Fertility
Lack of NHS funding forces IVF patients into private care, says study
Research reveals a complex and overlapping system that contributes to inequalities in treatment experience
The privatisation of UK healthcare services is creating unequal access to fertility treatment, researchers have said, leaving many people unable to afford the care they need.
The study, conducted by Queen Mary University of London, has shown that long NHS waiting lists along with the cost of living crisis are stopping people from starting families.
Only a fifth of the aspiring parents involved in the research could afford private fertility care, while 40 per cent said it would be just about possible with substantial financial planning. The remaining 40 per cent could not afford the treatment.
More than 50,000 people have fertility treatment every year in the UK, some as NHS patients but most paying privately, at prices from £3-5,000 for a standard IVF cycle to more than £20,000 with certain add-ons.
Although it is generally assumed that people struggling to conceive use NHS or private services, researchers have said this new study reveals a complex and overlapping system, where an initial round of IVF on the NHS often still leads patients into paying privately.
The findings have shown that while hopeful their treatment would work, participants knew that each round of IVF might not lead to a baby, and it was generally accepted by both patients and professionals that multiple attempts would probably need to be undertaken.
For many, the possibility that they might become private patients in the future involved substantial financial planning, coupled with worry about financial trauma.
One participant described how she was prepared for her funded IVF cycles not to be successful and started to save money, saying: “I thought, it’s going to cost us 16 grand in total to get two [private cycles of IVF]… I just needed that in my head, so I thought I could start saving, and so I’d be ready if it didn’t work.”
Dr Manuela Perrotta, study author and reader in technology and organisation at Queen Mary University of London, said: “Participants in our study went into fertility treatment expecting they may need to pay thousands of pounds for it, even if they were having NHS care.
“People know there is limited public funding for IVF, and each cycle has quite a low success rate which decreases further over time – so even if NHS care is available, it may not be enough.”
Many participants reported not being able to afford the costs of private IVF, and a lack of other options led some to make significant life changes in pursuit of the care they need.
One patient in the research moved 50 miles to be in a different catchment area with more supportive funding policies.
“I found out that if I lived in certain areas I would have had three rounds funded, so we moved [to another city] within about three weeks of finding that out and got the funding.”
The National Institute for Health and Care Excellence (NICE) recommends three cycles of IVF for women under 40, but access to treatment in the UK is determined by a patient’s home address and registered general practice, which can leave some unable to get help on the NHS.
This has led to an uneven provision of IVF treatment across different regions in the UK, with more funded cycles available in Scotland than in London and the east of England.
Paying for fertility treatment does not necessarily involve moving to a private clinic, the study has also suggested.
One patient described her first experience of private treatment being with the same consultant and at the same clinic as her previous NHS treatment.
Researchers have found that movement between NHS and private fertility care was often challenging for patients, with treatment options varying significantly from place to place.
Dr Josie Hamper, study author and post-doctoral researcher at Queen Mary University of London, said: “Our research shows that the boundaries between NHS and privately provided IVF are not as neat as they seem, and the hybrid public/private infertility landscape has had profound consequences for all IVF patients.
“The representation of a public/private divide contributes to inequalities in treatment experience, and does not reflect patients’ experiences of IVF in the UK.”
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Kindbody unveils next-gen fertility platform
Fertility
Baby2Home app boosts new mothers’ mental health
First-time mothers using the Baby2Home app for a year after birth reported fewer symptoms of stress, depression and anxiety than those receiving usual postpartum care.
The study found women randomised to the app reported better overall health than first-time mothers who received usual care alone.
Baby2Home is a digital tool to help new families with newborn care and staying healthy.
It offers tailored educational content, infant care trackers and mental health self-management tools, plus access to a care manager for on-demand mental health and problem-solving support.
Emily S. Miller is principal investigator and division director of maternal-fetal medicine at Women & Infants Hospital of Rhode Island.
She said: “Evidence-based digital tools like Baby2Home are opening the door to a new era of postpartum care.
