Rethinking Fertility Access
March 2026
Researchers from four UK universities, alongside a sperm donor action research group, are calling for equal access to fertility treatment for people who are classed as socially infertile, including same-sex couples and people without a partner.
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This follows NICE updating its guideline for diagnosing and treating fertility problems on Tuesday 31 March 2026.
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The NICE guideline focuses on people with health-related fertility problems – people with a clinical cause of infertility or who are unable to achieve pregnancy after 12 months or more of regular, unprotected penile-vaginal intercourse or after six cycles of artificial insemination.
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Socially infertile people often have to pay for up to 12 cycles of donor insemination themselves before being able to access NHS treatment. This creates another financial barrier on top of the existing postcode lottery in the UK, which sees the amount of state-funded fertility treatment cycles varying across nations, and for England, across regions, depending on local policy.
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As part of the Online Sperm Donation Project, Dr Turner-Moore, and his team, have carried out research with recipients and their partners, donors and platform owners who are involved in online sperm donation. The final phase of the project entails action research, where people with lived experience review the findings from the project to date, and informed by this, imagine an ideal future for online sperm donation. They then work with researchers from the team to take an action towards this ideal future.
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The donor research action group have produced a report that makes a case for changes to regulated donor insemination. This centres around addressing inequitable access for people experiencing social infertility and the high costs associated with clinical donor insemination. They believe that people should have the choice over whether to take the clinical route or informal, online route, to conceiving a child. But they argue that inequities in access to the clinical route mean that many do not currently have this choice. As one donor in the research action group explains, the costs associated with fertility treatment in clinics “reinforced for me why many intended parents look for alternative routes, and why accessibility matters”.
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–The report’s five recommendations are:
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1. Coordinated reform of NHS funding arrangements, including national standardisation of eligibility criteria to remove postcode-based disparities and removal of non‑clinical access restrictions, such as those affecting same-sex couples and single people.
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2. A feasibility report for a means‑tested Financial Fertility Aid scheme.
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3. A strategic review of investment in NHS-funded fertility treatment, with a view to reversing declining NHS‑funded treatment levels.
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4. Increased transparency in private fertility sector pricing.
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5. Introduction of harm‑reduction measures for online sperm donation.
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The Online Sperm Donation project is led by Dr Rhys Turner-Moore at Leeds Beckett University and funded by the Economic and Social Research Council. It is the largest study ever on online sperm donation. Ten researchers from five organisations are collaborating on the project. Click here to meet the team.
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You can read the report and download it at the top of the page.