Quick facts about fertility

Your treatment options This patient information includes details such as when a treatment is likely to be recommended, what the risks and costs are, and what the treatment involves.
The HFEA Guide to Infertility – This guide for people who are having, or considering, fertility treatment is also a useful source of information for anyone writing about these complex issues.

Scale of fertility problems

Infertility is defined as ‘failing to get pregnant after two years of regular unprotected sex’ by the National Institute for Health and Clinical Excellence (NICE).

Fertility guideline - NICE website

Infertility is the most common reason for women aged 20–45 to see their GP, after pregnancy itself.

Infertility is estimated to affect around one in six or one in seven UK couples – approximately 3.5 million people – at some point. Although the majority of these will become pregnant naturally given time, a significant minority will not.

Of 100 couples trying to conceive naturally:

20 will conceive within one month
70 will conceive within six months
85 will conceive within a year
90 will conceive within 18 months
95 will conceive within two years

Reasons for infertility

The following reasons for infertility were collected from patient registration forms for IVF treatment.

male factor - 32.5%
female factor - 32.5%
multiple male and female factors - 10.8%
unexplained - 23.1%
other factors - 1.1%

Fertility Facts and Figures 2007

Treatment abroad

The HFEA licenses and regulates clinics in the UK only. Clinics in other countries may, or may not, be regulated to local standards and regulations.

The EU Tissues and Cells Directive sets out standards of quality and safety that should be met within countries within the EU/EEA, but the HFEA recommends that in any case, would-be patients should research their chosen clinic thoroughly and ask about its standards of treatment and care. Important differences between treatment in the UK and abroad are:

standards of quality and safety
success rate reporting
patient confidentiality
donor anonymity and responsibility for offspring
complaints and legal issues
ethical issues such as payment to donors and limits on live births from a single donor
records of fertility treatment abroad using sperm, eggs, or embryos exported from the UK, which are not held on the HFEA Register
surrogacy arrangements where the child is born abroad
sex selection.

Donors and anonymity

Until 1 April 2005, people donating sperm, eggs or embryos could remain anonymous. They were asked to provide some non-identifying information which could be given to people choosing a donor for treatment, and to any person conceived using their donation (at age 18).

With a growing awareness of how important it would be for some donor-conceived people to find out more about their genetic origins, the Government lifted anonymity for donors in April 2005. This means that anyone born using donated sperm, eggs or embryos can obtain identifying information about the donor from the HFEA when they reach the age of 18.

Any woman sharing their eggs with another woman is also considered to be a donor, so the lifting of donor anonymity applies to them too.

Risks of treatment

Risks involved in fertility treatment can include reactions to fertility drugs that may be prescribed, and also the risks associated with any pregnancy. The main risks are:

Multiple births (twins, triplets or more) – the single greatest health risk associated with fertility treatment. For this reason, the HFEA has restricted the number of embryos that can be transferred in IVF to a maximum of two for women under 40; and three for women aged 40 or over who are using their own eggs (for those using donated eggs, the maximum is two because these eggs will be from donors who are not older than 35).

Multiple births carry risks to both the health of the mother and the unborn babies.
- The babies are more likely to be premature and to have a low birth weight.
- The risk of death before birth, or within the first week of life, is more than four times greater for twins than for a single baby.
- For triplets, the risk is seven times greater than for a single baby.
- The risk of cerebral palsy is five times higher for twins and 18 times higher for triplets than for a single baby.
Drug reactions – some women have mild reaction, such as headaches or nausea, to fertility drugs.
Ovarian hyper-stimulation syndrome (OHSS) – a potentially dangerous over-reaction to fertility drugs. A report for the HFEA in 2005, updated in 2008, found that severe OHSS occurs in approximately 1% of cycles.
Ectopic pregnancy – when an embryo develops in the fallopian tube rather than in the womb. The chances of having an ectopic pregnancy seem to be slightly higher in women having fertility treatment than those with a natural pregnancy.

Oneatatime website (risks of multiple births)
Risks of fertility treatment

OHSS - a short report for the HFEA (88Kb)

Funding

The typical cost of a cycle of IVF treatment alone is approximately £5000. This figure varies, depending on the consultations, drugs and tests that may be required for treatment. Procedures such as embryo freezing may also be charged separately.

The National Institute for Clinical Excellence (NICE) guidelines suggest that couples should be offered up to three cycles of IVF on the NHS if the woman is aged 23-39 years and the couple has an identified cause for their infertility, or have not conceived after 3 years. NICE recommend that it is appropriate to fund IVF treatment when the chances of success are more than 10%.

The Government has said that, from 1 April 2005, all women with appropriate clinical need should have at least 1 cycle of treatment paid for by the NHS. Local health bodies will apply their own eligibility criteria.

In August 2008, the Department of Health's’s expert group on commissioning NHS infertility provision is looking at the barriers to the implementation of the NICE fertility guideline.

Page last updated: 13 April 2009

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