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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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Cancer

Federal gov should fund drug to treat breast cancer and endometriosis, Aus committee says

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Australia’s drug advisory committee has recommended wider funding of triptorelin for women with breast cancer or endometriosis.

The recommendation comes after AstraZeneca announced plans to remove Zoladex from the market, risking leaving more than 7,500 women with breast cancer without an alternative treatment.

Both medicines block the release of oestrogen and testosterone and can be used as part of treatment, or for fertility preservation, in some forms of cancer.

The Pharmaceutical Benefits Advisory Committee met urgently in July and recommended making triptorelin unrestricted under the Pharmaceutical Benefits Scheme (PBS), which would mean it was funded for all uses.

The drug has been listed on the PBS for prostate cancer since 2006.

Triptorelin and Zoladex can also be used to treat endometriosis and to block puberty for either precocious puberty or gender-affirming care.

Vicki Durston, director of policy and advocacy at Breast Cancer Network Australia, described the recommendation as “a significant step forward” and said access to the medicine could mean the difference between life and death for some patients.

She said some women had already chosen to have their ovaries removed because of uncertainty over Zoladex supplies.

Marilla Druitt, Victorian state chair of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, said it remained unclear whether triptorelin would work exactly the same way as Zoladex, but the recommendation was likely to be positive for patients with endometriosis and pelvic pain.

She said: “I’m glad we’ve got an alternative.”

“That’s fantastic, and it remains to be seen whether or not it will be as good, but pain is so complex, pain is a really hard thing to study because it’s got so many contributors.”

Druitt said further research would be needed after the medicine was introduced.

If accepted by the federal government, the recommendation would also allow PBS funding of triptorelin for puberty suppression in precocious puberty and gender-affirming care.

This would make gender-affirming care federally funded through the PBS for the first time and would remove a financial barrier for transgender children in Queensland and the Northern Territory.

Stuart Aitken, medical director of Gender Health Australia, said the recommendation had sparked “absolute joy” among his patients.

He said: “It takes away a huge barrier to accessing evidence-based care.”

“It means that the ban has a very limited effect.”

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Insight

Benchmarking 2027: Shifting priorities in US health infrastructure

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By Women’s HealthX

As healthcare organisations navigate tightening compliance mandates, evolving reimbursement frameworks, and shifting health economics, the single most critical asset for leadership is operational visibility into what their industry counterparts are executing right now.

Ahead of the Women’s HealthX marketplace in Boston this December, a cross-functional steering committee of health plans, hospital networks, biopharma innovators, and enterprise employers has launched the definitive 2026 U.S. Health Infrastructure Survey.

The objective of this brief, multi-state index is to bypass abstract market fluff and map out exactly how the country’s elite healthcare stakeholders are practically structuring their 2027 budgets, clinical protocols, and technology procurement guidelines.

Some of the questions we are asking:

  • Health Plans & Payers “What is the biggest operational barrier to expanding women’s health coverage?”
  • Health Systems & Providers “What is the biggest women’s health priority for health systems over the next 24 months?”
  • Pharma & Life Sciences “What is the biggest commercial hurdle facing women’s health innovation?”
  • Employers & Benefits Leaders “Which women’s health challenge creates the greatest workforce impact?”

By contributing just 60 seconds of your operational insight to the index, you will ensure your specific sector’s parameters are accurately represented.

In return for your participation, you will secure a priority, pre-ordered copy of the completed 30-page intelligence report when the final data drops this September!

See where your direct peer groups are drawing their line in the sand for the upcoming fiscal year.

Contribute 60 seconds and pre-order your national benchmark report

Women’s HealthX 2026 | From Rhetoric to Results

Encore Boston Harbor | December 3-4 2026

Bypass abstract market rhetoric to evaluate real-world health economics, regulatory compliance mandates, and care delivery systems.

Join the region’s foremost health plan medical directors, hospital COOs, biopharma innovators, and enterprise benefits buyers anchoring our 2026 tracks.

Review full agenda

Meet confirmed speakers

Secure your pass

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Opinion

Why health AI needs to read between the lines

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Sahar Abid is a Science Associate at Ema EQ, where she works on cultural sensitivity and bias in AI.

A woman asks an AI health assistant about postpartum depression.

She mentions that her in-laws are telling her to “push through” and skip medical help, even as her symptoms get harder to manage. She never says where she is from or names her background.

The assistant describes the condition and gives her a hotline number. It sounds correct, but it misses what she needs.

That gap is more common than the industry admits, and it points to a blind spot in how we test health AI for bias.

Most bias testing looks at what people explicitly say.

The typical way to check an AI for bias is to label a prompt with someone’s demographic details and see if the answer changes. That catches some problems but misses a bigger one.

Most people do not lead with their identity. They lead with their situation. The woman above told the assistant everything it needed to help her, just not in the form of a label.

Her real question was not only “what is postpartum depression?” It was “how do I get care when the people around me don’t want me to?

When family members hold sway over health decisions, and in many communities they do, advice that asks someone to overrule their family is not something they can act on.

The AI didn’t say anything factually wrong. It answered a different question than the one she was living.

We call this culturally implicit bias, meaning the AI misses the cultural context a situation implies rather than the context a person spells out.

When systems are trained to notice only the explicit cues, they fall back on a default answer built for the majority. For everyone else, the response can feel generic, off-target, or discouraging enough that they stop looking for help.

In health, that is not small. The people most likely to be missed are often the ones the system already underserves.

What we set out to test.

At Ema, we wanted to know how well AI picks up on cultural context that is implied but never stated. So we built our own way to test for it, across a range of communities and real situations like postpartum depression and fertility, using questions that carried cultural meaning without announcing it.

The patterns were consistent. Models often missed the meaning underneath the question. They dropped the specific details a person did share and smoothed them into something generic.

And even when they pointed toward real care, they tended to offer one option instead of choices that might actually fit a person’s life. Any one of those can be the difference between someone following the advice and walking away from care.

Why this matters for anyone building health AI.

Getting this right is the right thing to do, and it also works better.

When an answer reflects a person’s real context, people trust and act on the recommendations more, so they get the help and support they need.

Testing for it is harder than the shortcut most teams use. Swapping a name or a demographic label in and out is easy. Checking whether a model actually understands the human context around a question takes more care.

The shortcut teaches models to perform cultural competence instead of practicing it. No matter how much or how little someone chooses to share, they deserve an answer that is warm, complete, and usable.

A better question.

The bar for equitable health AI should be “does it serve someone who never told you who they are?” It is the harder test, but it determines whether real people get help.

The work of getting there is far from finished, and it is exactly what we are building toward at Ema.

Sources: Naidoo, V., & Chadha, K. K. (2025), Culturally responsive AI chatbots: from framework to field evidence, Computers in Human Behavior: Artificial Humans. Souligne, N., & Subbian, V. (2026), FairLogue: A toolkit for intersectional fairness analysis in clinical machine learning models.

Learn more about Ema EQ

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