All patients with infertility problems should have prompt access to an integrated multidisciplinary service that provides efficient and accurate assessment of their clinical situation. Pre-implantation genetic diagnostic services require care in planning relevant to the number of centres which should be resourced to meet a national need. The intimate relationship which the in vitro fertilisation (IVF) services require with specialist genetic clinical and laboratory personnel is an important consideration. The delivery of high-quality specialist services demands the availability of personnel with special skills. Medical and nurse training in infertility has been enhanced through accreditation courses in the general management of infertility and assisted conception. A rolling audit programme should be in place at all stages in the pathway of care for patients and should regularly assess clinic and laboratory standards. Engagement in research should be encouraged in all settings and specialist and subspecialist centres should engage with national trials initiatives.

In the UK, unless surgery is required, most post-reproductive gynaecological care is delivered in the primary care setting. Clinical standards and guidelines are available from the Royal College of Obstetricians and Gynaecologists (RCOG), the Medicines and Healthcare products Regulatory Authority (MHRA), the British Menopause Society, and the National Osteoporosis Guideline Group and Clinical Knowledge summaries. Only women with complex problems need referral to a specialist hospital or community based sexual and reproductive healthcare service. The clinicians and nurse(s) need to maintain dedicated telephone, answer phone and email contact systems for women and health professionals. Staffs need to liaise with other allied health professionals who are involved in the care of post-menopausal women, such as radiographers, physiotherapists and continence advisors. Continuing training will need to be coordinated by the lead clinician to ensure that staffs are providing evidence-based advice.