When and how to refer

When and how GPs can refer a patient to the fertility centreIVF might be the answer to fertility problems

This page provides information on the referral criteria for the Shropshire and Mid-Wales Fertility Centre. The information on this page can be downloaded below, please note to save time it is important to have both the couples details at the time of the referral.

Referral Guidelines – Shropshire, Telford & Wrekin (PDF)

Referral Guidelines – Wales (PDF)


Guidelines for fertility assessment

  • Couples should be advised to lead as healthy a lifestyle as possible while trying to conceive (see NICE Guidelines).
  • Recommend Rubella Antibody Screening plus Folic acid 0.4mg daily while trying to conceive and through first 12 weeks of pregnancy.
  • If there is no pregnancy after 1 year of regular, unprotected intercourse, check luteal phase progesterone level (7 days before next expected period) and request a sperm function test.

Suggested referral criteria to the fertility clinic

All couples should have been co-habiting in a stable relationship for at least 2 years or have a stable marriage if registered with a Shropshire or Telford and Wrekin GP. This criteria is not specified for Welsh patients, however as with all patients, the welfare of the child will be reviewed by the Fertility Centre and treatment may not go ahead if the couple is not co-habiting. The woman must be <35 years of age (Shropshire) or <36 years of age (Telford and Wrekin, Wales)

Please refer your patient after 2 years of regular unprotected intercourse, if progesterone and sperm function are satisfactory. Refer after 1 year if progesterone or sperm test are abnormal.

Woman ≥35 years of age (Shropshire) or >36 years of age (Telford and Wrekin, Wales)

Please refer after 1 year of regular unprotected intercourse and arrange a day-2 FSH, luteal phase progesterone and sperm function test at the time of referral. Please be aware that the cut off for NHS funding is age 37.5 for Shropshire patients, age 40 for Telford patients, and age 42 for Welsh patients. For other CCGs, please refer to your Assisted Conception Commissioning Policy for further details. Please consider referring any woman or her partner over the age of 35/36 with known pathology sooner.

Earlier referral

Earlier referral would be indicated where there are clinical reasons for suspecting pathology, eg oligo/amenorrhoea, previous pelvic infection/intra-abdominal gynaecological operations, or in the male severe oligozoospermia or azoospermia, genital tract trauma, operations or infection. Patients who have had previous cancer treatment also require an early referral.

Man >55 years of age

Referral not recommended because of potential parenting problems, including possible serious illness or death before the child reaches majority.

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Requesting a referral

If possible some preliminary test could be performed prior to referral, further details can be found on the Blood Tests page. If your patient is suitable for referral please write a letter addressed to the Fertility Centre and send to the address below:

The Fertility Centre
Royal Shrewsbury Hospital
Mytton Oak Road
Shrewsbury
SY3 8XQ