Gynaecology and Fertility

Not routinely commissioned procedures

Policy	Last Updated Date	Review Date
Dilation and Curettage (D&C)	Nov 2019	Mar 2022
Reversal of female sterilisation
Surrogacy	June 2019	May 2022

Procedures commissioned with restrictions

Policy

Last Updated Date

Review Date

Prior Approval Required

Primary Care Referral Template

Gamete Storage

Last updated date

Nov 2019

Review date

Oct 2022

Prior Approval Required

Not Applicable

Hysterectomy for Menorrhagia

Last updated date

Nov 2019

Review date

Feb 2021

Prior Approval Required

Both Primary and Secondary Care

Prior Approval Form

IVF and ICSI

Last updated date

Feb 2020

Review date

Sept 2022

Prior Approval Required

Not Applicable

Intra-uterine Contraceptive Device and Mirena Coils

Last updated date

Oct 2019

Review date

Mar 2021

Prior Approval Required

Secondary Care

Intrauterine Insemination

Last updated date

Feb 2020

Review date

June 2022

Prior Approval Required

Not Applicable

Vaginal Pessaries Position Statement

Last updated date

Mar 2020

Review date

Feb 2023

Prior Approval Required

Not Applicable

Derbyshire Medicines Management
and Clinical Policies

Gynaecology and Fertility

Not routinely commissioned procedures

Procedures commissioned with restrictions

Policy

Last Updated Date

Review Date

Prior Approval Required

Primary Care Referral Template

Gamete Storage

Last updated date

Review date

Prior Approval Required

Hysterectomy for Menorrhagia

Last updated date

Review date

Prior Approval Required

Prior Approval Form

IVF and ICSI

Last updated date

Review date

Prior Approval Required

Intra-uterine Contraceptive Device and Mirena Coils

Last updated date

Review date

Prior Approval Required

Intrauterine Insemination

Last updated date

Review date

Prior Approval Required

Vaginal Pessaries Position Statement

Last updated date

Review date

Prior Approval Required

Derby and Derbyshire CCG