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UK fertility regulator finds racial disparities in treatment outcomes

A HFEA report showed funding decreased most among Black patients, from 60 per cent in 2019 to 41 per cent in 2021

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Fertility treatment outcomes vary widely for Black, Asian and ethnic minority patients, the UK fertility regulator has found. 

Data from the Human Fertilisation and Embryology Authority (HFEA) showed significant differences by ethnic group in the use and outcomes of fertility treatment.

The average IVF birth rate per embryo transferred has increased across all groups, but Black and Asian patients aged 18-37 had the lowest birth rates (23 per cent and 24 per cent respectively) compared to white patients (32 per cent) between 2020 and 2021.

Multiple births are a high risk to patients and babies. The Ethnic Diversity in Fertility Treatment 2021 report revealed that Black patients continued to have the highest multiple birth rates at nine per cent, compared to seven per cent for white patients.

Professor Geeta Nargund, member of the HFEA, said: “There is no room for the health inequalities that exist within fertility treatment,

“While it is good news that multiple birth rates in all groups have dropped, this new HFEA report highlights the health inequalities that still exist within fertility treatment.

“It shows that there is a need for meaningful changes so that Black, Asian and ethnic minority fertility patients and their partners are not left behind in access to and experience of fertility treatment.”

In its latest report, the HEFA also highlighted disparities in the age that patients start treatment, Nargund said. Black patients in heterosexual relationships, for example, started fertility treatment about a year later than other ethnic groups at 36.

While NHS-funded IVF cycles among patients under 40 in heterosexual relationships were found to have decreased across all ethnic groups, the report found that funding decreased most among Black patients, from 60 per cent in 2019 to 41 per cent in 2021.

IVF was most used by white patients (77 per cent), with Black IVF patients accounting for three per cent of IVF patients compared to four per cent of the age-matched population, the same report showed.

The HFEA, the Royal College of Obstetricians and Gynaecologists, the British Fertility Society and Fertility Network UK have called for action to ensure that Black, Asian and ethnic minority patients and their partners are not left behind in access to and experience of fertility treatment.

“We know that fertility declines with age, and we are concerned the data shows that Black, Asian and ethnic-minority patients are left behind,” said Professor Nargund.

“A shared focus of all members within the sector is equalising treatment and hearing from the impacted groups to inform robust policy making.

“Increasing information awareness, addressing high-risk factors and further investigating health conditions such as endometriosis or fibroids, start the right conversations to begin to eradicate the disparities.”

She added: “The HFEA is committed to working together with other key bodies and healthcare professionals to ensure patients across all groups have better access to fertility treatment.”

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Insight

Natural Cycles receives sixth FDA clearance for fertility algorithm

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Natural Cycles has received its sixth FDA clearance for an updated fertility algorithm designed to personalise digital contraception.

The regulator cleared the company’s next-generation NC° Fertility Algorithm, which combines statistical modelling with machine learning to predict fertile and non-fertile days.

Natural Cycles said the algorithm was trained on tens of millions of real-world fertility data points and adapts to individual cycle patterns.

“People don’t just want effective birth control; they want a method that fits naturally into their lives,” said Dr Elina Berglund Scherwitzl, chief executive and co-founder of Natural Cycles.

“One of the unique advantages of a software-based contraceptive is that it can continue to evolve.

“As our scientific understanding of fertility grows and we continue to learn from more than a decade of real-world data, we can responsibly refine the technology through rigorous research, clinical validation, and FDA review.

“This latest clearance is the result of that work, helping us give many users more flexibility while maintaining the effectiveness they rely on.”

Evidence supporting the FDA clearance showed that the updated system maintained the app’s established safety and effectiveness while giving many users more Green Days.

Green Days are those on which the app confirms that pregnancy protection is not needed.

The birth control app remains 98 per cent effective when used as intended and 93 per cent effective with typical use, according to the company.

Natural Cycles said these rates place it in the same effectiveness category as the combined oral contraceptive pill.

