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Increase in Success Rates and Use of Fertility Treatments

A new report from the Human Fertilisation and Embryology Authority (HFEA) showed "more people than ever before" having fertility treatment between 2019 and 2021. The preliminary data revealed that in 2021 both treatment numbers and pregnancy rates exceeded pre-pandemic levels. 

The regulator said the report, Fertility treatment 2021: preliminary trends and figures, painted "a promising picture" but cautioned that "pandemic aftershocks may continue to be felt".

The report also noted that the average age of an IVF patient had increased to 36 years – around 5 years older than that of women who conceived without fertility treatment. Even though pregnancy rates had increased across all age groups, "the likelihood of success decreases with age", HFEA said.

Success Rates Fall Precipitately in Older Women

The report revealed that in 2021, average IVF pregnancy rates using fresh embryo transfers were 41% per embryo transferred for patients aged 18-34, and 6% for patients aged 43-50 using their own eggs. Similarly, preliminary average IVF birth rates using fresh embryo transfers were 33% per embryo transferred among patients aged 18-34, and 4% for those aged 43-50 using their own eggs.

The figures showed that around 55,000 patients had IVF or donor insemination (DI) treatment at UK licensed fertility clinics in 2021, up from 53,000 in 2019. These patients underwent a total of 83,000 IVF and DI cycles in 2021, compared with 76,000 in 2019 – a 10% increase. In addition, "record numbers" of patients had frozen their eggs for future use, with a 64% increase in egg storage cycles from around 4000 in 2021 compared to 2500 in 2019.

Egg and embryo freezing cycles were "the fastest growing treatments in the UK", HFEA said, with 11 times more egg freeze cycles in 2021 than in 2011 (4215 compared with 373), and a more than 7-fold increase in the number of embryo freeze cycles in the same period (10,719 versus around 230). However these still accounted for only 4% and 11%, respectively, of all treatments carried out in 2021.

Multiple Births at 'Lowest Level Yet'

The UK average multiple birth rate reached "the lowest level yet" at 5% in 2021, a dramatic drop from the 28% rate seen in the 1990s.

Commenting to the Science Media Center (SMC), Daniel Brison, honorary professor of clinical embryology at the University of Manchester, described this as a "major piece of good news". It was "an excellent example of the way risks from IVF treatment can be managed and mitigated", he said, "and demonstrates the value of strong regulation in an area of medicine with strong commercial pressures".  

HFEA chair Julia Chain said that, overall, the report showed that treatment numbers were "back at pre-pandemic levels, and thanks to improved clinical and laboratory practice, over time pregnancy rates are increasing".

The report also noted that NHS funding for IVF "continued to vary across the

UK", in 2021 ranging from 58% in Scotland, 30% in Wales, to just 24% in England. It also "varied considerably across English regions" – a ' postcode lottery' that was described last year by the Progress Education Trust as "a terrible indictment" in the country where IVF was pioneered.

The report also said that the total number of NHS-funded cycles had actually reduced in 2021, to 20,000 from around 24,000 in 2019 – representing a 16% fall overall, comprising a 17% drop in England, 36% in Wales, but only 1% in Scotland. 

Most People Pay Privately for Fertility Treatment

In parallel, privately funded IVF treatments among patients aged 18-34 had continued to increase, to 63% in 2021 compared with 52% in 2019.

Ms Chain commented: "Although more people than ever are having fertility treatment, our data shows that more people than ever are now also paying for it."

She added: "We've seen a change in the type of family accessing fertility treatment, with clinics treating 44% more single patients and 33% more patients in same sex female couples in 2021 than they did in 2019." 

NHS funding criteria vary by region, she noted, and "under current rules, very few single and same sex patients qualify for NHS funding". 

Commenting on the report, Ying Cheong, professor of reproductive medicine at the University of Southampton, told the SMC: "It is excellent news that fertility treatment cycles continue to increase, when the birth rate in UK, like many parts of the world, has reached its lowest.

"The dramatic rise in egg and embryo freezing signals a medical and social acceptance and demand to preserve fertility."

However, he cautioned: "The average age for women seeking fertility treatment continues to rise, which [calls into] question the effectiveness of current fertility education and strategies for supportive working environments for women in their reproductive age."