ASIANS represent a larger proportion of IVF patients in the UK at 15 per cent, the latest data from the fertility regulator has revealed.
Black and Asian patients had lower birth rates from fertility treatment when compared to other ethnic groups, according to analysis from the Human Fertilisation and Embryology Authority (HFEA), published last Wednesday (13).
Asian and black single patients started fertility treatment at 38-39 years on average, compared to an average age of 36.2 years for white single patients for figures obtained from 2017 to 2021.
Asian patients also represented a smaller proportion of donor insemination (DI) patients at three per cent in 2017-21, compared to 11 per cent of an age-matched UK population.
There were disparities between ethnic groups in success rates, age at starting fertility treatment and access to funding in fertility treatment, the data showed.
Following the findings, the fertility regulator, British Fertility Society, the Royal College of Obstetricians and Gynaecologists and Fertility Network UK jointly called for action to bridge the disparity gap in fertility treatment for black, Asian and ethnic minority patients.
They stressed action in clinical policy development, information dissemination, NHS commissioning and research to reduce inequities in access and outcomes.
HFEA member Professor Geeta Nargund said, “There is no room for the health inequalities that exist within fertility treatment.
“While it is good news that multiple birth rates in all groups have dropped, this new HFEA report highlights the health inequalities that still exist within fertility treatment. “It shows that there is a need for meaningful changes so that black, Asian and ethnic minority fertility patients and their partners are not left behind in access to and experience of fertility treatment.”
Black patients started treatment later than other ethnic groups and were less likely to have NHS-funded treatment, the data showed.
Between 2008 and 2019, Asian patients began treatment at a younger age than other ethnic groups, although this has gradually risen from below 34 years in 2008 to nearly 35 in 2021. Chinese patients typically started treatment at an older age of 37 in 2021, while Bangladeshi and Pakistani patients were younger with an average age of 33.4 or below.
Geeta Nargund
IVF was most used by white patients (77 per cent) from 2017 to 2021, followed by Asian (15 per cent), black (3 per cent), other (4 per cent) and mixed (2 per cent) patients, the data showed.
Asian patients more commonly had a male partner for both IVF and DI treatment than other ethnic groups in 2017- 2021, and they were least commonly found in female same-sex couples or singles.
The report also found female same-sex couples started fertility treatment at 32.7 years on average, while Asian patients with a female partner were older at 35.8 years during the five years ending in 2021.
From the ages of 30 to 37, Asian and black patients showed lower birth rates per transferred embryo, although these differences became less pronounced after the age of 37.
In 2021, for patients aged 18-37 undergoing IVF with fresh embryo transfers, the average birth rate was 23 per cent for black patients and 24 per cent for Asian patients.
White patients had the highest rate at 32 per cent. White and Asian sperm were most commonly from the UK, with 50 per cent and 38 per cent of sperm donations used, respectively, from imports.
Conversely, most donor eggs used for treatment originated in the UK.
Egg donations from donors of other ethnicities had the highest likelihood of being imported at seven per cent, followed by black and Asian donors at three per cent.
NHS-funded IVF cycles for individuals under 40 in heterosexual relationships declined across all ethnic groups.
The sharpest decline was observed among black patients, dropping from 60 per cent in 2019 to 41 per cent in 2021.
Individuals with an ethnic background categorised as “other” were more inclined to receive NHS-funded treatment at 63 per cent, followed by those of white (53 per cent), Asian (49 per cent), and mixed (47 per cent) backgrounds.
Only three per cent of Asian and black surrogates received treatment during 2017-2021 compared to 90 per cent of white patients, the report added.
It added that the reasons for gaps in outcomes were not fully known and were complicated.
However, health conditions, cultural, social and economic factors, and the challenges faced by ethnic minority patients due to stigma have been cited as reasons for the disparities.
Nargund said, “We know that fertility declines with age, and we are concerned the data shows that black, Asian and ethnic minority patients are left behind.
“A shared focus of all members within the sector is equalising treatment and hearing from the impacted groups to inform robust policy making.”
She added, “Increasing information awareness, addressing high-risk factors and further investigating health conditions such as endometriosis or fibroids, will start the right conversations to begin to eradicate the disparities.”
Apsana Begum
