The number of clinical commissioning groups (CCGs) in England offering the recommended three IVF cycles to women under 40 has halved in the last five years, a report has found.
Just 12% of local medical centres now follow national NICE guidance of providing three cycles, down from 24% in 2013.
The number of CCGs offering one NHS-funded IVF cycle is 61%, up from 49% in 2013.
However, seven CCGs have stopped offering NHS IVF services entirely.
The figures, released to mark the beginning of National Fertility Awareness Week by campaign group Fertility Fairness, were drawn from analysis of 208 CCGs across England.
Fertility Fairness has drawn up an IVF league table, which ranks NHS CCGs in different areas of England.
They looked at:
* Number of cycles offered.
* Definition of one cycle.
* Age range of women IVF is offered to.
* How long couple have to have been trying to conceive before they are offered IVF.
* Restrictions on whether IVF will be offered to people who have children.
The league table showed a striking difference between accessibility in the south of England compared to the north: Just three CCGs located in the south offer three IVF cycles, while 21 CCGs offer three cycles in the north.
The definition of “one cycle” also varies from one CCG to another.
NICE guidelines define a full cycle as “one round of ovarian stimulation followed by the transfer of all resultant fresh or frozen embryos”. However, nearly half of all CCGs (49%) only transfer a finite number of embryos, rather than all embryos.
Some CCGs have different age criteria for access to NHS IVF.
Nearly half of all CCGs (48%) do not offer NHS IVF to women aged 40-42 and 10% refuse access to NHS IVF if women are over 35.
Sarah Norcross, co-chair of Fertility Fairness said: “The scale of disinvestment in NHS fertility services is at its worst since NICE introduced national fertility guidelines in 2004.
“Fertility Fairness is calling for full implementation of the NICE guidelines, standardisation of eligibility criteria across England and the development of a national tariff in England for tertiary fertility services - eliminating regional cost variants and removing a key barrier to CCGs’ compliance with national guidelines.”
Responding to the findings, an NHS England spokesperson said: “Ultimately these are legally decisions for CCGs, who are under an obligation to balance the various competing demands on the NHS locally while living within the budget parliament has allocated.”
IVF League Table: The Ratings For CCGs That Offer Three Cycles Of IVF
1. NHS Bury CCG
Definition of one cycle: One fresh transfer and all viable frozen transfers.
Age range offered to: 23-39, 40-42.
Time trying to conceive: Two years (one year for those aged 36 and over).
Previous children: No living children from current relationship and at least one partner childless from previous relationship.
1. NHS Heywood, Middleton And Rochdale
Definition of one cycle: One fresh transfer and all viable frozen transfers.
Age range offered to: 23-39, 40-42.
Time trying to conceive: Two years (one year for those aged 36 and over).
Previous children: No living children from current relationship and at least one partner childless from previous relationship.
1. NHS Oldham
Definition of one cycle: One fresh transfer and all viable frozen transfers.
Age range offered to: 23-39, 40-42.
Time trying to conceive: Two years (one year for those aged 36 and over).
Previous children: No living children from current relationship and at least one partner childless from previous relationship.
1. NHS Tameside And Glossop
Definition of one cycle: One fresh transfer and all viable frozen transfers
Age range offered to: 23-39, 40-42
Time trying to conceive: Two years (one year for those aged 36 and over)
Previous children: No living children from current relationship and at least one partner childless from previous relationship.
2. NHS Bassetlaw
Definition of one cycle: One fresh transfer and all viable frozen transfers.
Age range offered to: 18-40, 40-42.
Time trying to conceive: Two years
Previous children: No living children.
2. NHS Cumbria
Definition of one cycle: One fresh transfer and all viable frozen transfers.
Age range offered to: Under 40, 40-42.
Time trying to conceive: Two years.
Previous children: No living children.
2. NHS Darlington
Definition of one cycle: One fresh transfer and all viable frozen transfers.
Age range offered to: Under 40, 40-42.
Time trying to conceive: Two years.
Previous children: No living children.
2. NHS Durham Dales, Easington And Sedgefield
Definition of one cycle: One fresh transfer and all viable frozen transfers.
Age range offered to: Under 40, 40-42.
Time trying to conceive: Two years.
Previous children: No living children.
2. NHS Halton
Definition of one cycle: One fresh transfer and all viable frozen transfers.
Age range offered to: 23-39, 40-42.
Time trying to conceive: Two years (one year for those aged 36 or over).
Previous children: No living children.
2. NHS Hartlepool and Stockton-on-Tees
Definition of one cycle: One fresh transfer and all viable frozen transfers.
Age range offered to: Under 40, 40-42.
Time trying to conceive: Two years.
Previous children: No living children.
2. NHS Knowsley
Definition of one cycle: One fresh transfer and all viable frozen transfers.
Age range offered to: 23-39, 40-42.
Time trying to conceive: Two years.
Previous children: No living children.
2. NHS Newcastle Gateshead
Definition of one cycle: One fresh transfer and all viable frozen transfers.
Age range offered to: Under 40, 40-42.
Time trying to conceive: Two years.
Previous children: No living children.
2. NHS North Durham
Definition of one cycle: One fresh transfer and all viable frozen transfers.
Age range offered to: Under 40, 40-42.
Time trying to conceive: Two years.
Previous children: No living children.
2. NHS North Tyneside
Definition of one cycle: One fresh transfer and all viable frozen transfers.
Age range offered to: Under 40, 40-42.
Time trying to conceive: Two years.
Previous children: No living children.
2. NHS Northumberland
Definition of one cycle: One fresh transfer and all viable frozen transfers.
Age range offered to: Under 40, 40-42.
Time trying to conceive: Two years.
Previous children: No living children.
2. NHS South Sefton
Definition of one cycle: One fresh transfer and all viable frozen transfers.
Age range offered to: 23-39, 40-42.
Time trying to conceive: Two years.
Previous children: No living children.
2. NHS South Tees
Definition of one cycle: One fresh transfer and all viable frozen transfers.
Age range offered to: Under 40, 40-42.
Time trying to conceive: Two years.
Previous children: No living children.
2. NHS South Tyneside
Definition of one cycle: One fresh transfer and all viable frozen transfers.
Age range offered to: Under 40, 40-42.
Time trying to conceive: Two years.
Previous children: No living children.
2. NHS Southport and Formby
Definition of one cycle: One fresh transfer and all viable frozen transfers.
Age range offered to: 23-39, 40-42.
Time trying to conceive: Two years.
Previous children: No living children.
2. NHS Sunderland
Definition of one cycle: One fresh transfer and all viable frozen transfers.
Age range offered to: Under 40, 40-42.
Time trying to conceive: Two years.
Previous children: No living children.
2. NHS Thurrock
Definition of one cycle: One fresh transfer and all viable frozen transfers.
Age range offered to: Under 40, 40-42.
Time trying to conceive: Two years.
Previous children: No answer provided.
2. NHS Warrington
Definition of one cycle: One fresh transfer and all viable frozen transfers.
Age range offered to: 24-40 (three cycles), 40-42 (one cycle).
Time trying to conceive: Two years.
Previous children: No living children.
3. NHS Camden
Definition of one cycle: One fresh transfer and all viable frozen transfers.
Age range offered to: Under 40, 40-42.
Time trying to conceive: Two years or one year if they’re aged 36 or over.
Previous children: No living children from current relationship and at least one partner childless from previous relationship.
4. NHS Luton
Definition of one cycle: A maximum of six embryo transfers with a maximum of three fresh transfers.
Age range offered to: 23-40, 42.
Time trying to conceive: Three years.
Previous children: No living children.
View the full IVF NHS league table here.