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Introduction 

We (NHS South Yorkshire Integrated Care Board (ICB)) are seeking views from citizens of South Yorkshire, South Yorkshire health care professionals and other local interested parties on proposals to review our current policy in relation to commissioning In Vitro Fertilisation (IVF) services. 

To capture your views and feedback before any decision is made, a period of public engagement will run for 12 weeks from 28 July until 17 October. 

If you would like this document in another format, please contact us. 

About this engagement document 

This document provides information about the services we currently commission and explains the reason why we are considering changing our policy on commissioning IVF services. 

At the end of the document you will find a link to a survey which aims to capture your views and feedback. 

The survey also offers you the opportunity to share any significant information you think we should know before making a decision. 

About us 

We, NHS South Yorkshire ICB, commission (buy) health services for patients in South Yorkshire, making decisions about local services. 

We have a budget to plan and purchase a range of health services including those provided in hospitals and in the community, including GP services. 

Our ICB Board oversees our work and sets our priorities and direction.  

We have four core purposes, they are: 

  • Improve outcomes in population health and health care 

  • Tackle inequalities in outcomes, experience and access 

  • Enhance productivity and value for money 

  • Help the NHS to support broader social and economic development 

Priorities 

The NHS has been asked to prioritise access to care, such as GP appointments in primary care, elective treatment in hospitals and to improve waiting times for urgent and emergency care, such as the length of time waiting in an accident and emergency department. 

Over the last few years our communities have told us that they want the NHS to prioritise access, agency and awareness. This is access to the types of care mentioned above, choice over their care, and the information to support people to make decisions about their care and that of their families. 

The NHS in South Yorkshire has a duty to live within our financial allocation and to break even (balance the books) each year. In addition, we have a duty to secure the best investment for the funds that we have been allocated to provide high quality care for local people. 

Within this context, we are now reviewing some of our services and policies because we need to focus our resources on the services that matter to our communities the most. 

We have explored all areas of our commissioning in relation to our organisational priorities, the priorities of our citizens, cost effectiveness, clinical outcomes and essential services. 

One of the areas we have identified for review is the current arrangements for the provision of IVF services in South Yorkshire. 

What is IVF? 

IVF is one of several techniques available to try to help people with fertility problems have a baby. 

During IVF, an egg is removed from the woman’s ovaries and fertilised with sperm in a laboratory. The fertilised egg, called an embryo, is then returned to the woman’s womb to grow and develop. It can be carried out using your eggs and your partner’s sperm, or eggs and sperm from donors. 

What is a cycle of IVF? 

One cycle of IVF comprises an episode of stimulation of ovarian function which hopefully results in one to several eggs being harvested. After eggs are harvested, the best ones are fertilised and the most viable embryo is then implanted in the womb. Any other fertilised eggs that are viable are frozen. 

A cycle completes either with the birth of a baby or when all the viable embryos have been implanted, generally one at a time. 

How many people in South Yorkshire access IVF services? 

Around 650 people access IVF services, of which around 135 people access a second cycle of IVF treatment.  

What is the national guidance on IVF? 

The National Institute for Health and Care Excellence (NICE (an organisation which provides national guidance (https://www.nice.org.uk/guidance/cg156/ifp/chapter/in-vitro-fertilisation) and advice to improve health and social care) fertility guidelines make recommendations about who should have access to IVF treatment on the NHS in England and Wales. 

However, the final decision about who can have NHS funded IVF in England is made by ICBs - local NHS organisations like us, whose criteria may be stricter than those recommended by NICE. NICE recommends that women aged under 40 who have been unable to conceive after two years of regular unprotected intercourse (or 12 cycles of artificial insemination (IUI), in which semen is introduced into the woman’s vagina), should be offered three full cycles of IVF. 

These IVF cycles can be either with or without intra-cytoplasmic sperm injection (ICSI), a technique in which a single sperm is injected into the egg. If the woman reaches the age of 40 during treatment, the current full cycle should be completed, but no further cycles offered. 

