Headline findings include an increase in IVF success rates, a surge in egg and embryo freezing, and a decrease in NHS funding for fertility treatments. Sally Cheshire, chair of the HFEA, said:
‘While fertility treatment is never a guarantee for a baby, we are pleased to see that birth rates have increased over the years and the average birth rate is now steady at 23 percent. Whilst this leaves many couples without their longed-for family after treatment, these small year-on-year increases are important for the sector to build on.’
In 2018 about 54,000 patients underwent 68,724 fresh and frozen IVF cycles and 5,651 donor insemination cycles at HFEA licensed fertility clinics across the UK. IVF birth rates increased for all patient groups under the age of 43 over time. Patients below the age of 35 had a birth rate of 31 percent per transferred embryo (23 percent for all patients), an increase from only nine percent in 1991, when HFEA was established.
Age remains a key factor for IVF success, with a birth rate below five percent for women over 43 who use their own eggs.
Multiple pregnancy, one of the main risk factors of IVF, has for the first time fallen to eight percent, as it has become clear – using current methods – that implanting more than one embryo has no significant impact on the chance of live birth.
The report also states that the number of patients choosing embryo and egg storage cycles increased five-fold from 1400 in 2013 to 9000 in 2018. The number of women freezing unfertilised eggs has also climbed from 569 in 2013 to 2000 in 2018. Frozen embryo transfers are now more successful than fresh ones, although only by a small margin.
Sarah Norcross from the Progress Educational Trust said:
‘The women we have spoken to value motherhood and having a family is really important to them and so they are choosing to freeze their eggs as a back-up plan in case they need them in the future. Of course, they may not need them as they may find a partner and get pregnant the old-fashioned way. I think there is a greater awareness of egg freezing as a reproductive choice and also of the biological clock and so women are choosing to invest money in trying to improve their reproductive options’.
The level of NHS funding for fertility treatment varies across the UK: in Scotland, 60 percent of fertility treatments are funded by the NHS, but in England where funding is controlled locally by clinical commission groups (CCGs), this figure has fallen below 30 percent in some areas.
‘What is hugely disappointing is the continued fall in NHS-funded cycles. … Whilst the NICE [National Institute for Health and Care Excellence] guidance states that all eligible couples should be entitled to three full cycles (including the use of frozen embryos)’
said Professor Adam Balen, the Royal College of Obstetricians and Gynaecologists spokesperson on reproductive medicine. ‘IVF is cost effective and has shown to be an economic benefit to society.’