a referral to a specialist fertility clinic can chose to receive their care from any NHS-commissioned service in England. Please note that not all providers offer the same specialist fertility services and being referred is not a guarantee that treatment will be given.

Your GP will make this referral and will be able to talk to you about the process. The Human Fertilisation and Embryology Authority website also has lots of information about choosing a fertility clinic, which you might find useful.

Nearby providers of specialist fertility treatments to north central London:

Please note that this list is not exclusive nor exhaustive.

Useful fertility resources
Fertility Services explainer videos

The ICB has produced some short videos that explain what assisted conception services are available on the NHS in North Central London in English and Turkish. More languages will be added as the videos become available.