Infertility. In 2023, it remains a health ‘taboo’, yet it’s something I see all the time in my practice as an NHS GP. And it’s much more common than people think: 1 in 6 of us will experience infertility at some point in our lives. But for those struggling to conceive, alongside a severe lack of information and understanding, there is a significant gap in access to affordable and effective care.

Despite the large number of people who we know struggle to conceive, fertility care provision in the UK is sorely lagging behind. Those seeking support with infertility face a minefield of hurdles and barriers.

On the NHS, access to care is dependent on where you live, with a postcode lottery meaning treatment options and wait lists vary significantly across different regions. Data also shows that NHS funded IVF fell by 17% between 2019-2021, limiting available treatment even further. This leaves many prospective parents no choice but to turn to private clinics. But inhibitively high costs lead many into debt, while leaving others unable to undergo treatment at all.

The situation is even worse for minority groups, including single parents, LGBTQ+ couples and those undergoing secondary infertility. Access to treatment such as IVF frequently requires people to meet numerous and stringent thresholds. Until changes proposed in the Women’s Health Strategy come into play, same-sex female couples must self-fund six rounds of Intrauterine Insemination (IUI) before they can access IVF on the NHS (heterosexual couples need to have been trying to conceive naturally for two years to qualify for the same treatment).

This inequality in access to support, and the significant gap between demand for and availability of affordable and effective care, makes fertility a space that is ripe for innovation. New solutions and technologies are desperately needed to help bridge the fertility gap and meet the growing need for care and support services. Innovation also has a vital role to play in making fertility care more inclusive, breaking down the discriminatory barriers that currently leave minority groups at an even greater disadvantage when accessing care.

Luckily, we’re seeing this call for innovation being answered. There is no shortage of pioneering initiatives emerging to help fix the fertility gap. Not only does this next wave of innovation promise to improve the efficacy of and access to fertility treatment, but new technologies are also making it easier to generate broader and more diverse fertility data, which is vital for improving future knowledge and care.

Advancing clinical capabilities 

A great deal of innovation is focused on advancing the accuracy and capability of clinical fertility procedures. These tools are helping improve our understanding of the causes of infertility, as well as broadening treatment options for those who require medical intervention.

Most notably, the UK recently celebrated its first ever successful womb transplant. This pioneering technique promises to unlock new opportunities for those born without a uterus, or who have had to undergo hysterectomy, to carry their own children. It’s a watershed moment which demonstrates the power of ongoing innovation for unlocking new potential for patients.

Other clinical advancements include the introduction of three-person IVF. Having become the first country to legalise the procedure back in 2015, this year the UK saw the birth of its first baby using three people’s DNA.

Empowering patients to take fertility into their own hands

Outside the clinic, a wealth of innovation is also placing greater power in prospective parents’ hands. Earlier this year, the UK’s first ever clinical grade at-home fertility treatment was launched by UK company Béa Fertility. By reviving an existing fertility procedure – called Intracervical Insemination (ICI) – it’s enabling those struggling to conceive to safely perform artificial insemination in the comfort of their own home. With no hormonal stimulation involved, it’s reducing the risks and side effects for those undergoing treatment, and providing a less invasive, more accessible and cost effective step on their fertility journey (Béa’s treatment is twenty times cheaper than IVF).

With the Cost of Living crisis making clinical procedures, such as IVF and IUI, even less affordable, safe access to cheaper alternatives, such as ICI, is only gaining in importance. By expanding fertility care outside of the clinic, innovations like these are also increasing accessibility for those struggling with stigma, by offering a more discreet and less invasive treatment option and giving people greater control over their fertility journey.

Encompassing the whole fertility journey 

Innovation is also recognising the need for holistic, wraparound fertility support. It’s not all about the physical treatment – those struggling to conceive are also in great need of community, information, and wellbeing support.

We’re seeing significant progress in solutions arming patients with the tools to test and understand their own fertility. At-home sperm testing kits are becoming increasingly sophisticated, supporting couples to explore the potential causes of infertility in a safe and comfortable environment. This is particularly important for its role in improving the visibility of male-factor infertility. Data shows public perception still sees fertility as a women’s problem, despite half of fertility problems originating in a male partner.

Fertility tech is also breaking new ground by entering the workplace, with access to fertility benefits becoming a growing concern for employers. Technology is helping provide virtual support services, connecting people with the right care and providing them with the knowledge to make the best decision for their own personal health.

Closing the fertility care gap is vital to ensuring that patients are able to safely and affordably start their own families. Technology is key to unlocking new treatment options, empowering individuals to take control of their own fertility and providing the community and support they so desperately need. We’re only just seeing the baby steps of what is possible with fertility tech. I’m excited to see what comes next.

By Dr Hannah Allen – NHS GP

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