Sharp drop in number of NHS IVF procedures in UK, report reveals

The NHS has significantly reduced the number of IVF procedures performed in the UK, leaving infertile women unable to access the treatment or having to pay for it themselves.

Barely one in four (27%) IVF cycles in 2022 were paid for by the health service – the lowest figure since 2008 and a sharp drop from the 40% paid for by the health service in 2012.

The sharp decline in recent years is evident from the latest annual report from the Human Fertilisation and Embryology Authority (Hfea), which regulates fertility treatments in the four home countries.

Women who desperately want a child are facing a postcode lottery in healthcare, amid a widespread misconception that childlessness is a ‘lifestyle choice’, experts say.

The National Institute of Health and Care Excellence (Nice) has instructed the NHS in England to offer all eligible women three cycles of IVF. However, this rarely happens because provision is spotty.

Dr Kevin McEleny, chairman of the British Fertility Society (BFS), said women were being affected by widespread variation in IVF availability, which was “heartbreaking and so unfair”.

“Cost-cutting by NHS funding bodies that should be implementing the Nice IVF recommendations means that patients in one part of the country are unable to access NHS-funded fertility treatments that people in a similar situation elsewhere in the country can.

“Infertility is recognised as a health problem. Yet many people still see involuntary childlessness as a lifestyle choice, and this attitude reflects why it does not get the NHS funding it deserves,” he added.

The number of IVF cycles funded by the NHS fell by 17% in England, 16% in Wales and 7% in Scotland between 2019 and 2022, the HFEA found. England’s East Midlands saw the biggest fall over the period, with a 48% drop, but Yorkshire and the Humber saw a 17% increase.

The BFS, which represents fertility specialists, is “very concerned that an increasing number of people are having to pay privately for IVF treatment that they should be entitled to through the NHS. There is a risk that we are getting into a situation where only wealthy people can afford IVF. Are we saying that the wealthy are better parents?” McEleny said.

Expectant parents are selling their homes, cashing in their pensions, cancelling their weddings and maxing out their credit cards to fund private fertility treatments, amid rising fees and inadequate NHS provision, a Fertility Network UK report last year found.

Fertility patients are also starting treatment later. The average age at which women first undergo IVF has risen above 35 – to 35.1 – for the first time since records began in 1991, the regulator said. That is six years later than when women in England and Wales first gave birth, at 29, it added.

The trend is due to delays in access to gynaecological care on the NHS during the Covid pandemic, people’s struggles to fund fertility treatments and cuts to IVF provision in the NHS, the Hfea said.

However, Julia Chain, chair of the Hfea, warned women who wait so late to seek help that they are less likely to have a child. “The chances of having a baby decrease rapidly with age,” she said.

McEleny added: “The age at which children first become parents has risen steadily since the 1960s for both men and women, reflecting broader societal changes. (But) this worrying trend could be affecting graduation rates.”

Better news is that the percentage of women who become pregnant after IVF using fresh embryo transfers and their own eggs has reached 31%, up from 21% in 2012 – “a great result,” McEleny said. However, the odds are much higher for those between the ages of 18 and 34.

And the percentage of IVF pregnancies resulting in twins or other multiple births has fallen to 4% – the lowest level ever. The Hfea welcomed the drop because multiple births carry a higher risk of late miscarriage, premature birth, gestational diabetes and other problems.

More broadly, the number of births in England and Wales – 598,400 in the year to mid-2023 – has fallen to its lowest level since 2002, figures from the Office for National Statistics showed last week.

NHS England declined to comment on the declining IVF provision, but stressed that local health services should offer the full three cycles that Nice recommends.

A spokesperson said: “While these decisions are legally for local health commissioners, it is absolutely right that they provide equal access to services, tailored to the needs of people in their areas.”