Frequently asked questions
Why has NHS Cheshire and Merseyside made changes to their fertility policy?
Previously, ten different NHS subfertility policies were in use across Cheshire and Merseyside, meaning people had varying access to NHS‑funded fertility treatment depending on where they lived.
NHS Cheshire and Merseyside now has a single fertility policy, ensuring that everyone in our area receives consistent access to treatment.
The updated policy removes variation, brings local practice in line with national guidance, and includes changes needed for financial sustainability.
What changes have been made?
A key change is that NHS Cheshire and Merseyside ICB now funds one cycle of in vitro fertilisation (IVF) per eligible individual or couple. Previously, between one and three cycles were funded depending on location.
Other changes standardise eligibility criteria, so they are consistent across Cheshire and Merseyside and aligned with the latest clinical guidance. These include updates relating to BMI, smoking status, age limits, and the definition of childlessness.
Who will be affected by these changes?
It applies only to people who are referred to fertility services on or after 1 February 2026. Anyone who was referred before 1 February 2026 will not be affected by the new policy.
This includes:
- people who have already begun treatment
- people who have been referred but have not yet started treatment
- people who are on a waiting list
- people who are partway through investigations prior to starting IVF or other fertility treatment
All of these individuals will continue to be assessed and treated under the previous fertility policy for the area in which they live. This means that their entitlement to NHS‑funded fertility treatment, including the number of IVF cycles, will remain exactly as it was at the time they were referred.
Only people whose referral to fertility services is made on or after 1 February 2026 will come under the rules of the new, single Cheshire and Merseyside fertility policy.
Why couldn’t we leave things as they were?
Keeping ten different policies would have continued unequal access to treatment, with different numbers of NHS‑funded IVF cycles depending on where people lived.
It also would not have allowed NHS Cheshire and Merseyside to reduce costs at a time when significant financial pressures needed addressing.
Is this just about saving the NHS money?
Some changes are necessary due to the serious financial challenges facing the NHS, meaning we must make careful decisions about how local resources are used.
However, the changes are also about ensuring local care is consistent, fair, and in line with national guidance.
How can you justify reducing the number of funded IVF cycles?
We recognise that access to fertility treatment is a sensitive and important issue. Moving to a single funded IVF cycle means that we can continue to offer treatment to the local population in a way that remains clinically appropriate and financially sustainable.
How much money does the NHS save through these changes?
NHS Cheshire and Merseyside previously spent over £5 million each year on IVF treatment. The policy change is estimated to save around £1.3 million annually.
What does the IUI change mean for same‑sex couples and single women?
The change makes NHS‑funded IUI available in Wirral, bringing it into line with other areas.
However, the existing requirement for self‑funded IUI for same‑sex couples and single women before eligibility for NHS treatment remains in place.
This policy is interim. When new national guidance from NICE is published, we will review and update the local policy accordingly.
Why didn’t you introduce two IVF cycles instead?
We considered whether two cycles could be offered to all eligible people, and this option was supported by local NHS fertility specialists. However, providing two cycles would cost around £40,000 more per year than current spending.
Given the financial pressures on the NHS, increasing expenditure was not considered a responsible option. We needed a policy that reduced costs, not increased them.
What if most people disagreed with the changes?
The consultation process gathered views, personal experiences and information about potential impacts. This informed the decision‑making process, but the final decision rests with the NHS Cheshire and Merseyside Board, who carefully considered all evidence before approving the changes.
Questions about individual patients’ fertility treatment and care plans
People currently receiving fertility treatment should continue to follow the advice of their care provider. If you have questions about your specific treatment plan, please speak directly with your fertility clinic.