NICE has updated its fertility guidance to include a dedicated pathway for people with endometriosis, marking a significant shift in how the condition is handled in reproductive care across England.
The move, announced on 31 March 2026, comes after consultation feedback from patients, clinicians and professional bodies. NICE said the new section recognises endometriosis as a diagnosed condition that requires a tailored approach, rather than being grouped with unexplained infertility.
A more personalised route into fertility treatment
Under the updated guidance, clinicians are expected to discuss a broader range of options with patients who are trying to conceive, including how long they have been trying, the severity of symptoms, age, ovarian reserve and male fertility factors. Where appropriate, expectant management or surgery may be offered first, while intrauterine insemination or IVF can be discussed if those approaches are not suitable or do not work after two years.
NICE also said terms such as “mild” and “severe” endometriosis have been removed from the final guideline because respondents argued they were clinically ambiguous and did not reflect the condition’s complexity or its impact on fertility. The committee agreed and made the change, saying it wanted to reduce confusion and variation in care.
Patient voices shape the final guidance
Endometriosis UK and other respondents told NICE during consultation that the previous approach failed to reflect the reality faced by many patients. NICE said the final guidance was shaped by that feedback and is designed to give clinicians a clearer, evidence-based framework for conversations about fertility care.
Eric Power, interim director of the Centre for Guidelines at NICE, said the update should help ensure people with endometriosis get the right care at the right time. Lucy Common, nursing adviser at NICE, said nurses often play a central role in helping patients through what can be a deeply emotional process.
The guidance also reflects wider ambitions in the NHS 10 Year Health Plan, which aims to shift care closer to home and support more personalised decision-making. NICE said the changes should help reduce variation in treatment and improve equitable access across England.
Wider changes to fertility care
Alongside the endometriosis pathway, the updated guidance includes other changes confirmed after consultation. These include stopping fertility clinics from offering unproven add-on treatments and broadening access to NHS-funded fertility preservation beyond cancer patients.
Public Health Minister Sharon Hodgson described the update as a landmark step toward ending inconsistency in fertility care. Endometriosis UK chief executive Emma Cox said the change was urgently needed, noting that many people still face long delays before diagnosis and often reach fertility services after years of waiting.
For patients, the new pathway is intended to provide a clearer route through the system and a more consistent standard of care. For clinicians, it offers a specific framework for decision-making that better reflects the complexity of endometriosis and its impact on fertility.
Sursa foto: Imagine generată AI
