BFS response to HFEA document Fertility treatment 2021: preliminary trends and figures

The British Fertility Society in its response to the HFEA’s 2021 Fertility Trends report finds a sector providing safe and effective treatment, but a worrying drop in NHS funding forcing more people to pay for the treatment they need


Fertility clinics in the UK are helping increasing numbers of patients realise their dream of having a family, and are doing so safely, data from the HFEA show. Responding to the HFEA report on Fertility treatment in 2021, Dr Raj Mathur, Chair of the British Fertility Society said ‘There was a significant increase in the number of treatment cycles performed in 2021 compared with previous years, with a further increase in the clinical pregnancy rate. At the same time, the rate of multiple pregnancy has declined to an all-time low of 5%. This is to be celebrated, and shows that clinics in the UK are delivering good care, effectively and safely, for their patients’.


At the same time, the BFS is anxious about a reduction in the number of NHS-funded fertility treatment cycles across all jurisdictions except for Scotland. We have long campaigned for fair funding of fertility treatment by the NHS, in keeping with existing NICE recommendations. The post-code lottery in respect of IVF funding is well-recognised, but this report highlights in addition the effect of post-pandemic delays in women accessing diagnostic and other procedures before they can commence IVF. We call upon government to ensure that commissioners of NHS services pay due attention to fertility and to prioritising reduction in surgical backlogs affecting fertility patients. Delaying the start of treatment is likely to reduce the chance of success, and result in some women not being able to have the baby they otherwise would have. This should be unacceptable in all parts of our health service.


The increasing number of cycles of egg freezing probably reflects growing awareness among women about its role as a potential hedge against age-related fertility decline, and among practitioners as an essential part of the care of women facing medical treatment that may damage their fertility. However, the data in the report do not distinguish between egg freezing for medical reasons (for instance, if the woman is facing cancer treatment which has the potential to harm fertility) and egg freezing in the absence of a medical indication. It would be useful for the HFEA to provide this information and also describe any trends that can be identified in the age of women freezing their eggs. Professionals have the responsibility of adequately counselling women who seek egg freezing, including providing information about their likelihood of having a baby in the future using stored eggs. This is crucially dependent on the age of the woman when she stores her eggs.


The increasing number of fertility treatment cycles in same-sex female couples and single women reflects broader societal norms. However, NHS funding for these patients is even more variable than for heterosexual couples, and leaves some groups at risk of unfairness and even discrimination. Fairness in funding still has a long way to go in the country that invented modern fertility treatment.