“We can now extend high-quality support beyond hospital walls and into families’ everyday lives. The mental health improvements we saw underscore just how transformational that support can be.”
Researchers from Women & Infants Hospital of Rhode Island, Warren Alpert Medical School of Brown University, Northwestern University’s Feinberg School of Medicine and Lurie Children’s Hospital of Chicago ran a multi-site randomised controlled trial between November 2022 and July 2025.
The trial enrolled 642 postpartum patients, all first-time parents. For 12 months after birth, all participants received usual postpartum care; half also used the Baby2Home smartphone app.
Participants reported progress electronically at five time points over the first year. Compared with the control group, those assigned to Baby2Home reported significantly fewer symptoms of stress, depression and anxiety.
They also reported better overall health, higher relationship satisfaction with partners and family members, and greater confidence in their parenting than the control group.
Miller said: “The first year after birth is a critical period for parental mental health. Baby2Home helped new parents feel more confident, more supported and more connected.
“That translated into better health outcomes for them and their families.”
Pregnancy
Most NHS regions in England limit IVF to single cycle, research finds
Nearly 70 per cent of NHS regions in England fund only one IVF cycle for women under 40, breaking national guidelines, new research has found.
Twenty-nine of the 42 integrated care boards, which control local NHS budgets, now offer only one round of treatment, after four reduced access in the past year.
National Institute for Health and Care Excellence (Nice) guidelines recommend three full cycles for women under 40 who have been unable to conceive for two years.
Only two of England’s 42 integrated care boards have policies consistent with these guidelines, which they are not legally obliged to follow.
The research was conducted by the Progress Educational Trust, a fertility charity.
Sarah Norcross, the director of PET, said the impact was “devastating” for couples struggling with infertility.
She said: “Infertility is already incredibly stressful for people, and it puts them under even more pressure, because there is so much riding on whether that one NHS-funded cycle is going to work.
“And for some people, that will be their only chance, because private fertility treatment is so expensive.”
The data showed regional variations, with the whole of the north-west offering just one cycle.
“It’s a postcode lottery, and we’re seeing a race to the bottom,” said Norcross.
Of the 29 integrated care boards that offer a single cycle, 19 provide only a partial cycle, where not all viable embryos created are transferred.
There was just one recent example of improved services, from NHS South East London, which in July 2024 went from one partial to two full cycles.
The NHS estimates that about one in seven couples may have difficulty achieving a pregnancy. One cycle of IVF can cost from £5,000 at a private clinic.
Fertility rates in England and Wales have fallen since 2010 to 1.41 children per woman in 2024, the lowest on record and below the replacement level of 2.1 at which a population is stable without immigration.
Health minister Karin Smyth said in a written parliamentary answer last month that it was “unacceptable” that access to NHS-funded fertility services varied across the country.
Revised Nice fertility guidelines are due this spring, but Norcross said changing them seemed pointless.
She said: “Fertility treatment has always been a Cinderella service. It’s always been the one they’ve chosen to cut or to ignore.
“Nice has recommended three full NHS-funded cycles, for women under 40, for more than 20 years. This has never been implemented across England, unlike in Scotland.”
Norcross advocated centralised commissioning and replicating Scotland’s approach, which included financial modelling and a phased implementation starting with two cycles to avoid long waits, moving up to three once capacity was achieved.
“It is a tried and tested plan that England could follow,” Norcross added.
A Department of Health and Social Care spokesperson said: “We recognise access to fertility treatment varies across the country and we are working with the NHS to improve consistency.
“Nice provides clear clinical guidelines, and we expect integrated care boards to commission treatment in line with these.
“Updated Nice fertility guidelines are expected this spring and we will continue to support NHS England to make sure the guidance is fully considered in local commissioning decisions.”
An NHS England spokesperson said: “These clinical services are commissioned by integrated care boards for their area based on the needs of the local population and prioritisation of resources available.
“All ICBs have a responsibility to ensure services are provided fairly and are accessible by different population groups.”
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