New NICE Guidelines: Dedicated Fertility Pathways for Endometriosis Patients

The National Institute for Health and Care Excellence (NICE) has introduced a dedicated fertility treatment pathway specifically for individuals with endometriosis. This update to the fertility guidelines, published on March 31, 2026, establishes a tailored approach to care for those struggling to conceive due to the condition, separating them from other causes of infertility.

Endometriosis occurs when tissue similar to the lining of the womb grows in other parts of the body. In the United Kingdom, the condition affects approximately 1.5 million people and is recognized as one of the primary causes of fertility problems.

Addressing Barriers to Care

The creation of a distinct pathway follows a public consultation process involving clinicians, professional bodies, and patient groups. A key driver for the change was feedback from organizations such as Endometriosis UK, which noted that patients with this diagnosed condition were previously grouped with those experiencing unexplained infertility.

NICE’s independent committee determined that grouping endometriosis with unexplained infertility was inappropriate. The new guidance aims to eliminate additional barriers for patients once they have received a diagnosis, aligning with the theme of Endometriosis Action Month: Endometriosis doesn’t wait.

Clinical Changes and Recommendations

The updated guidelines introduce several specific changes to how clinicians manage fertility for patients with endometriosis:

• The removal of the terms mild and severe to describe endometriosis, as the committee agreed these terms were clinically ambiguous and failed to reflect the complexity of the condition or its actual impact on fertility.
• The requirement for clinicians to discuss a broad range of fertility support options, which may include natural conception, surgery, and in vitro fertilization (IVF).
• A focus on individualized care factors when determining the best course of action for patients trying to conceive.

According to the guidance, the specific factors clinicians should consider include the patient’s age, their ovarian reserve, the severity of their symptoms, how long they have been attempting to conceive, and any relevant male fertility factors.

Broader Fertility Guideline Updates

While the dedicated endometriosis section is a primary addition, the overall fertility guideline contains updates applicable to all patients. These updates include instructions for fertility clinics to stop offering add on treatments that are considered unproven.

The new framework is intended to provide consistency and clarity in a system where patients have historically faced confusion when attempting to access necessary fertility treatments.

Although the guideline provides a clear pathway for care following a diagnosis, NICE noted that the updated guidance cannot address the existing delays in the initial diagnosis of endometriosis.