As reported by the National Health Executive, national fertility guidance has been overhauled to include specific recommendations for people living with endometriosis who are trying to conceive, in a move aimed at making care more personalised and responsive to individual needs
The changes form part of an updated guideline from the National Institute for Health and Care Excellence, published to mark the conclusion of Endometriosis Action Month. The update follows extensive input from patients, clinicians, charities and professional organisations.
Feedback from the consultation process raised concerns that commonly used labels such as “mild” and “severe” endometriosis fail to capture the complexity of the condition and its varied effects on fertility. In response, the committee has removed these terms from the guidance, citing risks of confusion, misdiagnosis and delays in accessing appropriate treatment.
The revised recommendations place greater emphasis on shared decision-making between clinicians and patients. Healthcare professionals are now expected to explore a full range of options with those affected, taking into account factors such as how long someone has been trying to conceive, their age, symptoms, ovarian reserve and any male fertility considerations.
A clearer care pathway has also been set out. In suitable cases, patients may first be advised to continue trying to conceive naturally under expectant management. If necessary, surgical treatment for endometriosis should be considered in line with existing NICE guidance. Where these approaches are not appropriate or unsuccessful after two years, clinicians are advised to offer assisted fertility treatments, including intrauterine insemination (IUI) and in vitro fertilisation (IVF).
The updated guidance is intended to provide more consistent, evidence-based support, ensuring that people with endometriosis receive fertility care that reflects their individual circumstances rather than a one-size-fits-all approach.
