NHS Criteria for Fertility Treatment

By Nick Peplow·Founder and editor

Last reviewed 27 September 2026· How this site is researched

NHS-funded fertility treatment exists and it is free at the point of use. What it is not is one national offer. Whether you are funded, for how many cycles, and on what conditions, is decided by the integrated care board that covers the address you live at. Two couples with identical test results a few miles apart can get different answers, and neither of them is being treated unfairly. They are under different rules.

That is the most useful thing to understand before you start reading policies. The criteria someone confidently quotes you, including someone who has just been through treatment themselves, may have nothing to do with yours. A friend two counties over may have been given something different, and both of you can be right.

The guideline and the offer are different documents

NICE publishes a national clinical guideline on fertility problems. It is the document everyone cites, and it recommends more than most areas commission. The well-known example is its recommendation of three full cycles for eligible women under 40. A guideline is advice to commissioners, not an entitlement you can hold up at a desk.

Commissioning happens locally. In practice that has meant one funded cycle in a great many areas, two in some, three in a few, and at various points none at all in a handful. Those numbers move, in both directions, as local budgets and national pressure shift. So "the NHS gives you three cycles" is a true sentence about the guideline and an unreliable one about any particular postcode.

The only authoritative source for your position is your own ICB's published fertility policy. Ask for it by that name, in writing, from your GP or the fertility unit. It is usually a PDF of a few pages and it will answer most of what follows better than I can.

The criteria you will usually meet

Local policies differ in their numbers more than in their categories. Expect most of these to appear in some form.

• An age ceiling for the person carrying the pregnancy, commonly somewhere from the late thirties to the early forties, often with a stricter tier above a certain age. Some policies also set a lower age limit, or an upper age for a male partner.
• A period of trying. For unexplained infertility this is frequently around two years of regular unprotected intercourse, and is shortened or waived where a cause has been identified. Note that this threshold is usually longer than the one that gets you investigated, which is commonly twelve months, or six over 35. Being investigated and being funded are separate gates.
• A BMI range, often with a lower bound as well as an upper one, and usually to be met before treatment starts rather than promised for later.
• Not smoking, sometimes for a stated number of months beforehand, sometimes verified with a test. Vaping and nicotine replacement are treated differently in different policies.
• No living children in the relationship, from either partner. This is the criterion that causes the most distress and the most confusion, so it has its own page: previous children.
• A number of funded cycles, which is where areas diverge most sharply.
• Sometimes a limit on how many cycles you may already have self-funded, and sometimes a rule that any previous private treatment disqualifies you entirely.

Do not take any figure in that list as your figure. They are the categories to look for in your own policy, and the questions to ask when you find them.

"A cycle" is not a fixed quantity

This is the detail most worth checking. In some areas a funded cycle means one round of stimulation, egg collection, fertilisation and a single fresh transfer. Any remaining embryos are then yours to store and transfer at your own expense, or not at all. In other areas the same word means that fresh transfer plus every frozen embryo transfer from the same batch of embryos, until they are used up. That version is often called a full cycle.

The gap between those two definitions is several thousand pounds, and more to the point it is several extra chances at a pregnancy from eggs that have already been collected. Ask the question in plain words. How many embryo transfers does my funded cycle include, and who pays for storage and for thawing the rest.

Ask too what happens if a cycle is cancelled before egg collection, which is not rare. Some policies count an abandoned cycle against your allocation and some do not.

Where the criteria get applied

The usual route starts with your GP, who arranges initial tests and then refers you on. Eligibility is normally checked at the point of referral into a funded service, and it is often checked again before treatment begins. That matters because waiting lists are long enough that people cross an age threshold or a BMI threshold while they wait.

Ask which version of the policy applies to you if it changes between referral and treatment. Policies vary on that too, and the answer is sometimes negotiable and sometimes not.

If you do not qualify

You have more options than a flat no suggests, though none of them is guaranteed. Many NHS units treat self-funding patients alongside funded ones, which is sometimes cheaper than a standalone private clinic and sometimes not. Most areas have a route for an individual funding request, which asks the commissioner to make an exception on clinical grounds. Most are not granted, so a request built around a specific clinical reason gives you the best chance.

If a criterion is one you can change, such as weight or smoking, ask exactly what evidence will be accepted and by when. If it is one you cannot, ask what the timetable looks like privately, because the calculation past the late thirties is mostly about time rather than money.

None of this is medical, legal or financial advice. Your ICB's policy and your clinic's reading of it are what decide the matter. Get both in writing before you build a plan on either.