Women in many parts of England may continue to struggle to get free IVF on the NHS, a survey suggests.
Some PCTs are concerned about the cost of IVF
The government announced in February that infertile couples would be given one cycle of IVF on the NHS.
But a survey of primary care trusts, which control 70% of the NHS budget, suggests they will ignore the ruling.
A survey of 53 of the 298 PCTs, by the charity Infertility Network UK, found just one in three were planning to pay for IVF treatment.
The NHS watchdog, the National Institute for Clinical Excellence, had originally recommended that women aged between 23 and 39, who have been trying to have a baby for more than three years, should be offered three cycles of IVF.
However, ministers over-ruled the institute saying the NHS should only be obliged to offer one cycle.
Around 25% of women who have one cycle of IVF treatment become pregnant. The figure increases to 50% for those who have three cycles.
All PCTs are supposed to offer at least one IVF cycle from April next year.
However, just one in three of the 53 PCTs that took part in the survey said they planned to do so.
Half said they had not finalised their plans while 15% said they did not plan to offer IVF from April.
Three out of four PCTs indicated that they were concerned about the high cost of providing the treatment.
Infertility Network UK said there was also confusion over who was eligible for IVF.
"A lack of central guidance on social eligibility criteria and perceptions of high cost of implementation are standing in the way of equitable access," said Sheena Young, its head of business development.
The Department of Health said all PCTs should be offering IVF treatment from next April.
"The immediate priority in tackling the postcode lottery must be to ensure that everyone has access to IVF, wherever they live," said a spokeswoman.
"The aim is that a minimum national level of provision of one fresh cycle of IVF treatment is provided by all PCTs by April 2005.
"Some PCTs may already be offering more than this minimum national level.
"The NHS has to prioritise its services. It does not have unlimited resources. PCTs need to consider the detail of the full guideline, take stock, and review their services."