February 2025: It has become clear during development that the work required to deliver the entire scope would result in publication being delayed by a number of years. NICE is keen to ensure timely delivery of the most important parts of the original scope. To achieve this, we plan to divide the work into a series of updates. See the update information statement for further details. 

 
 

Update information statement

It has become clear during development that the work required to deliver the entire scope would result in publication being delayed by a number of years. NICE is keen to ensure timely delivery of the most important parts of the original scope.

To achieve this, we plan to divide the work into a series of updates.

Update 1

See the guideline update 1 and 2 in development page for more information on this update.

See table 1 for details of questions covered by these categories.

Update 2

This will focus on male factor fertility, an important area identified by our stakeholders. The review questions for update 2 are outlined in Table 2.

Potential future updates

We have identified other potential future updates as part of the original scope, the details of which are outlined in table 3. We will take a decision on these topics following publication of update 1 and 2.

Table 1: Questions covered by update 1 

Question no.

Review question

3.1.1

What is the predictive performance of clinical prediction models for assessing the chances of pregnancy or live birth for people with health-related fertility problems using: expectant management, intrauterine insemination (IUI), or IVF with or without intracytoplasmic sperm injection (ICSI)?

3.2.1/3.3.1

What is the clinical and cost effectiveness of ovarian stimulation, intrauterine insemination (IUI) with or without ovarian stimulation, IVF with or without intracytoplasmic sperm injection (ICSI) and expectant management for people with unexplained health-related fertility problems, mild endometriosis, and people with a single abnormal semen parameter?

2.2.3a

What is the clinical and cost effectiveness of tubal surgery (as a standalone treatment) compared to expectant management or in vitro fertilisation (IVF) for fertility problems associated with tubal disease?

2.2.3b

What is the clinical and cost effectiveness of surgery for hydrosalpinges prior to assisted reproductive technology (ART), relative to standard ART without prior surgical optimisation, for people with tubal disease?

2.2.3c

What is the likelihood of spontaneous conception associated with selective salpingography with tubal catheterisation or hysteroscopic tubal cannulation, for the evaluation and treatment of proximal tubal obstruction?

3.4.1

What is the effectiveness of intracytoplasmic sperm injection (ICSI) versus standard in vitro fertilisation (IVF) in non-male factor fertility problems?

4.1.1

What is the effectiveness and safety of fertility preservation for children and adults undergoing treatment for cancer and other conditions or situations which are likely to impair their fertility?

3.5.1

What is the clinical and cost effectiveness of advanced sperm selection techniques as a treatment add-on for people undergoing fertility treatment?

3.5.2a

What is the clinical and cost effectiveness of pre-implantation genetic testing for aneuploidy (PGT-A) as a treatment add-on for people undergoing fertility treatment?

3.5.2b

What is the clinical and cost effectiveness of embryo selection guided by continuous time-lapse sequence as a treatment add-on for people undergoing fertility treatment?

3.5.3

What is the clinical and cost effectiveness of endometrial scratching as a treatment add-on for people undergoing fertility treatment?

3.5.5

What is the clinical and cost effectiveness of immune therapies as a treatment add-on for people undergoing fertility treatment?

2.1.4

What is the clinical and cost effectiveness of tests for endometrial receptivity (including gene expression analysis and microbiological analysis) as a treatment add-on for people undergoing fertility treatment?

2.1.1

What is the association between markers of ovarian reserve and: the likelihood of spontaneous conception, the response to fertility treatment, and the outcome of fertility treatment?

2.1.2

What is the clinical and cost effectiveness of treating subclinical hypothyroidism for female factor fertility problems?

2.1.3

What is the effectiveness of hysteroscopy in improving outcomes for women with fertility problems?

2.2.1b

What is the clinical and cost effectiveness of ovulation induction strategies in people with hypogonadotrophic hypogonadism?

2.2.2

What is the clinical and cost effectiveness of cabergoline for fertility problems associated with hyperprolactinaemic amenorrhoea or oligomenorrhea?

Table 2: Questions covered by update 2 (male factor fertility)

Question no.

Review question

1.1.1a

What is the clinical and cost effectiveness of treating DNA fragmentation (identified from screening ejaculated sperm) on reproductive outcomes for people with male factor fertility problems?

1.1.1b

What is the association between Y chromosome microdeletions (positive AZF a, b, and c) and successful sperm retrieval in people with non-obstructive azoospermia?

1.2.1

What is the effectiveness of hormone treatment in male factor fertility problems?

1.2.2

What is the clinical and cost effectiveness of treatments for ejaculatory failure?

1.2.3

What is the clinical and cost effectiveness of surgical interventions for fertility problems associated with obstructive azoospermia?

1.2.4

What is the effectiveness of treatments for fertility problems associated with varicocele (including radiological embolisation and surgery)?

1.3.1

What is the clinical and cost effectiveness of surgical sperm retrieval (SSR) techniques for fertility problems associated with non-obstructive azoospermia, or obstructive azoospermia?

Table 3: Potential future updates

Question no.

Review question

2.2.1a

What is the clinical and cost effectiveness of ovulation induction strategies in people with polycystic ovary syndrome (PCOS)?

2.2.3d

What is the clinical and cost effectiveness of hysteroscopic septum resection compared to expectant management for people with fertility problems associated with a septate uterus?

3.6.1

What is the effectiveness and safety of different embryo or blastocyst transfer strategies in relation to both: number of embryos, timing of transfer?

3.7.1

What is the effectiveness and safety of different regimens of frozen embryo transfer?

3.8.1

What is the effect of ART on obstetric risk in women undergoing fertility treatment?

3.8.2

What is the long-term safety of in vitro fertilisation (IVF) with or without intracytoplasmic sperm injection (ICSI) in women with fertility problems and their children conceived through ART?