Women of colour are less likely to have successful fertility treatment, with Black patients having the lowest chances of having a baby, according to a new report.
Overall birth rates from fertility treatment have increased in recent years, but Black patients aged 30-34 have an average rate of 23%, compared to 30% for mixed and white patients, new data from the fertility regulator HFEA shows.
The report, titled ‘Ethnic Diversity in Fertility Treatment’, also highlights that 31% of Black fertility patients have problems related to issues with their fallopian tubes, compared to only 18% of patients overall.
Black patients also start IVF almost two years later (36.4 years old) compared to the average patient at 34.6 years old.
It’s yet another example of racial inequalities in UK healthcare, with the regulator and other charities calling for urgent research into why the outcomes are so disparate.
Vanessa Haye, founder of Femelanin, a platform created to empower and support Black women, says she’s “not surprised” to hear about the lower outcomes for Black women who access fertility treatment.
She had two cycles of IVF aged 29 in 2016 and 2017. The first resulted in a miscarriage, but she gave birth to her son following the second cycle. “I was never familiar with the general low success rates for patients under 35,” she says. “I had ovulation problems and low progesterone so the odds were already against me – however I was never prepared for that.”
Haye says the pandemic has shown inequalities exist “at various levels for Black patients”. She adds: “More attention and research needs to be put into the reproductive health needs of this group.”
The report also shows Black patients experienced higher than average multiple births from double embryo transfers, at around 14% from 2014-2018. On average, multiple birth rates are as low as 8%. Multiple births represent the “single biggest risk to both mother and babies,” the report states.
While disparities for Black patients are the most notable, other ethnic groups also have worse outcomes when going through fertility treatment.
Asian patients, who represent a larger proportion of IVF users at 14% whilst comprising 7% of the UK population, are struggling to access donor eggs.
The report shows 89% of egg donors are white, followed by 4% Asian, 3% mixed and 3% Black, resulting in the use of white eggs in 52% of IVF cycles with an Asian patient.
Seetal Savla, a fertility patient of Indian heritage currently undergoing donor egg IVF (DEIVF), welcomes the HFEA’s report, because she’s hopeful the findings will lead to fairer treatment for all ethnicities.
“One of the reasons why my husband and I decided against having an Indian donor was due to lengthy waiting lists in the UK,” she tells HuffPost. “Given that time isn’t on our side, we couldn’t afford to lose one to two precious years, just waiting and hoping to hit the jackpot.
“We therefore chose to move forward with a Portuguese or Spanish donor, so not only am I giving up my genetic link to our potential baby, I’m also losing part of my cultural heritage as a result of the lack of Asian donors. If my husband wasn’t Indian, this would be a significant loss and take some time to grieve.”
Sally Cheshire, chair of the HFEA, said the report made clear “several disparities in fertility treatment across ethnic groups” that need to be addressed. “Whilst we currently do not have definitive explanations for why these differences exist between patients of different ethnicities, it’s crucial more work is done, and action is taken to level the playing field for all our patients,” she said.
And Sarah Norcross, director of the fertility charity Progress Educational Trust (PET), added that the report reveals the scale of research that needs to be done immediately, “to unpick why IVF success rates and access to fertility treatment are so different for ethnic minority patients, in particular Black women”.
“We need social science research to understand why ethnic minority patients may not be coming forwards to access healthcare which can potentially prevent fertility problems and also why there are delays in starting fertility treatment,” she said. “Hand-in-hand with this work, we need to prioritise scientific studies to investigate the reduced success rates experienced by young Black women as this is a phenomenon that has been noted for over a decade.”
Dr Christine Ekechi, co-chair of the Royal College of Obstetricians and Gynaecologists’ Race Equality Taskforce, described the fertility inequalities faced by Black, Asian and minority ethnic women as “disappointing but not surprising”.
“When tackling racial inequalities in health outcomes for women, it is important to acknowledge that for some women, these poorer outcomes affect them throughout their life course, limiting the available choices that others often take for granted,” she said. “It is essential we begin to understand the factors contributing to these poorer outcomes in this particular group of women.”