The National Institute for Health and Care Excellence (NICE) has issued new draft guidelines calling on both NHS and private fertility clinics to stop offering unproven IVF treatments that fail to improve the chances of having a baby.
The updated guidance warns against a range of popular but untested fertility “add-ons,” such as endometrial scratches and certain womb tests, which experts say provide false hope and subject patients to unnecessary procedures during an already challenging time.
A survey conducted by the Human Fertilisation and Embryology Authority (HFEA) revealed that nearly three-quarters of patients undergoing fertility treatment in late 2024 used additional procedures or emerging technologies—despite most lacking scientific evidence of effectiveness. Alarmingly, only 37% of patients reported being informed of the associated risks.
The draft guidance specifically advises against:
- Intracytoplasmic sperm injection (ICSI) in men with healthy semen
- Endometrial scratch, performed before IVF
- Hysteroscopy as a pre-treatment to improve IVF outcomes
- Endometrial receptivity testing before embryo transfer
“People going through fertility treatment are often willing to try anything that might help them conceive. This makes them vulnerable to unproven treatments that can do more harm than good,” said Dr Fergus Macbeth, Chair of NICE’s Fertility Guideline Committee. “Our recommendations aim to protect patients by ensuring they only receive care that works.”
Beyond discouraging unproven add-ons, NICE also recommends widening access to fertility preservation services, including egg freezing. Currently offered mainly to cancer patients, these services should also be available to individuals with severe recurrent endometriosis, genetic or metabolic conditions, or those undergoing surgeries that may impact fertility.
The guidelines further address access to IVF, finding stronger evidence that three full cycles of IVF provide couples with the best chance of success and represent good value for the NHS. NICE recommends:
- Up to three full IVF cycles for women under 40 who meet specific criteria
- One full cycle for women aged 40 and 41 who meet criteria
- While NICE sets recommendations, final decisions on funding remain with local integrated care boards.
Professor Jonathan Benger, NICE’s Chief Medical Officer, acknowledged the financial challenges faced by the NHS: “Integrated care boards must balance our guidance with local priorities when determining IVF provision.”
The draft guidelines are now open for public consultation in England, Wales, and Northern Ireland until 21 October 2025, with final recommendations expected in 2026.
