Here we discuss what people told us about how their care was funded and how they went about choosing a clinic.
We spoke to people who had only had NHS care, some who had only private treatment, and some who had used a mixture of private and NHS care.
Funding for fertility treatment
Funding for fertility treatment on the NHS in England is determined by local integrated care boards (ICBs) (previously known as the clinical commissioning group (CCG) and the local Primary Care Trust (PCT)). Eligibility for provision of this funding is dependent on local ICB policy, postcode, and various factors dependent on personal circumstance (NHS, 18 October 2021).
Criteria for NHS-funded infertility treatment varies in each local ICB, and each ICB has different policies that are based on the clinical needs of each locality (area) (GOV.UK Department of Health & Social Care, 1 February 2024).
While NHS funding can cover the costs of IVF or ICSI, eligibility for infertility treatment (including age limits) and the number of cycles that the NHS will fund varies across the UK.
While each ICB is expected follow recommended guidance set by the National Institute for Health and Care Excellence (NICE) for infertility treatment on the NHS, this is not always the case, as the guidance is not mandatory (GOV.UK Department of Health & Social Care, 01 February 2024).
Due to financial pressure in recent years, some ICBs are choosing not to follow NICE guidance and offer only 1 cycle of IVF or ICSI (rather than the NICE stated guideline of 3 cycles) or will only offer NHS-funded IVF in exceptional circumstances. People are increasingly paying for their own treatment through private clinics.
The Human Fertilisation Embryology Authority (HFEA) licenses private clinics to practice in the UK but does not regulate how private fertility clinics set the cost of their treatments. Prices vary from clinic to clinic and the final cost will depend on a number of factors.
The HFEA states that
The same treatment could be 2 or even 3 times more expensive depending on which clinic you choose. We strongly recommend you shop around before committing to a clinic and consider a wide range of factors when making your final decision.
(HFEA, 2025)
Experiences with funding and costs for infertility treatment
Fiona and her husband felt that, while they could have saved up money for expensive treatment, they decided that, given the odds of treatment being successful for them, they would not do so.
They said they thought ‘we were quite sensible about thinking, well, we are not going to spend thousands and thousands of pounds on something that is actually pretty horrible to go through’.
Liz and her husband couldn’t afford private treatment, and one clinic refused to treat her because she was over-weight. They had a long battle with their local ICB (at the time called a Primary Care Trust) to get ICSI treatment (Intra-cytoplasmic sperm injection).
Liz was refused treatment in one clinic because she was overweight. She and her husband had to battle to get accepted at another clinic.
Liz was refused treatment in one clinic because she was overweight. She and her husband had to battle to get accepted at another clinic.
Age at interview: 46
Sex: Female
Age at diagnosis: 29
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Did anyone mention your weight to you before?
The initial referring consultant said, he didn’t say to me that, he just said to me, “As you are a bit over weight it is a little bit less likely that any treatment we will do, will be successful. But it wouldn’t stop you having any treatment.” You see. And it did.
So and I knew I must have been, I have been overweight all my life, so I knew that it wasn’t anything, it wasn't a new story, I knew that if they asked me to lose weight. I knew it was going to be a long time before I would be able to, you know, I had lost weight once before and it took over a year to do that. So therefore, again it was all about delays and all about can’t start it. And I think the fact that I couldn’t. If they had said to me, “We are not going to let you do it now, but we will let you do it in two months.” That would have been all right. But what they said was, “No. We won’t accept you.” And at that point I thought that was the only route to get to it.
So I thought that was the only route but it wasn’t the only route but at the time the door was just being slammed in my face and that was terrible. Because I then thought I had a year to lose weight, you know, and all this time was creeping on. I am getting on for 30 odd and you do feel that clock is really ticking. We are back to numbers again but that is true, the clock felt that it was really ticking.
And so you then went to see another clinic?
Yes.
And had IVF? Open cycle with them. Which resulted in…
Which resulted, one was it was sort of two really because one was a no starter because of no eggs. And the second one that didn’t fertilise. So that was sort of like two goes, but one was a non starter and the second one was… and then because it was a fairly local clinic, I thought, at that point, when it failed, I thought I wasn’t getting the right treatment. So you are looking elsewhere then. For the best treatment. You want the best, you want the best, you know. And then it was the process by which we could get the best because we didn’t have any money. So they would, you know, they paid bet sort of thing, you know. That is why we went to the third place really.
Did it feel like a real struggle?
