Infertility affects “the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse” (World Health Organisation, WHO) and if “the woman has not conceived after 1 year of intercourse or after 6 cycles of artificial insemination” (National Institute for Health and Care Excellence, NICE). This service specification relates to the specialist fertility service tier (level 3) of the service only. It is expected that Service Users will have already completed the medical (for example, the use of drugs for ovulation induction) and surgical management (for example, laparoscopy for ablation of endometriosis) prior to referral to this service The NICE clinical guidance on Fertility was updated in September 2017. The new guidelines confirm the provision of specialist fertility treatments to certain sections of the population for whom it was not previously available. This service specification needs to be read in conjunction with the respective Fertility Commissioning Policies for each Clinical Commissioning Group (CCG) party to this contract. The Commissioning Policy defines the Commissioners eligibility criteria and Service Users should not be treated outside these without seeking Prior Approval from the relevant CCG.