Typical use includes mistakes or inconsistent use, while intended use means following the method correctly.

Digital contraception uses technology and physiological data, such as body temperature, to provide personalised fertility predictions.

Natural Cycles said its updated algorithm can identify fertile and non-fertile days more precisely than traditional fertility awareness methods, which may classify larger parts of the cycle as potentially fertile.

The changes provide more Green Days while maintaining effectiveness, improve performance for people with irregular cycles and better handle lower-quality temperature or biomarker data, the company said.

A biomarker is a measurable biological signal, such as body temperature, that provides information about processes taking place in the body.

Natural Cycles also said the system can personalise its predictions more quickly as a user’s menstrual cycle changes over time.

“Years ago, the question was whether digital contraception could work. Today, Natural Cycles has demonstrated robust clinical and real-world evidence that it can,” said Dr Kerry Krauss, senior medical adviser at Natural Cycles.

“The next chapter for digital contraception is making it more personalised and easier to use while maintaining the same high standard of safety.

“This FDA clearance demonstrates how advances in AI and machine learning can improve the user experience while preserving the scientific rigour expected of a regulated medical device.”

Natural Cycles has filed a patent application covering key innovations in the updated algorithm.

The decision follows the FDA’s first De Novo clearance of the company’s birth control app in 2018.

Later clearances allowed the app to integrate with the Oura Ring in 2021 and Apple Watch in 2023.

In 2024, the FDA cleared a Predetermined Change Control Plan, creating a regulatory pathway for future hardware integrations.

Natural Cycles said the plan has since enabled the launch of its NC° Band and other hardware integrations, including a Garmin connection introduced in March 2026.

A further clearance in 2025 allowed the birth control app to be offered both over the counter and by prescription.

The company has also received regulatory authorisations in more than eight markets worldwide, including Europe, Canada, Brazil, Australia, South Korea and Singapore.

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Insight

Experimental treatment significantly slows progression of fatal brain disease in women, study finds

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Davunetide may significantly slow the progression of a fatal brain disease in women, according to a new analysis of clinical trial data.

The findings indicate that women and men with progressive supranuclear palsy (PSP) may respond differently to the experimental treatment.

Progressive supranuclear palsy, or PSP, is a rare and fatal neurodegenerative disease.

Researchers at Tel Aviv University led the analysis and said the results reinforce the need for sex-specific approaches to neurodegenerative diseases.

Neurodegenerative diseases are conditions in which nerve cells in the brain or nervous system gradually lose function and die.

The team reanalysed data from a 52-week international clinical trial involving more than 300 people with PSP.

The disease is caused by the abnormal accumulation of tau protein in the brain. Tau is a protein found in nerve cells that builds up abnormally in people with PSP.

There is currently no effective drug treatment for the disease.

The work was led by professor Illana Gozes of the Sagol School of Neuroscience and the Gray Faculty of Medical and Health Sciences at Tel Aviv University.

The research team included current and former students Dr Guy Shapira, Jason Blatt and Liri Guz, together with professor Noam Shomron.

The original clinical trial found that Davunetide was safe but ineffective.

However, the researchers separated female and male participants and re-examined the data using updated assessment measures recommended by the FDA.

Women treated with Davunetide experienced a significant slowing of disease progression, while no similar effect was observed in men.

The treatment helped preserve essential movement and functional abilities, including balance, fine motor skills and everyday tasks such as using cutlery, buttoning clothes and washing the face and hands.

Fine motor skills are the small, precise movements needed for tasks involving the fingers and hands.

Treated women also showed significant improvements in language ability, working memory and overall cognitive function.

Cognitive function covers mental abilities such as memory, attention, language and problem-solving.

The analysis also identified profound molecular differences between women and men.

The relationship between levels of pathological tau in cerebrospinal fluid and clinical symptoms was completely reversed between the sexes.

Cerebrospinal fluid is the clear liquid surrounding the brain and spinal cord. A biomarker is a measurable sign that can indicate disease activity.

For example, language abilities declined significantly as tau pathology increased in women, but not in men.

The researchers said this suggests the disease mechanisms may work differently in women and men, potentially explaining their different responses to treatment.

According to professor Gozes, overlooking biological differences between the sexes may hide a genuine treatment effect.

“Our data show that analysing women and men separately is not merely a statistical exercise, but an essential tool for developing more effective treatments for neurodegenerative brain diseases,” she said.

The researchers believe the findings provide a strong scientific basis for future clinical trials and treatment protocols designed from the outset to account for patients’ sex.

These trials could evaluate Davunetide as a targeted treatment for women with PSP.

They said the approach may also pave the way for more precise treatments for tau-related diseases, including Alzheimer’s disease and other neurodegenerative brain disorders.

The study was supported by ExoNavis Therapeutics, which is developing Davunetide for brain diseases under licence from Ramot, Tel Aviv University’s technology transfer company.

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Pregnancy

UK research paves way for new preeclampsia therapies

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A preeclampsia study has found unusual cell activity in mothers and babies that could reveal new targets for treatment.

The condition affects 2 to 4 per cent of pregnancies worldwide and is a leading cause of maternal and foetal mortality.

There is currently no cure, and severe cases can put both the mother and baby at risk.

Scientists from UCL and University College London Hospitals found that stressed placental cells, poorly functioning blood vessels and an overactive immune response all contribute to the condition.

Preeclampsia causes high blood pressure during pregnancy. It can affect blood flow to the baby and cause symptoms such as swelling, headaches, blurred vision and pain under the ribs.

Without treatment, it can damage the mother’s health, slow the baby’s growth and, in severe cases, become life-threatening.

Previous research has focused only on the placenta, the organ that develops during pregnancy to support the baby’s growth, rather than the tissues around it.

The researchers said the findings could reveal new therapeutic targets, which are biological processes that future treatments could be designed to alter.

Senior author professor Sara Hillman, of the UCL EGA Institute for Women’s Health, said: “We studied individual cells from both the mother and the baby to see how their activity changes in healthy pregnancies compared with preeclampsia.

“This helped us to confirm some changes already suspected in the condition and also discover new ones.”

The team studied 20 pregnant women recruited at UCLH, including 10 with severe preeclampsia and 10 without the condition.

They used genomic testing to examine individual cells in the placenta and other tissues where cells from the developing baby and mother come into contact.

Genomic testing examines genetic information to help researchers understand how cells behave and the roles they may play.

The other tissues studied were the myometrium, the muscular layer of the womb, and the chorioamniotic membranes, which surround the baby during pregnancy.

The team compared cells from healthy pregnancies and those affected by preeclampsia at different gestational ages, meaning different stages of pregnancy.

They used technology that can read the genetic information of thousands of individual cells at the same time, allowing them to see what each cell was doing and where it was located in the tissue.

In preeclamptic pregnancies where babies were born prematurely, before 37 weeks, during the third trimester, placental cells showed signs of stress and low oxygen levels.

The cells also did not use energy in the normal way.

Some cells responsible for reshaping the mother’s blood vessels were not working properly, the researchers found, which may affect blood flow to the baby.

There were also signs of an overactive immune response in the placenta, nearby tissues and the mother’s blood.

The researchers said this response, together with other stress molecules released by the placenta, helps explain why preeclampsia affects the whole body and can become serious.

They hope the findings will help researchers find treatments for the condition and potentially save lives.

Co-lead author Dr Yara Sanchez Corrales, of the UCL Great Ormond Street Institute of Child Health, said: “These findings point to specific biological processes that could be targeted with treatments. Acting early in pregnancy, especially in more severe early-onset cases, could help improve outcomes and reduce the high risks associated with severe preeclampsia.

“We hope that our findings may set us on the path to reducing premature births and fatalities associated with preeclampsia.”

Co-lead author Mr Theodoros Xenakis, of the UCL Great Ormond Street Institute of Child Health, said: “Future studies may provide an even clearer picture of the biological changes linked to the disease by including more participants and using even more precise methods.”

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