Absolutely. Agony. It was awful. He was ringing at work all the time. He was ringing daily and this was like, this was a bit of a vendetta mission-type thing, you know. It was the fact that we were entitled to it, we were entitled to another go of IVF definitely because the first one of the two, at the local clinic didn’t count. So we had that agreed. And we were thinking of strategies all the time. You know, thinking what can we say to them. And what we actually said in the end was, what he said to them was, “Look if,” you know, at the point they were thinking of funding more than two and all this. “Is it not in your interest to give us the more expensive treatment in a good place and we won’t come back to you for another IVF. Because if we have another IVF it is probably going to fail.” That is where we were at. They were thinking of all these ideas trying to… but he was, it was a, we go like power from nowhere in our minds. We were just on it all the time. Because we felt like it was a right. And it was a right that we should be allowed to have the opportunity to try and be parents, you know. It really was. You felt a bit political about it. And I am not really political at all really either. But you did feel that that was an inherent human right, to be allowed to do what is the right treatment for you. Because they said to us, “There is every likelihood of these place where the two failed. Your likelihood is ICSI is your best bet. We don’t do it.” You know, so where do we get it done and they agreed that probably we needed more specialist treatment then they were able to give. So therefore everything pointed to this place, but to get to it was agony because it was not really within the catchment area, it wasn’t within their defined tertiary referral. There was all that about it, and then they had to have a special board to talk about us. And that in itself, you didn’t need it, we didn’t need it. All we wanted them to say was, yes that is fine. But we had to give evidence, we didn’t go and give it, we had to write a letter to say why we wanted it, and why we thought ICSI was the best and ever such hard work, ever such hard work.
So it was agony of months and months and months of agony. Trying to get, and again the months of waiting were waiting and time was ticking again.
Some couples tried to maximise their chances of success by having treatment both on the NHS and privately. However, this approach does not always work.
Some people who applied for NHS-funded infertility treatment had their application denied because they had already had treatment with private fertility clinics.
Marine had a good experience when she attended both NHS and private clinics in London, but elsewhere in the country, people struggled to obtain NHS treatment if they had already funded treatment themselves.
James thought that he and his partner would try private treatment during the 6 months they had to wait to qualify for NHS treatment. They were delighted to be successful with their treatment, and it was only afterwards that it 'dawned on us’ that they could have been denied NHS funded treatment if private treatment was unsuccessful (see Fertility Network UK).
Martin and his wife had funded some of their initial treatment themselves which then rendered them ineligible for NHS funding after their PCT changed their rules.
Martin and his wife had funded some of their initial treatment themselves which then rendered them ineligible for NHS funding after their PCT changed their rules.
Age at interview: 41
Sex: Male
Age at diagnosis: 35
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So again back up on the horse really and we just wanted to get on with it. We were desperate, absolutely desperate to have our family, so we got back up on the horse, and [wife] went to the doctor and the doctor said yes, you comply with all the guidelines laid down by NICE for NHS funding, but when he actually went to put us forward they realised that our local PCT had introduced some additional guidelines that rendered us ineligible.
The one that really I think got was the fact that we had privately funded treatment historically, retrospectively they had brought a guideline in and they penalised people for something they’d done retrospectively. I just can’t understand how you can exclude somebody for something because of something they did before you set the rules, before you laid those rules down. And it turned out if we had spent the money on gambling or a holiday or a car or something, if we’d been frivolous with the money and said, “Okay the NHS will help us when we’re ready” they’d have funded us. But because we had tried to take to take the burden off the NHS by funding ourselves they then penalised us for it. And I think, today struggle with that, how they can see that’s fair?
In some clinics it is possible to get assistance with the costs of private treatment by taking part in an egg-sharing scheme. Egg-sharing allows people to donate some of their collected eggs to another person or couple going through IVF to save on costs.
We spoke to one couple who tried taking part in an egg-sharing scheme and they unfortunately had a negative experience.
Phil and his wife decided to try an egg sharing scheme to help with the costs of treatment. They found it a stressful experience and eventually withdrew.
Phil and his wife decided to try an egg sharing scheme to help with the costs of treatment. They found it a stressful experience and eventually withdrew.
Age at interview: 34
Sex: Male
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While it all happened, it did cause a hell of a lot of stress. More so on Karen’s part because I saw it as a money saving exercise rather than her well being, but she was happy to do that at the time as well. But as we got into it we felt we were… lied to, the truth wasn’t told, Karen they had said she would be on the drugs for four weeks. She landed up with about six or seven weeks on the drugs. The lady, oh we’ve got a lady, then it sounded like they didn’t have a lady. There was conflicting information coming every time. And obviously, you know, they say one thing and your mind just goes off at a tangent. Thinking well is it true? Are they saying what they say they’re saying? They’re a private business. They are in it for the money. Get you in. Get you out. Next in.