Women aged 40-42 years who have been unable to conceive after two years of regular unprotected intercourse (or 12 cycles of artificial insemination) should now be offered one full cycle of IVF, with or without ICSI. However, NICE recommends they must also: 

  • Have never previously had IVF treatment  

  • Show no evidence of low ovarian reserve (this is when eggs in the ovary are impaired or low in number)  

  • Have been informed of the additional implications of IVF and pregnancy at this age  

The majority of ICBs in England offer one funded cycle. 

What do we currently provide? 

In 2022, quite soon after the NHS South Yorkshire ICB came into being, we undertook work to align the policies in South Yorkshire, which had previously been different as they had been set by four separate NHS organisations – NHS Barnsley Clinical Commissioning Group (CCG), NHS Doncaster CCG, NHS Rotherham CCG and NHS Sheffield CCG. At the time our governing body took the decision that the fairest course of action was to align with the area in South Yorkshire that offered the highest number of cycles – which was two cycles. 

How successful is IVF? 

The success rate of IVF depends on many factors including the age of the woman undergoing treatment, as well as the cause of the infertility (if it is known). 

Younger women undergoing IVF treatment are more likely to have a successful pregnancy. 

IVF isn’t usually recommended for women over the age of 42 because the chances of a successful pregnancy are thought to be too low. 

2023* data from the Human Fertilisation and Embryo Authority (HEFA), suggests the percentage of IVF treatments that resulted in a live birth were as follows: 

  • 29% for women under 35 

  • 23% for women aged 35 to 37 

  • 15% for women aged 38 to 39 

  • 9% for women aged 40 to 42 

  • 3% for women aged 43 to 44 

  • 2% for women aged over 44 

(*preliminary HFEA data to be validated) 

On average the percentage of people that progress to a second cycle of IVF treatment is 26%.  

How much does IVF cost? 

The total cost of people accessing IVF treatment in of south Yorkshire in 2024/25 was £1.97 million. This includes different procedures that are part of a cycle of IVF treatment. The cost of each funded cycle varies based on the specific nature of the intervention and person being treated. The total cost includes first and second cycles undertaken by people accessing the service. 

How much money could be saved by reducing the provision of IVF? 

Using the activity and data available in South Yorkshire, savings could range from: 

  • One year estimated savings if we reduced to one cycle £280,000 

  • Five year estimated savings if we reduced to one cycle £1.4million 

What are we proposing? 

As part of our review of all commissioned services in South Yorkshire, we are faced with difficult decisions, including considering whether IVF services should continue to be funded as they currently are. 

Maintaining the current level of provision of IVF would mean that we would need to consider our investments in other areas of healthcare in order to ensure we are using our resources efficiently. 

Thinking about the case for change, we would like to hear your views about the options presented below: 

Option 1 

Continue to offer up to two funded cycles of IVF as per the current policy 

Option 2 

A reduction in provision to up to one funded cycle of IVF 

Option 3 

Moving to zero cycles and therefore no longer funding IVF services 

At this stage, we believe that Option 2, which would bring us in line with most other parts of England, would be the best way to ensure value for money whilst maintaining a service that we know is important to people who are affected by it. However, we would like your views on this before we make a final decision, which is why we are running this engagement exercise. 

For any service no longer routinely provided through the NHS, an individual funding request could be put forward by a patient’s clinician if there is evidence of exceptional circumstances. 

Our duty to involve 

We have a legal duty to involve patients and the public in our work in a meaningful way to improve health and care services. This duty is relevant to designing and planning services, decision making and proposals for changes that will impact on individuals or groups and how health services are provided to them. 

Where public involvement is required, we must make the best possible judgement on what is a fair and proportionate approach. As a public body, we are mindful of our responsibility to involve local patients and the public on this proposed change. 

What will happen with your feedback? 

Feedback from the involvement period will help to inform the NHS South Yorkshire Integrated Care Board to make a decision on the future provision of IVF in South Yorkshire at its meeting on 5 November 2025. 

The Board meets in public.  

We will publish the outcome of the engagement period on our website, through social media and via the press and media. 

How to get involved 

You can get involved in the twelve-week involvement in the following ways: