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Record numbers of women are freezing their eggs, data shows

Egg and embryo freezing cycles are the fastest growing treatments in the UK

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More people than ever before are having fertility treatment as new data shows a 64 per cent increase in egg freezing and fertility preservation cycles.

The Fertility Treatment 2021: Preliminary Trends and Figures report, published by the Human Fertilisation & Embryology Authority (HFEA), has shown that around 55,000 patients had IVF or donor insemination treatment at UK licensed fertility clinics in 2021, compared to 53,000 in 2019.

The data has found that 83,000 IVF and donor insemination cycles were carried out in 2021 compared to 76,000 in 2019.

It has also revealed record numbers of patients are freezing their eggs for future use with 4,000 in 2021 compared to around 2,500 in 2019 (a 64 per cent rise).

The report, which shows how many patients undergo fertility treatment each year in UK fertility clinics, the type of treatment they have and the success rate, also shows the average pregnancy rate from IVF.

It suggests pregnancy rates using fresh embryo transfers have increased, rising to 29 per cent per embryo transferred in 2021 from 10 per cent in 1991.

“Overall, the new HFEA report paints a promising picture,” says Julia Chain, chair of the Human Fertilisation & Embryology Authority (HFEA).

“It shows treatment numbers are back at pre pandemic levels and thanks to improved clinical and laboratory practice, over time pregnancy rates are increasing.

“Despite the pandemic being declared officially over, the aftershocks are still being felt as delays across other areas of healthcare prevent some patients accessing fertility services.

“Our report shows that the average age of IVF patients has increased to 36, around five years older than mothers who get pregnant naturally and these aftershocks could mean that the average age of an IVF patient continues to rise.

“Although pregnancy rates have increased, the likelihood of success decreases with age. For some patients, this may mean they never get the baby they hoped for and that’s heart breaking.”

The Fertility Treatment 2021: Preliminary Trends and Figures report also shows:

  • IVF cycles increased to 76,000 cycles in 2021 from almost 70,000 in 2019
  • There were 11 times more egg freeze cycles in 2021 than in 2011; 373 cycles in 2011 compared to 4,215 cycles in 2021. The number of embryo freeze cycles increased from 230 cycles in 2011 to 10,719 in 2021.
  • In 2021, the average IVF pregnancy rate using fresh embryo transfers for patients aged 18-34 was 41 per cent per embryo transferred with a birth rate of 33 per cent. This compares to six per cent for patients aged 43-50 when using their own eggs and a birth rate of four per cent.
  • Single patients and patients in female same-sex relationships had the largest increase in IVF usage from 2019 to 2021.
  • The use of private funding by patients across the UK aged 18-34 has continued to increase with 63 per cent of IVF cycles funded privately in 2021 compared to 52 per cent in 2019.
  • The number of IVF cycles funded by the NHS continued to vary across the UK with an overall decrease to 20,000 cycles in 2021 from around 24,000 in 2019 (-16 per cent).

The fertility sector is a unique area of healthcare in the UK as the majority of patients pay for treatment themselves.

The proportion of NHS funded cycles have decreased right across the UK between 2019 and 2021, with data showing a 17 per cent reduction of NHS funded IVF cycles in England, 36 per cent in Wales and one per cent in Scotland.

“There were just under 4,000 fewer IVF cycles funded through the NHS between 2019 and 2021 so although more people than ever are having fertility treatment, our data shows that more people than ever are now also paying for it,” explains Chain.

“There could be several reasons why NHS funded cycles lag behind those seen before the pandemic.

“Firstly, we’ve seen a change in the type of family accessing fertility treatment with clinics treating 44 per cent more single patients and 33 per cent more patients in same sex female couples in 2021 than they did in 2019.

“Secondly, funding criteria varies depending on where you live and under current rules, very few single and same sex patients qualify for NHS funding,” she continues.

“And finally, measures put in place during the Covid-19 pandemic saw clinics prioritise older patients and this combined with waiting list backlogs elsewhere in the NHS, could mean that women are no longer eligible for NHS funding by the time they are referred for fertility treatment.”

Menopause

High street bakery chain Gail’s reveals menopause plan

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Gail’s has unveiled a menopause action plan offering new workplace support to thousands of staff ahead of legal reforms due in 2027.

The high street bakery chain will offer new benefits including 24/7 digital GP access and a new employee assistance programme, according to The Times.

It will also explore new online training for staff, including specific training for management.

Gail’s people director Miranda Burgum told The Times: “All we’re trying to do is talk freely and for it not to be a forbidden subject. It’s helping our managers and teams understand that this isn’t a taboo.”

“We’re going to develop the education with our managers, so it will be threaded through all our policies

“It will look at induction training, it will look at the types of people we need to make sure that we make reasonable adjustments for.

“And if somebody needs some sort of risk assessment, we’re going to be looking at [that].”

The move comes ahead of reforms due to be introduced in spring 2027 under the Employment Rights Act.

UK employers with 250 or more employees will be legally required to publish and update official menopause action plans.

The plans are intended to support employers to take effective action to improve workplace gender equality and support employees experiencing menopause.

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Fertility

Paracetamol use may impact future fertility, studies suggest

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Paracetamol use in pregnancy was not linked to autism or ADHD, while separate research found reproductive differences in girls exposed before birth.

One study analysed health records from more than 120,000 children and found no increased risk of autism following prenatal paracetamol exposure.

A separate analysis of nearly 100,000 children also found no increased risk of ADHD among those born to mothers who used the painkiller during pregnancy.

Researchers from the Hong Kong Hospital Authority examined electronic health records covering pregnancies between January 2001 and December 2023.

