Fertility nursing and its role extension has increasingly been referred to as 'specialist' or 'advanced nursing practice'. Nevertheless, Government initiatives have prompted a review of 'Advanced Nursing Practice' and the Nursing & Midwifery Council (NMC) has taken steps to address the disparity of roles, job titles, training and competence of nurse practitioners, concluding that advanced nursing practice should be subject to revalidation in the same way as professional registration. Fertility nurses form an integral part of the multidisciplinary team. Yet no formal or nationally recognised framework or training pathway exists. In this paper, we present the findings of a recent online survey of training and educational needs of fertility nurses; its aim being to work toward developing a national training pathway. Our findings identify the relationship between fertility nurse competencies, advanced nursing practice and medical sub-specialist training, at the same time, highlighting the difference in accessibility, funding and levels of training, as well as assessment and expertise within clinical practice. We conclude that it is essential to protect role extension through regonised Higher Educational Institution (HEI) accreditation, by appropriate, role-focussed training. Notwithstanding a national review, the diverse list of job titles also needs to be addressed adequately to encompass and respect role extension.