text: Availability of IVF in England is determined by Clinical Commissioning Groups (CCGs). The National Institute for Health and Care Excellence (NICE) recommends up to 3 cycles of treatment for people under 40 years old with minimal success conceiving after 2 years of unprotected sex. Cycles will not be continued for people who are older than 40 years. CCGs in Essex, Bedfordshire and Somerset have reduced funding to one cycle, or none, and it is expected that reductions will become more widespread. Funding may be available in "exceptional circumstances" – for example if a male partner has a transmittable infection or one partner is affected by cancer treatment.  According to the campaign group Fertility Fairness "at the end of 2014 every CCG in England was funding at least one cycle of IVF".  Prices paid by the NHS in England varied between under £3,000 to more than £6,000 in 2014/5. In February 2013, the cost of implementing the NICE guidelines for IVF along with other treatments for infertility was projected to be £236,000 per year per 100,000 members of the population.
  IVF increasingly appears on NHS treatments blacklists.  In August 2017 five of the 208 CCGs had stopped funding IVF completely and others were considering doing so.  By October 2017 only 25 CCGs were delivering the three recommended NHS IVF cycles to eligible people under 40.  Policies could fall foul of discrimination laws if they treat same sex couples differently from heterosexual ones.  In July 2019 Jackie Doyle-Price said that women were registering with surgeries further away from their own home in order to get around CCG rationing policies.
  The Human Fertilisation and Embryology Authority said in September 2018 that parents who are limited to one cycle of IVF, or have to fund it themselves, are more likely choose to implant multiple embryos in the hope it increases the chances of pregnancy.  This significantly increases the chance of multiple births and the associated poor outcomes, which would increase NHS costs.  The president of the Royal College of Obstetricians and Gynaecologists said that funding 3 cycles was  "the most important factor in maintaining low rates of multiple pregnancies and reduce(s) associated complications".