“There is a need for greater diversity in egg and sperm donors,” says Dr Thanos Papathanasiou, Medical Director for Bourn Hall, who was speaking after the publication of findings by a HFEA report ‘Ethnic diversity in fertility treatment 2018’, showed that eggs from white donors were used in 52% of cycles with an Asian recipient.
The research found that although Asian people make up only 7% of the UK population, 14% of IVF patients were of Asian descent, suggesting higher levels of infertility in this group. However, there were proportionally smaller numbers of Asian egg and sperm donors and fewer Asian patients had accessed donor gametes.
Shortage of donors
The HFEA reports lower national success rates for Black and Asian patients.
Dr Papathanasiou comments: “The recent HFEA report highlights that some ethnic groups are less likely to have a baby through fertility treatment. However, it does not provide conclusive answers as to why this is the case.
“Some groups may have personal or cultural reasons for not seeking treatment with donor eggs or sperm, and this may reduce the number of treatment options available to them. However, there is also a need for greater diversity in sperm and egg banks. This would give some ethnic groups greater access to donor sperm or eggs that match their characteristics.
He also considered there might be medical issues: “There are also some conditions that are more common in certain ethnic groups, such as tubal problems or fibroids for Black populations. Clearly, we need more real-life research to confirm if and how much these may contribute to lower chances of having a baby with fertility treatment.”
Black patients often older
The HFEA research found that Black patients tended to start treatment later than other ethnic groups, at an average age of 36.4 compared to the national average of 34.6 in 2018, and were more prone to blocked fallopian tubes and fibroids.
In natural conception the sperm would fertilise the egg in the fallopian tubes so blocked tubes are a common cause of infertility. Fibroids are non-cancerous growths that develop in or around the womb (uterus) that are made from muscle and fibrous tissue, and vary in size. Although not always the case, fibroids can sometimes prevent a fertilised egg attaching itself to the lining of the womb, or prevent sperm reaching the egg.
Devastating impact on lives
Speaking about the report, Dr Christine Ekechi, Co-Chair of the Royal College of Obstetricians and Gynaecologists’ Race Equality Taskforce, said: “It is disappointing but not surprising to see healthcare inequalities for Black, Asian and minority ethnic women extend to every corner of their lives, including sadly for those who desire to have a baby.
“We know that infertility can have a devastating effect on people’s lives, causing distress, depression, and the breakdown of relationships. It is therefore essential that we begin to understand the factors contributing to these poorer outcomes in this particular group of women.
“This HFEA report is vital in understanding the barriers faced by women from ethnic minority backgrounds. What is now required is a combined effort to provide solutions.”
Increasing diversity of donor eggs and sperm
Dr Papathanasiou agrees and says that research is urgently required to explain why there is a difference in success among ethnic groups.
“We would suggest, in the light of these findings, that clinics and regulators should consider recording and reporting performance indicators according to ethnicity. This would allow couples from all ethnic groups to better understand their chances of having a baby with fertility treatment.
“This may also highlight the need for more donors to come forward from certain ethnic groups.
“However, the greatest predicator of success after IVF is the woman’s age. Therefore, raising awareness about the report’s findings may encourage couples that want children to avoid delaying trying to conceive or to seek medical help earlier if they are not getting pregnant within a year or two.”