Male Infertility Most Common Reason For IVF Treatment, UK Audit Reveals | HuffPost Life

'Current treatments are now 85% more likely to succeed than when records began in 1991.'

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Life editor at HuffPost UK

Male infertility is the most common reason couples in the UK have IVF treatment, official UK data has revealed.

The most common reasons for IVF treatment after male infertility (37%) were ovulatory disorder (13%), blocked fallopian tubes (12%) and endometriosis (6%), although in 32% of cases the cause of infertility was unexplained.

The Human Fertilisation and Embryology Authority’s (HFEA) report for 2014-2016 revealed that 40 years after the first child was born following in vitro fertilisation, IVF treatment is at the strongest it has ever been in the UK. The report showed that in 2016, more than 68,000 IVF treatments were performed (an increase of 4% from 2015), with over 20,000 babies born. Current treatments are now 85% more likely to succeed than when records began in 1991, as the average birth rate per embryo transferred for women of all ages is 21%.

“Assisted reproduction has come a long way in the 40 years since British doctors pioneered IVF with the birth of Louise Brown,” said Sally Cheshire, chair of the HFEA. “With well over a million treatments performed in the UK since records began, and more than 300,000 babies born, as a country we remain at the forefront of fertility treatment.”

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Age remains the single most important factor for successful outcomes from fertility treatment. The average birth rate for women of all ages is 21%, while women under 35 have a 29% chance of a successful birth.

In 2016, 42% of patients undergoing IVF treatment cycles were aged under 35. 23% were aged between 35-37, 14% aged 38-39, 14% 40-42, 4% 43-44 and 3% over 44 (1,812).

The HFEA noted several other trends in its latest report: Treatments involving donor eggs and sperm are becoming more popular. In 2016, 4,306 treatment cycles involved a patient using their own eggs and donor sperm, up 15% from 3,749 in 2015. There were also 3,000 IVF treatment cycles using donor eggs and partner sperm – a year-on-year rise of 6%.

The report also found that since 2014, the number of IVF treatments for patients with a female partner has increased by 30% and the number of IVF treatments for patients with no partner increased by 35%. IVF treatments for patients with a male partner increased by 6% over the same period.

Overall, heterosexual couples still account for the vast majority of all treatments. In 2016, 64,903 IVF treatments were for women who registered with a male partner (95%); 1,683 for women who registered with a female partner (3%) and 1,272 for women who registered with no partner (2%).

“I am delighted to see that more people than ever before are able to have successful treatment."”
- Sally Cheshire CBE, chair of the HFEA

Despite a general increase in birth numbers, the report revealed that the multiple birth rate continues to fall. This is a positive step, as multiple births carry significant risks for both mother and child. Multiple births have reduced from 28% of IVF births in 2008 to 11% in 2016 - its lowest rate to date.

Other significant findings included the number of cycles using eggs frozen for later treatment rose by 10% in the last recorded year, with 1,170 freezing cycles in 2016. The age profile for women having egg thaw cycles is very different from standard IVF treatment, with the largest group aged over 44 (27%). Only 17% of patients using thawed eggs in treatment were aged under 35.

And, for the first time ever, the HFEA detailed the number of surrogacy treatments taking place in UK clinics: 232 surrogate cycles, and 79 births in 2016. The birth rate for surrogates is also higher than IVF overall, at 26% when using fresh embryos.

Cheshire added: “I am delighted to see that more people than ever before are able to have successful treatment. But the same level of care must be shown to those patients whose treatments do not result in a birth. In that way, the UK will lead not just in clinical treatment, but in the provision of vital emotional support from the beginning to the end of each patient’s journey”.

In 2016, 41% of IVF treatments across the UK were funded by the NHS, a ratio that has remained broadly stable since around 2010.

Before You Go

10 Things You May Not Know About Your Fertility

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1. Your fertility is mostly determined by genetics, which influences how many eggs you are born with. Doctors believe that the number of eggs you have at birth determines the length of time you will remain fertile. At birth, women have about two million eggs in their ovaries. For every egg ovulated during your reproductive life, about 1,000 eggs undergo programmed cell death. Other things, such as smoking cigarettes and certain types of chemotherapy, can accelerate egg cell death and promote an earlier menopause.

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2. Regular menstrual cycles are a sign of regular ovulation.Most women have regular cycles lasting between 24 and 35 days. This is usually a sign of regular, predictable ovulation. Women who do not ovulate regularly have irregular menstrual cycles. Those who do not ovulate at all may have a genetic condition called polycystic ovarian syndrome (PCOS).

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3. Basal temperature charting does not predict ovulation.An older method of tracking ovulation involves taking your oral body temperature each morning before getting out of bed. This is called basal body temperature. This method is used to spot a rise in basal temperature, which is a sign that progesterone is being produced. The main problem with using this method is that your temperature rises after ovulation has already occurred. This makes it more difficult to time intercourse at an optimal time for conception. A better method is to use over-the-counter urine ovulation predictor test kits such as Clearblue Easy. These kits test for the hormone that prompts ovulation, which is called luteinizing hormone (LH).

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4. Most women with blocked fallopian tubes are completely unaware they may have had a prior pelvic infection.About 10 percent of infertility cases are due to tubal disease, either complete blockage or pelvic scarring causing tubal malfunction. One major cause of tubal disease is a prior pelvic infection from a sexually transmitted disease such as chlamydia. These infections can cause so few symptoms that you may be completely unaware your tubes are affected. This is why fertility physicians will order a dye test of the tubes, called a hysterosalpingogram (HSG), if you have been trying and failing to conceive for 6 months or longer.

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5. In most cases, stress does not cause infertility. Except in rare cases of extreme physical or emotional distress, women will keep ovulating regularly. Conceiving while on vacation is likely less about relaxation than about coincidence and good timing of sex.

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6. By age 44, most women are infertile, even if they are still ovulating regularly. Even with significant fertility treatment, rates of conception are very low after age 43. Most women who conceive in their mid-40s with fertility treatment are using donated eggs from younger women.

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7. Having fathered a pregnancy in the past does not guarantee fertility. Sperm counts can change quite a bit with time, so never assume that a prior pregnancy guarantees fertile sperm. Obtaining a semen analysis is the only way to be sure the sperm are still healthy!

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8. For the most part, diet has little or nothing to do with fertility. Despite popular press, there is little scientific data showing that a particular diet or food promotes fertility. One limited study did suggest a Mediterranean diet with olive oil, fish and legumes may help promote fertility.

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9. Vitamin D may improve results of fertility treatments. A recent study from the University of Southern California suggested that women who were undergoing fertility treatments, but had low vitamin D levels, might have lower rates of conception. This vitamin is also essential during pregnancy. At Pacific Fertility Center, we recommend our patients take 2,000-4,000 IU per day.

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10. Being either underweight or overweight is clearly linked with lowered levels of fertility. The evidence in recent years is that obesity is clearly linked with a longer time to conception. Having a body mass index less than 18 or over 32 is associated with problems ovulating and conceiving, as well as problems during pregnancy.

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