Uma and Sudhir* have recently decided to remain childless after three failed rounds of IVF over 5 years. Though the doctors could not really explain what led to their infertility and what caused the failed rounds of IVF or embryo transfers, the couple is clearly left with no money, after spending over 30,000 pounds for private treatments.
Speaking to Asian Voice, the couple said, “When we see couples with children and family, we feel inadequate. Our friends and families often do not include us in their plans, because we do not have children. But there is no answer to the loss we are facing. It is hard for people with a family to realise the grief we are going through.”
Last week a new report published by the Human Fertilisation and Embryology Authority (HFEA) shows that people from ethnic minority backgrounds undergoing fertility treatment are less likely to have a baby, with Black patients having the lowest chances of successful 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 if needed. The report shows that 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 even an Asian patient.
While overall birth rates from fertility treatment have increased and are highest in patients under 35, Black patients aged 30-34 have an average birth rate of 23%, compared to 30% for Mixed and White patients, new data from the FEA shows.
The findings also confirm the prevalence of certain conditions amongst ethnic communities – including tubal damage and fibroids amongst Black women and polycystic ovaries and ovulation issues amongst Asian women – and the need for more targeted education and early treatment programmes to address these and reduce their negative impact.
Alpesh Doshi, Consultant Embryologist and Founder at IVF London said that fertility treatments are seeing a rise, though Covid-19 has added an extra layer of stress on those who are either actively trying to conceive or wanting to meet a partner and think about starting a family. He told Asian Voice, “Many Asian women have chosen to freeze their eggs due to the uncertainty of meeting a partner during the lockdown whilst others have taken the bold step of trying to have a child as ‘single women’ using donor sperm. Whilst the country embarks on one of its largest vaccination drives, fertility clinics continue to see an exponential rise in fertility treatments and also Fertility Wellness checks.”
Concerns – health and economic
While cultural pressure is one of the key concerns among couples, affordability is another huge problem, as the pandemic dries up financial resources or supports.
Seetal Savla a current DEVIF (donor egg IVF) patient, fertility advocate and freelance writer told Asian Voice, “South Asian culture sees parenthood as the ultimate symbol of success and therefore places constant pressure on newlywed couples to conceive. But instead of suffering in silence, couples could use this opportunity to respectfully educate their elders about fertility issues, the different options available to start a family and explain what their chosen route entails in order to foster more understanding and empathy towards them and others in similar situations. If we do not attempt to improve our elders’ knowledge, attitude and behaviour if we are in a position to do so, how can we ever expect anything to change?
“Navigating infertility is extremely difficult because your body’s limitations can make you feel like a failure, which can lead to shame, embarrassment, guilt, anger and grief. If women cannot or do not want to discuss these emotions with anyone, they will become isolated, and their mental health will suffer. If talking to others is impossible, they can seek solace and support from reading about or hearing others’ stories on fertility podcasts, apps, social media (particularly via #TTCCommunity (Trying To Conceive) on Instagram) and blogs. More South Asians are sharing their experiences online and their experiences will be relatable and informative.”
Dr Geeta Nargund, a senior consultant gynaecologist at the NHS and Medical Director of CREATE Fertility believe the high cost of access to treatment must also be addressed by making IVF more affordable. She added, “HFEA report highlights the stark inequalities faced by ethnic minority communities.
“In tackling the HFEA’s findings a key tool will be driving education and awareness, encouraging ethnic women and couples to seek earlier diagnosis as a means of increasing potential success of treatment. The high cost of access to treatment must also be addressed by making IVF more affordable for all and ending the current postcode lottery for NHS funding for those who need it.”
“With those in ethnic minority communities having a greater reliance on NHS funded treatment, the continued postcode lottery for NHS funding in IVF disproportionately impacts ethnic minority women and couples. For those who cannot access NHS funding they are more likely to have to spend time saving to fund IVF privately, and this delay risks a further decline in fertility and a reduced rate of success.
“There is also a need to optimise lifestyle factors that are a result of socio-economic inequality; for example, ethnic minority patients often report higher obesity rates that are well known to directly impact fertility outcomes. Cultural issues can also play a part as stigma’s associated with infertility put some women and couples off seeking help and treatment early enough.”
Professor Nicky Hudson, Professor of Medical Sociology, Centre for Reproduction Research, De Montfort University told Asian Voice, “Research I have conducted at De Montfort University highlights how members of South Asian communities may have particular challenges to face if they are having problems conceiving…Experiences of infertility are challenging regardless of a person’s ethnicity, but the latest data show that important discrepancies exist in access to treatment and care that urgently need to be addressed.”
Dr Christine Ekechi, Co-Chair of the Royal College of Obstetricians and Gynaecologists’ Race Equality Taskforce, said, “This HFEA report is vital in understanding the barriers faced by women from ethnic minority backgrounds when trying to start a family. What is now required is a combined effort to provide solutions to include better awareness, safeguarding of reproductive health and improving the availability of targeted options for fertility treatments. We owe it to Black, Asian and minority ethnic women to give them an equal opportunity to starting a family, and to provide the solutions that will help them achieve this dream."
(*Name changed to protect identity)