And, the sum total of it was it caused a hell of a lot of stress. The egg was put back. But while the egg was put back, it wasn’t inserted – well it was inserted but the egg appeared to be sitting outside of the syringe so they had to have another go. So whether that was part of it, or because of the stress that was going on and her body not coping, it was a failure in the end. So she didn’t have a positive pregnancy.
At the time, after all of this had kicked off, and we are absolutely sorry to the people who we let down in the end, because of it. Because obviously they’d been waiting a long time to get eggs from, healthy eggs from somebody and we eventually withdrew consent.
So it was awful on both sides. But because of the stress that it had caused, Karen was not happy. I wasn’t happy as the time went on. I was all for it in the beginning. There was, you know, we’d agreed to help somebody else, and as reality started setting it, it’s then when it actually struck us.
So, the whole experience was awful. Plus the amount of time Karen was on the drugs. She got very bad tempered with me. Everything was my problem, not her own, and that was just the hormones and everything kicking in. So I tried to take some of it on, but at the same time it did cause us to fight with each other, and any way, as time went on.
So we stopped. We had to wait for her to come off the drugs, get it through her system, and then we thought right forget it, we are going to go somewhere else.
Saskia and her partner were looking for a clinic to give them treatment with a sperm donor. Saskia's GP advised her that, although some trusts funded treatment for lesbian couples on the NHS, at the time, her local one didn’t.
Of note, since these interviews were collected, NICE guidance states that same-sex couples should be offered fertility treatment on the NHS (NICE CG156, 06 February 2017).
Saskia and her partner went privately as their local Trust would not fund treatment for lesbian couples. They were pleased to find that their local clinic had good success rates.
Saskia and her partner went privately as their local Trust would not fund treatment for lesbian couples. They were pleased to find that their local clinic had good success rates.
Age at interview: 38
Sex: Female
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And once you, firstly how did you find the clinic. How did you decide where to go?
Oh I’m trying to think. I think we, I sent for a few brochures from different clinics and looked on line and somebody had some good things about [hospital]. Well I think it had good statistics. I think I’d look at live birth rate, I mean something very raw. I thought that’s great, and it’s our nearest. And was kind of so delighted that our nearest one seemed good, I just sort of plumped for it. I didn’t do a lot of proper research.
I think, had the first consultation not gone well I think I would have thought hang on, I’m going to shop around a bit. But at that point I didn’t know anyone else who’d done it, so the internet was the only sort of source. And I think I’d read a couple of positive things about it.
So would you have been able to get NHS treatment, IVF treatment? As a lesbian couple, did you investigate that?
I asked the consultant, and he said that there were some [PCT’s] at that time, I think Islington or Harringay, something like that, he said did give lesbians IVF treatment, but our one didn’t. And I’d assumed they wouldn’t so that wasn’t, that wasn’t a surprise. So..
So you knew that you were signing up for private treatment if you decided to do this?
Yes, I was hoping I could get anything corrective done on the NHS. That was my original thought. That if there was something wrong I’d get that corrected. But then if it came to IVF I’d have, or IUI I’d have to pay for it. And you know, I was happy, happy to do that.
Yes.
Because you know I’d rather go without a holiday and pay for… you know, it was a priority, it wasn’t something I felt entitled to. Or… anything.
We also spoke to some couples who had been able to afford to pay for all of their treatment privately, although it was often not easy to find the money.
Lulu was grateful that her mother lent her and her partner money to pay for treatment, but she also said it felt like 'quite a pressure'.
Although Tim felt he had 'numbed' himself to the negative results from treatment, he said that
The worst thing is, we spent so much with nothing to show for it. So when it does actually come out as a negative, it is almost to say, 'well I am already expecting it'. Again, whether I intentionally suppress the feelings or whether it is just that I am numb to it now, I don’t know. But, as I say, the worst thing for me really is that we have spent this much money and again we have got nothing to show for it.
Some couples were often acutely conscious that the ability to start treatment now rather than wait for NHS referral could 'make all the difference'.
The high costs involved with fertility treatment raises the stakes; for example, some were happy to forgo holidays and new cars to maximise their chance of having a baby. Most people we spoke with felt that it was impossible to equate any monetary value to the possibility of having a baby.
Choosing a fertility clinic
The HFEA recommends that people take into account location, appearance, success rates, and embryo transfer policy when choosing a clinic.
Success rates were certainly an important factor to take into account when deciding where to have treatment. Many of the couples we talked to had done a lot of research online before they chose a clinic (see ‘Information and support’).
Janine explained that they 'looked at league tables and statistics' but were 'dubious about some of the fairly unsophisticated results' and decided to go to their local centre for treatment.
