The Rise in Egg Freezing & IVF

The shape of fertility assistance in the UK

The Human Fertilisation and Embryology Authority, which regulates fertility clinics and fertility research centres, released a new data dashboard last month. The dashboard gives us a world-first window into fertility treatment in the UK going back all the way to 1991, with data from 665,690 patients.

Focusing on IVF, egg freezing, sperm and egg donation, we’ve drawn out some interesting trends and observations below.

There has been a very sharp increase in egg freezing.

In 2019, there were 2,660 egg freeze cycles for 2,135 patients, declining slightly to 2,520 cycles in 2020 and 2,015 patients, presumably because of pandemic restrictions (cycles outnumber patients because some patients have more than one cycle). But in 2021, the number of egg freeze cycles rocketed up by 66% to 4,175 and the number of patients by 65% to 3,315: this seems unlikely to be the result of pent up pandemic demand.

And also an increase in IVF cycles.

The number of IVF cycles in the UK has been increasing since 1991, but between 2010 and 2019 that increase was gradual. In 2019, there were 68,750 IVF cycles and 49,840 patients. Again, there was a clear pandemic-related dip in 2020, with a decline in cycles of 21% and in patient numbers of 19%.

But in 2021, a year that still saw pandemic restrictions in place, IVF cycle and patient numbers more than recovered to pre-pandemic levels. Cycle numbers went up to 72,735, 4.5% higher than in 2019. Patient numbers also beat out 2019 numbers, but only by 1.3%. This spike is likely the result of pent up demand from the pandemic and also indicates a higher rate of cycles per each patient post-pandemic.

A 23% chance of birth per embryo transfer.

The average birth rate per embryo transferred across all types of IVF is 23% and slightly higher (25%) for frozen IVF, where the embryo has been frozen prior to implantation in their mother’s womb. 23% might sound low to you, but that figure is the result of years of improvement. In 1995, the year that Phoebe’s husband was born via IVF, the birth rate per embryo transfer was only 8%. In 2010, it was 16%. 

As you can see below, birth rate per embryo transfer declines with patient age. We’re not sure what explains the bump in the over 45 group. There aren’t very many patients seeking IVF above the age of 45 and it might be that this is an unusual group in some way. 

• 18-34 – 33%

• 35-37 – 26%

• 38-39 – 20%

• 40-42 – 14%

• 43-44 – 10%

• Over 45 – 17%

There aren’t many sperm and egg donors. 

Many couples use IVF without needing a sperm or egg donor, but some will rely on a donor egg, donor sperm, or both. In 2021, there were 8,705 cycles and 3,585 patients using donor egg, donor sperm, or both.  

The HFEA data tells us how many new egg and sperm donors are registered per year. In 2021, there were only 1,405 new egg donors registered and a mere 765 sperm donors.

The vast majority of donors are white. In 2021, 82% of new egg donors and 78% of new sperm donors were white. Only 35 new black egg donors registered in 2021, and only 25 black sperm donors. Asian donors are also underrepresented. For prospective parents from ethnic minorities who are keen to have a child who looks like them, this represents a challenge that means many must rely on imported donor eggs and sperm.

However, foreign sperm donors in 2021 were actually most likely to be from Denmark, with 230 Danish men stepping forward to help others start their families. The US is also a popular country of origin for sperm donors. 

NHS funding has not kept up with IVF demand.

The majority of IVF cycles are funded privately rather than by the NHS: 74% versus 26% in 2021. The number of NHS funded cycles has not increased alongside demand for IVF and the share of NHS funded cycles is declining. In 2009, the NHS funded 21,705 cycles and peaked in 2016 with 28,810 cycles. But in 2021, only 20,500 cycles were NHS funded, less than in 2009. In 2009, there were 35,820 privately funded cycles. By 2021, that had increased by 67% to 59,825. 

Postcode lottery: move to Scotland?

The only part of the UK where the majority of IVF cycles are NHS funded is Scotland, where 57% of cycles are NHS funded. Unlike those living in other parts of the UK, eligible Scottish women can access three free cycles of IVF on the NHS. In England, the majority of Integrated Care Boards (local NHS health authorities) offer only one IVF cycle to eligible women.

The highest demand for IVF is in London, where there were 22,065 privately funded cycles in 2021 and only 4,190 NHS funded cycles (84% versus 16%).

By Phoebe Arslanagic-Little and Anvar Sarygulov