Below are some of my some of my reflections from reading the full report. Please note my comments are based on my own experience of treatment. Black people are not a monolith - I am not speaking for all black women. I don’t believe the ‘blanket’ approach for all has been working and I think the more visibility/voices we have of the nuances of our experiences the better we will be able to inform next steps for the HFEA, practitioners and all of us within our minority ethnic communities.
Furthermore, I recognise that my comments are sound bites and I know in reality more elaborate discussions have to take place. I also appreciate that more research will need to be done to get more of the granular detail which will paint a clearer picture of the various determining factors of the data.
A lot of women I have spoken to do not find the data surprising, with many telling me that they have been saying a lot of this stuff for a while – and that in itself says a lot. In any case, this was long over-due and it is great in some respects to finally have something tangible that hopefully will be acted on by all the actors in the fertility sector, including patients.
Black patients reported higher rates of tubal factor infertility, accounting for 31% of patient-based infertility compared to the 18% average.
Do you believe it is public knowledge – that infertility prevalence varies by ethnicity? If not, what actions would be helpful to get this information to patients? i.e. info from GPs; charities; HFEA?
Black patients generally started IVF at later ages than other ethnic groups at an average age of 36.4, compared to the national average of 34.6 in 2018.
What are your thoughts on why Black patients are starting treatment later than the average patient?
What are actions that we as the regulator (or the fertility sector as a whole) should be taking to reduce any external factors that may play a role in delaying fertility treatment among Black patients?
Black patients had lower IVF birth rates: for Black patients aged 30-34, the birth rate per embryo transferred was on average 23% compared to Mixed and White patients at 30% from 2014-2018.
Is there an argument to provide tailored success rates to patients based on their ethnicity following our findings?
Multiple births are the single biggest health risk in fertility treatment for patients and babies. This includes increased risk of miscarriage, high blood pressure, pre-eclampsia, gestational diabetes, c-section and a 2.5 times increased risk of maternal mortality for patients. In the report, Black patients had the highest multiple birth rates of any ethnic groups at 14%, compared to a national average of 12% from 2014-2018. We also know that there is a higher prevalence of maternal mortality among Black women (5 times higher than that of White women).
Do you think patients are likely to agree with whatever is recommended by the clinic? Are patients provided with enough information from the clinic to weigh out the risks involved when making the final decision?