Some people travel abroad for fertility treatment (see ‘Travelling abroad for treatment’). Naomi and Martin used the internet to find out about clinics in Spain and to read about the experiences of others who had been treated there.
Experiences choosing a fertility clinic
The people we spoke to also stressed the importance of the ‘feel’ of the clinic and of their relationship with the clinicians. Frances followed her gynaecologist’s recommendation to see a specialist with 'very good results and is absolutely super, and this is the person you want to see', and so, 'without a second thought, without a second opinion, without anything, I toddled off and that is what I did'.
Karen and her husband had a bad experience at one clinic where they did not feel they were given enough information; at the next clinic, Karen prioritised the clinic's success rates and how open the clinicians were to her questions.
Janine and her husband chose a clinic that did not have the best results, but that they didn’t have to travel far to attend. They 'decided that (it) might not be the best, but its good enough and it’ll keep our stress levels down'.
Others, like Martha, did not have the option of a local clinic because of her address. There wasn’t a fertility clinic nearby and she had a long journey to get to one.
After a bad experience at one private clinic, Karen chose to go privately at a NHS clinic which had a very good success rate and an open approach to information and answered all her questions.
After a bad experience at one private clinic, Karen chose to go privately at a NHS clinic which had a very good success rate and an open approach to information and answered all her questions.
Age at interview: 34
Sex: Female
Age at diagnosis: 32
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We went to have a look at another place and it was an NHS, but you could go in as a private patient. So we looked at that on the internet and they had a very good reputation, a very good success rate, so we thought fair enough, yes, we’ll go and have a look at this place. And I said, “If I go for the initial evening and I don’t like it, I’m not coming back.” I said, “Do you understand? We will look for somewhere else, until, you know, we’re happy.”
But the initial, even the initial consultation, was great, answered so many more questions. I could sit there and think, now that’s why they did that, or that’s why they did that. They answered the questions from before that I’d never got answers to. Made me feel completely at ease. Told me we could ask as many questions as we want. We could ring and ask questions if we were feeling unsure at home. The counsellor was on standby most of the time. But if you rung and said before you came there, they’d make sure someone was available to speak to you. You know, or if you said on the day that you were struggling, you might have to wait, but somebody would eventually come and speak to you and sort things out for you. And it was just, and they explained all the drugs to me on that night, “This is what you’ll be taking.” And, “This is why you are going to take this. And then we’ll give you this and this is why. And this is what this is going to help you do. This is going to help relax you on the day when you come in to have your egg collection. And they explained absolutely everything. And it was a much, from the outset it was a much nicer experience.
The overall 'feel' of the clinic was key for several of the people we talked to. Lulu had visited 'a very famous clinic but felt it was too impersonal'. She chose one closer to home that was smaller but that was 'much more friendly'.
Naomi also rejected clinics that she said 'felt like a production line' and went for one that seemed friendlier.
For Bev, her personal relationship with the consultant was very important. She told us that
It’s important to have a good relationship with your consultant. For them to be able to understand where you’re coming from, what your anxieties are, what your concerns are. And for you to be able to communicate how you feel with your consultant.
Lulu described how the caring atmosphere of the clinic made a big difference. It felt right for her.
Lulu described how the caring atmosphere of the clinic made a big difference. It felt right for her.
Age at interview: 40
Sex: Female
Age at diagnosis: 31
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I think people you know they cared, and I think that is very important. You are not part… that was actually why I chose that clinic, because it was a smaller clinic. It was very small, five members of staff I think. So you knew everybody and whereas I had the opportunity to go to a much bigger one and I just felt, although they had fantastic success rates, you were just a number in a machine and I actually have heard that from a couple of people who have been there. Great, but you are just a part of the… you know, a lot of numbers and for me that is not all right for me.
Naomi chose her clinic on the basis of their success rates, professionalism and personal touch.
Naomi chose her clinic on the basis of their success rates, professionalism and personal touch.
Age at interview: 35
Sex: Female
Age at diagnosis: 30
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We had three local ones. One did very, very small number of treatments every year. Their success percentage wasn’t too bad. But it was just sort of they only did egg collections on a Tuesday or a Wednesday and it was, you know, we didn’t feel that we could really rely on them I suppose. One was a London clinic that was, we just felt it was a bit production line when we went there.
And then the one that we ended up going to, it was just so friendly. It was, seemed very professional but still hadn’t lost the personal touch. The nurses were lovely. And the doctors were really nice. And it was very local to us as well, you know, it was only about half hour, forty minute drive or something like that.
So we made the decision on the clinic in the July and then we started up our cycle in October 2004.
See also 'Attending a fertility clinic'.
Last reviewed: May 2025.
Last updated: May 2025.
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