Fertility Care in the UK
Fertility care in the UK is a bit of a minefield. Depending on your postcode, your access to care varies. I believe we should view fertility care as essential healthcare considering the prevalence and significance, the impact on both the individual and society, as well as the ethical responsibility to support both couples and individuals trying to build their families.
Infertility is a global issue affecting 1 in 6 couples (WHO, 2023), with 52,400 patients receiving over 77,500 In Vitro Fertilisation (IVF) cycles in 2023 (HFEA, 2025). In 2021, the European Parliament framed infertility as an essential aspect and sexual and reproductive rights (European Union, 2021). This framing of fertility care as a right is an important thing to note, as this implies a moral, ethical demand for well-funded fertility care.
Restricting fertility care affects both the individual and the boarder society.
For women, we know there is a 9-fold risk on depression following infertility, as well as lower self-esteem, sexual satisfaction and higher risk of anxiety (Fallahzadeh et al, 2019) (Zayed & Eldidy, 2020). This suggests that failure to access appropriate fertility care could alter the life course mental and physical health of these women substantially.
Declining birth rates in the UK provide a long-term challenge to the workforce, with concerns about how an aging population will fund public services (Scripps & Webb, 2025). Therefore fertility care that would intern increase birthrate should be seen as an investment. Cost of fertility care is often the reason stated for limiting access however Kawwass et al argues that the defence to limiting fertility care due to cost is unfounded, especially when this is compared to other healthcare procedures (Kawwass et al, 2021).
Marginalised groups face greater barriers to care, especially those building families outside of hetero norms. As per the South East London Integrated Care Board, patients trying to conceive using doner sperm and/or through artificial insemination require an amount of self-funded Intrauterine Insemination (IUI) before being able to access NHS IVF (South East London Integrated Care Board, 2024). It was found that 16% of female same-sex couples and 18% of single patients had NHS funding for their first IVF treatment compared to 52% of opposite-sex couples (HFEA, 2024). This demonstrates the higher financial burden of fertility care for same sex couples and single people. Providing broader care benefits marginalised groups, with evidence showing that broader fertility care is shown to reduce racial disparities in access to care (Dieke, 2017).
Given the data, it could be argued that there is an ethical responsibility to broaden and expand the UK fertility care offering. This will benefit the individual, respect their reproductive rights and improve their life course. It will help to tackle the long-term societal work force crisis and reduce healthcare disparities.
References
Dieke, A. et al (2017) Disparities in Assisted Reproductive Technology Utilization by Race and Ethnicity, United States, 2014: A Commentary Journal of Women’s Health, 26, 6
European Union (2021) REPORT on the situation of sexual and reproductive health and rights in the EU, in the frame of women’s health Publications Office of the European Union (OP)
Fallahzadeh H, Zareei Mahmood Abadi H, Momayyezi M, Malaki Moghadam H, Keyghobadi N (2019) The comparison of depression and anxiety between fertile and infertile couples: A meta-analysis study. Int J Reprod Biomed 17:153362.
HFEA (2025) Fertility treatment 2023: trends and figures. Human Fertilisation and Embryology Authority
HFEA (2024) Family formations in fertility treatment. Human Fertilisation and Embryology Authority
Kawwass, F. Penzias, A. Adashi, E. (2021) Fertility—a human right worthy of mandated insurance coverage: the evolution, limitations, and future of access to care Fertility and Sterility, 115, 1
Scripps, E. & Webb, L. (2025) Impacts of birthrate decline. UK Parliament POST, 745
South East London Integrated Care Board (2024) South East London Fertility Policy SEL ICB Executive
WHO (2023) WHO Infertility prevalence estimates 1990-2021. World Health Organization, Geneva.
Zayed, A.A., El-Hadidy, M.A. (2020) Sexual satisfaction and self-esteem in women with primary infertility Middle East Fertil Soc J 25, 13
