For many of us in the UK struggling to build a family, the NHS is the natural place we turn to for treatment and support. What we soon find, however, isn't clearcut: instead, we quickly realise that getting fertility treatment on the NHS isn't guaranteed — and getting started means first of all understanding if you're eligible for treatment.

In this straightforward guide, we explain the fundamentals of NHS IVF and IUI eligibility to help you decide whether NHS fertility treatment is the right option for you.

Or, if you’re in a hurry and If want to jump straight into to find out if you are eligible for NHS funded IVF or IUI you can find this out using our handy NHS IVF Eligibility Calculator — answering the question am I eligible for NHS funded treatment in minutes.

In short, yes, you can get fertility treatment on the NHS in the UK. Most commonly, this involves assisted fertility techniques like IVF, but in some circumstances, may also include fertility preservation, such as egg or sperm freezing.

But there's a problem, because getting NHS-funded treatment is actually more complicated than many people realise.

To understand why, it's first important to understand that the healthcare services you receive on the NHS — including fertility treatment — are funded and determined at a regional level, by bodies like integrated care boards (ICBs) if you live in England. Scotland, Wales and Northern Ireland each have a different, nationwide policy.

If you live in England, an integrated care board (ICB) works in partnership with other NHS organisations (like NHS hospitals and GPs) in your area to deliver health services that meet the needs of your local community.

But the most important thing to know about ICBs is that they manage the NHS budget in your region — deciding what services, including fertility treatment, should be funded and to what extent. Currently, there are 42 ICBs across England.

ICBs should ensure 'equal access' to fertility treatment across England, in accordance with National Institute for Health and Care Excellence (NICE) guidelines. [1,2]

In reality, though, ICBs set their own local policies and priorities. That means NHS-funded fertility treatment varies significantly across England, with ICBs deciding independently:

1. Who can (and can't) access NHS-funded fertility treatment (otherwise known as 'eligibility criteria');
2. What is included in the treatment on offer (something we refer to as 'service generosity').

What about other parts of the UK?

Funding for fertility treatment in Scotland, Wales and Northern Ireland is decided at a national level and each country has a different, but unified policy.

What is the NHS postcode lottery?

The 'NHS postcode lottery' is a popular phrase you might hear that describes the inequalities and regional differences in NHS-funded fertility care across England. This is the result of ICBs setting their own policies for fertility treatment.

Eligibility criteria are the requirements, set by your local ICB, that must be met in order for you to receive NHS-funded fertility treatment.

Who qualifies for IVF on the NHS depends on where you live, your age, your medical history, and sometimes your relationship status — and the rules aren’t always clear or consistent. Let’s break down what this means for different circumstances, so you can better understand your options.

What are the NHS IVF eligibility criteria for heterosexual couples?

As we've explored above, there's no consistent set of eligibility criteria for heterosexual couples seeking NHS-funded fertility treatment. Each ICB and region sets its own criteria — and that can make things really confusing.

However, there are some common factors and requirements that most NHS boards take into account:

• Evidence of infertility: before you can be considered eligible for NHS-funded fertility treatment, most people will need to demonstrate that they have tried to conceive naturally through unprotected sex for at least two years (unless there is a medical reason why this isn't possible). Some ICBs in England require at least three years of trying.
• Clinical factors: because age is one of the leading factors of infertility, one of the most important requirements for whether you can receive NHS-funded fertility treatment is your age. Typically, the upward age limit is between 40-42, but in some places the requirements are stricter. Other factors include whether you have any underlying conditions, and the number and quality of eggs you have available (this is known as your ovarian reserve).
• Lifestyle factors: lifestyle factors include things like whether you have ever smoked, and your body mass index (BMI). While these do vary considerably across local the UK, it's important to be aware that all policies have a maximum BMI limit for the maternal partner — and some also take into account the BMI of the paternal partner.
• Fertility history: many policies take into account fertility treatment you may have had previously. For example, in some areas, if you've already had IUI or IVF treatment — even if you've paid for it privately - you may not be able to access further NHS-funded treatment.
• Family history: in most parts of the UK, whether or not you already have children will be taken into account. Some boards will allow children from previous relationships, but over 76% of ICBs in England will only fund IVF if neither you nor your partner has any living children. Existing children isn't the only factor to consider here, either — some policies also factor in how long you've cohabited with your partner.

What are the NHS IVF eligibility criteria for female same-sex couples?

As a female same-sex couple, one of the key differences in eligibility criteria is that you'll need to provide evidence of infertility by first going through a number of rounds of unsuccessful artificial insemination (such as IUI).

It's important to be aware that ICBs and the regions have different or additional requirements regarding:

• How many rounds of artificial insemination (such as IUI) are required before IVF is considered as an option (this is also often much higher than for heterosexual couples);
• How many of these qualifying rounds must be self-funded, versus how many can be paid for by the NHS.

Self-funded artificial insemination can cost between £900 to £1250 per treatment package and it's not uncommon for ICBs in England to require a female same-sex couple to have undergone 12 rounds of artificial insemination. This makes it a really important budgeting factor to be aware of, and the basis for important campaigns about equality in the fertility sector. [3]

What are the NHS IVF eligibility criteria for single women?

Single women may be eligible for NHS-funded IVF if they have a diagnosed cause of infertility or can show they’ve undergone at least 12 cycles of unstimulated IUI over a year. Access can also vary depending on local NHS policies, so it’s important to check the specific criteria in your area. [4]

To qualify for NHS-funded IVF, most local policies ask that you (and your partner, if you have one) have a body mass index (BMI) between 19 and 30 and be non-smokers before treatment starts. These criteria are in place because research shows that a healthy weight and lifestyle can improve the chances of success and reduce treatment risks — but eligibility can vary by area, so it’s important to check the details with your local ICB. [1]

Another thing to make sure you understand is your NHS board's 'service generosity'. This is the term we use here at Fertility Mapper to describe how comprehensive the fertility treatment on offer is. In particular, we look at three elements:

1. The number of rounds of treatment available
2. The number of embryo transfers offered
3. The number of years of embryo storage provided

Service generosity varies widely across the UK. For example, not all ICBs offer the same number of rounds of IVF — in fact, 68% of ICBs in England only offer one round.

It's also important to know how many embryo transfers are included, and how long you can store surplus embryos free of charge (41% of ICBs will only store embryos for one year — after which, you'll need to find alternative private storage).