The autism analysis included 124,333 children, who were nine years old on average and split almost evenly between males and females. There were 3,445 autism diagnoses, representing 2.8 per cent of the group.

The ADHD analysis involved 97,285 children, who were seven years old on average and also split evenly between males and females. There were 5,168 ADHD diagnoses, representing 5.3 per cent.

Women prescribed paracetamol during pregnancy were more likely to be older and have pre-existing conditions including psychiatric disorders, as well as reasons for taking the drug such as infection, fever or chronic pain.

No association was found between prenatal paracetamol exposure and either autism or ADHD.

The findings did not differ according to the trimester in which paracetamol was taken or whether use was intermittent or daily. Advanced maternal age, defined as pregnancy in women over 35, did not alter the findings.

The researchers wrote: “Paracetamol remains a safe and essential analgesic [pain reliever] and antipyretic [fever reducer] during pregnancy, whereas alternatives, such as NSAIDs and opioids carry well-documented risks.

“Unwarranted reluctance to use paracetamol could lead to undertreatment of pain and fever, or the use of more harmful alternatives, both posing risks to the pregnancy and developing fetus.”

The authors said women should assess paracetamol use with guidance from their doctor.

A separate study involving 685 pregnant women without pre-existing conditions and 302 infant daughters found associations between prenatal paracetamol exposure and differences in reproductive organs and hormone levels.

Researchers from Copenhagen University Hospital enrolled the women during their first trimester and assessed them during the first trimester, third trimester and again when their babies were three months old.

At around three months, infants experience a temporary rise in reproductive hormones sometimes called mini-puberty.

Pregnant participants completed questionnaires every two weeks about their use of pain medicines including paracetamol. Infant girls underwent ultrasound scans of their reproductive organs and blood tests to measure hormone levels.

Researchers also examined a separate group of 1,210 girls followed from infancy to adolescence whose mothers reported paracetamol use during the third trimester.

Three-month-old girls exposed to paracetamol before birth had an average 40 per cent smaller ovarian volume, 13 per cent smaller uterine volume and 23 per cent fewer ovarian follicles.

Girls exposed during the first trimester also had lower levels of Anti-Müllerian hormone, a marker of ovarian function.

Among the older girls, those exposed before birth were more likely to have smaller uteruses at puberty and smaller ovaries during their teenage years.

Dr Margit Bistrup Fischer, lead study author and postdoctoral researcher in the Department of Growth and Reproduction at Rigshospitalet hospital in Denmark, said: “Animal studies have demonstrated that impaired formation of ovarian follicles can lead to reduced fertility and earlier reproductive aging.

“Whether the differences observed in our study have implications for fertility and age at menopause in humans remains unknown and will require long-term follow-up of the girls in our cohort.”

She cautioned that women who had used paracetamol during pregnancy “should not be alarmed by our findings”, as the study found associations rather than direct causation and outcomes for individual women and children are unclear.

“Importantly, our study does not evaluate whether [acetaminophen] causes reproductive problems, nor does it provide evidence that prenatal exposure affects future fertility or age at menopause,” she said.

“Although we observed similar associations in an independent cohort, long-term follow-up is needed to determine whether these early-life differences have any clinical significance later in life.”

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Insight

Research uncovers potential new target for breast cancer therapy

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Targeting CD1d altered immune cells slowed tumour growth and improved immunotherapy responses in mouse models of breast cancer, researchers found.

The findings suggest blocking the molecule could make the environment around breast tumours more favourable to anti-cancer immune responses.

Further work is needed to understand how these immune changes occur and how the approach could be safely used in patients.

Researchers from King’s College London, the Francis Crick Institute and University College London investigated how immune cells inside breast tumours influence cancer growth.

They focused on myeloid cells, a group of immune cells found in large numbers within tumours that can either support an immune attack against cancer or contribute to tumour growth and immune evasion.

The team examined CD1d, a molecule found on the surface of myeloid and other immune and tissue cells that helps regulate immune responses.

When CD1d was genetically removed from cells in a mouse model of breast cancer, the mice were more resistant to tumour growth. Researchers also saw changes in myeloid cell populations, including increased activity among cells that can help attack cancer.

The team then blocked CD1d using an antibody and again observed changes in myeloid cells and slower tumour growth. Blocking CD1d also improved responses to immunotherapy in the mouse model.

Researchers used single-cell RNA sequencing, a technique that examines gene activity in individual cells, to investigate the immune changes in more detail.

They identified a population of myeloid cells called monocytes that expressed genes associated with inflammation, an important part of the immune response. These cells were particularly important in restricting tumour growth in the mouse models.

A similar pattern of gene activity was identified in data from human breast cancer tumours. Its presence in myeloid cells was associated with positive responses to immunotherapy in breast cancer patients.

However, the findings in people were based on gene expression data and did not test CD1d-targeting treatment in patients.

Professor Patricia Barral, professor of immunobiology at King’s College London and senior author of the study, said: “Many breast cancers do not respond well to current immunotherapies.

“Our findings reveal a previously unrecognised mechanism by which immune cells within tumours are regulated.

“While CD1d is best known for helping immune cells recognise lipid molecules, we found that it also plays a role in shaping the behaviour of myeloid cells within tumours.

“These findings suggest that targeting the immune cells that surround and support tumours could boost anti-cancer immunity and potentially improve treatment responses in the future.”

Researchers now plan to investigate how the immune changes occur and how they can be safely harnessed in patients.

They also want to examine whether targeting CD1d could enhance existing treatments and influence treatment responses in different cancer types.

The work was supported by UKRI BBSRC, Breast Cancer Now and the Cancer Research UK City of London Centre.

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