Black patients were disproportionately affected by the drop in NHS-funded IVF cycles that occured during the pandemic.
While 60 percent of IVF cycles undertaken by black patients in 2019 in the UK were NHS-funded, this had fallen by a third, to just 41 percent of the cycles undertaken by this group in 2021, a report by the the Human Fertilisation and Embryology Authority (HFEA) showed. While the number of NHS-funded IVF cycles dropped for white patients too, this drop was smaller, from 66 percent to 53 percent. Black and Asian patients had lower live birth rates per embryo transfer than white patients, with a live birth rate of 23 percent, 24 percent and 32 percent respectively, in 2020-21.
The HFEA, the British Fertility Society, the Royal College of Obstetricians and Gynaecologists, and Fertility Network UK are now calling for action to be made to tackle these disparities. ‘There is no room for the health inequalities that exist within fertility treatment.’ said Professor Geeta Nargund, senior consultant gynaecologist and member of the HFEA. ‘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.’
The report, ‘Ethnic diversity in fertility treatment 2021‘ looked at IVF and intrauterine insemination treatment in the UK, and also showed the age of black and Asian women was higher than that of white women when they received their first treatment. Asian and black single women started treatment at an average of 38.2 and 38.5 years on average respectively, while white women and those of mixed ancestry started at 36.2 and 36.8 years on average respectively, in 2017-21. Black patients in heterosexual couples started treatment a year later than their white counterparts.
Professor Nargund said: ‘A shared focus of all members within the sector is equalising treatment and hearing from the impacted groups to inform robust policy making… Increasing information awareness, addressing high-risk factors and further investigating health conditions such as endometriosis or fibroids, start the right conversations to begin to eradicate the disparities.’
Vanessa Haye, a 36-year campaigner for better healthcare for women of colour told Metro: ‘Black women are not a monolith […] So it’s not an easy thing to fix unless we start by understanding the intersectional challenges they face and how that informs Black women’s health seeking behaviours.’
Black women were also more likely to have multiple births, despite campaigns by the HFEA and others to reduce the number of multiple embryo transfers due to the higher risk of complications during pregnancy and birth. The MBRRACE-UK Perinatal Confidential Enquiry reports that examined perinatal deaths in black and Asian women, and compared the care they had receieved to that of white women, was published the day after the HFEA report. It highlighted lower access to tests and treatments by black women, throughout pregnancy.
This report followed its 2021 report that showed black women in the UK were four times more likely to die in childbirth than white women. The UK Government rejected the Women and Equalities Committee’s recommendation to produce a strategy to end disparities in maternal deaths in June 2023.
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