Greater Manchester is the best place to live in England if you need "gold standard" fertility treatment on the NHS, an IVF campaign group says.
Of 209 clinical commissioning groups (CCGs), it said only four were meeting national guidelines on IVF treatment.
All four - where patients are offered three cycles of IVF as part of their care - are in Greater Manchester.
The Fertility Fairness campaigners single out Essex and South Norfolk for cutting all NHS fertility treatments.
It said Essex was the worst place to be for those struggling to conceive, with three CCGs in the county having cut all NHS fertility treatment.
South Norfolk CCG, meanwhile, has also decommissioned its NHS fertility services.
Across England, only one in six CCGs offers three rounds of IVF, with the majority (60%) offering just one, Fertility Fairness said.
Greater Manchester was singled out because it offers even more support than the minimum recommended by the National Institute of Health and Care Excellence (Nice).
A Fertility Fairness spokesman said that in Scotland three cycles were offered, while the NHS in Wales and Northern Ireland offered two and one respectively.
'Cruel and unethical'
It warned the situation could be about to worsen further, with 10% of CCGs in England consulting on reducing or decommissioning services.
"This is cruel and unethical, and a national disgrace for the country that pioneered IVF," said Fertility Fairness co-chair Susan Seenan.
"Infertility is a disease, and women and men who cannot become parents without medical help are as deserving of healthcare as people with other medical conditions."
Health secretary Jeremy Hunt has said that the government would step in if local health bodies were not meeting clinically agreed standards of care.
England health minister Nicola Blackwood said: "I am very disappointed to learn that access to IVF treatment on the NHS has been reduced in some places and it is unacceptable that some clinical commissioning groups have stopped commissioning it completely.
"I would strongly encourage all CCGs to implement the Nice fertility guidelines in full, as many CCGs have successfully done."