England head coach Stuart Lancaster has confirmed that Leicester Tigers duo Tom Youngs and Tom Croft will miss this summer's tour to New Zealand.
Tigers hooker Youngs will remain at home to support his wife who is requiring treatment for an illness.
Director of rugby Richard Cockerill said: "These things are more important than rugby, and Tom and his family have the full support of everyone at Leicester Tigers. We hope everyone respects their privacy at this time."
Lancaster said: "Our thoughts are with Tom and Tiffany at this time and it is entirely right that he stays at home to support her and their daughter. Everyone in the England squad sends them our best wishes."
Croft - who could play his first game since the opening day of the season this weekend after his recovery from a knee injury - also misses the summer tour, together with Alex Corbisiero (Northampton Saints), Jack Nowell (Exeter Chiefs) and Christian Wade (London Wasps).
Lancaster added: "Alex and Tom have worked really hard to come back before the end of the season but they will not have played enough rugby for them to be considered for such a tour. It's the same with Christian Wade.
"They have had significant injuries and their return to play has been carefully managed in conjunction with their clubs. It will be a short-term loss but a long-term gain for us and their clubs as we enter a huge 18 months.
"Jack needs to get his knee sorted so he will be ready for next season and the World Cup and it's the right decision for him to have the operation next week."
England's medical team are liaising with Bath and Gloucester over injuries to Rob Webber (knee) and Billy Twelvetrees (ankle).