Endometriosis & fertility: What the new NICE guidance means for your workforce

For years, employees with endometriosis have faced a frustrating paradox. They have a diagnosed condition, yet when it came to fertility care, they were grouped alongside those with unexplained infertility. The result? Inconsistent care, unclear pathways and too many people falling through the gaps.

That changes with NICE's updated fertility guideline, which for the first time includes a dedicated pathway specifically for people with endometriosis who are struggling to conceive. It's a landmark moment and one that HR and benefits leaders should pay close attention to.

The scale of the issue

Endometriosis affects around 1.5 million people in the UK. It occurs when tissue similar to the lining of the womb grows in other parts of the body, and it is one of the leading causes of fertility problems.

Despite its prevalence, the average diagnosis time currently stands at 9 years and 4 months - rising to 11 years for those from ethnically diverse communities. By the time many employees reach fertility services, they have already been waiting for over a decade.

The impact on your workforce is significant. Endometriosis doesn't just affect people at home, it affects concentration, attendance, energy and engagement at work. And when employees are navigating fertility challenges on top of a poorly understood condition, the emotional and physical toll is considerable.

What the new NICE guidance means

The updated guideline is a step change in how endometriosis-related fertility care should be delivered. Key changes include:

• A dedicated fertility pathway for people with endometriosis, no longer grouped with unexplained infertility
• Removal of misleading labels such as "mild" and "severe" endometriosis, which failed to reflect the true complexity of the condition
• Personalised care conversations that take into account individual factors including age, symptoms, how long someone has been trying to conceive, ovarian reserve and male fertility factors
• A clear treatment route from expectant management, to surgical treatment, to IUI or IVF where appropriate

This is good news. But updated guidance doesn't automatically translate into better experiences for your employees. The NHS is under significant pressure, and the reality is that many people will still face long waits, limited access and little proactive support between appointments.

That's where employers have a genuine opportunity.

Why this is also a benefits issue

Fertility challenges affect employee performance in ways that are easy to overlook. 90% of people struggling with fertility report feeling depressed. Many are managing appointments, treatment cycles and emotional strain while trying to show up and perform at work.

And the stakes for retention are high. 88% of employees say they would change jobs for better fertility support. In a competitive talent market, the benefits you offer signal how much you value your people, particularly through life's most difficult moments.

Endometriosis sits at the intersection of women's health and fertility - two areas where workplace support has historically been inadequate. The new NICE guidance is a clear signal that these conditions deserve serious, specialist attention. Forward-thinking employers are already acting on that.

How Peppy supports employees with endometriosis and fertility challenges

Peppy gives employees unlimited, confidential access to specialist fertility clinicians through a simple app, available whenever they need it

For employees with endometriosis, Peppy provides:

• One-to-one support from fertility and women’s health specialists who understand the complexity of endometriosis
• Personalised support at every stage, from initial concerns through to treatment decisions and emotional wellbeing
• Proactive check-ins so employees never feel alone between appointments
• Women's health support that addresses endometriosis symptoms holistically, not just in the context of fertility

Peppy bridges the gap between what the NHS can offer and what your employees actually need: timely, expert, human support that fits around their lives.

Learn more about Peppy's Women's Health service

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The opportunity for employers

The new NICE guidance sends a clear message: endometriosis is a complex, distinct condition that requires its own pathway. Employees navigating this deserve more than a signpost to their GP.

By investing in specialist fertility and women's health support, you're not just improving health outcomes, you're improving retention, productivity and the day-to-day experience of some of your most dedicated people.

Because when your people feel genuinely supported, your business feels it too.

Interested in how Peppy can support your workforce? Book a call with our team.