The Past and Future of Fertility
The pandemic has put a disruption in many people’s lives, including those who are looking to start families. However, clinics across the UK have continued to work with people to help them on their journey to becoming parents.
TFP Fertility Group, one of the UK’s largest fertility services providers, has spoken with a few of their top experts to find out what the key trends in fertility were in 2021 and what their predictions are for 2022 and the next few years hold.
· Dr. James Hopkisson, Medical Director, TFP Fertility (Nottingham)
· Dr. Chantal Simonis, Consultant, TFP Fertility (Wessex)
· Dr. Marco Gaudoin, Medical Director, TFP Fertility (Glasgow)
What key fertility trends emerged in 2021?
Increase in same sex parenting
Dr. James Hopkisson, Medical Director, TFP Fertilty says ‘The increase in same sex parenting requires the need for donor gametes and surrogates. The demand for treatment is one that certainly is out stripping the provision of donor gametes. The pandemic initially has had an impact on donors coming forward however this has begun to pick up. The Fertility Partnership clinics are always trying to recruit donors through social media campaigns, advertisements and increasing the awareness for donors.
Concern over vaccine effects on fertility
Dr. James Hopkisson says ‘The obvious concern that many still have about uptake of the Covid vaccine and its perceived effects on fertility. TFP Fertility clinics have been promoting vaccination to all our patients who remain unvaccinated, explaining the benefits of vaccination, its safety and the risks of remaining unvaccinated in pregnancy. ‘
Dr. Chantal Simonis, Consultant at TFP Fertility says, 'There has been a marked increase in the number of women wishing to freeze eggs. The effect of social isolation during the pandemic has heightened anxieties about having children, particularly for our single patients. These prospective mothers have become worried about whether they will meet a partner easily, now that their social activities have been so curtailed. They also feel they have lost a year of trying to conceive, and the pressures of increasing age on their chances of conception has only served to increase their concerns.’
Dr. Chantal Simonis, Consultant at TFP Fertility, says ‘Couples and single women are wanting to investigate their fertility sooner rather than later. We have been seeing couples who have only been trying to conceive for a few months, but they wish to have sperm tests, AMH and sometimes tubal patency tests straight away, rather than waiting for a year. Many of them have expressed anxiety about another lockdown having a negative impact on access to fertility services, both for investigation and treatment. There is a noticeable increase in younger patients accessing private fertility services, due to the very long waiting times to be seen in local NHS fertility clinics. ‘
Preimplantation genetic screening
Dr. Chantal Simonis, Consultant at TFP Fertility says ‘Patients over the age of 40 years continue to form a large part of our work and pre-implantation genetic screening is a useful tool to screen out abnormal embryos and increase the chance of a successful pregnancy for these patients. Although PGS has not been given a green light on the HFEA traffic light system, there is continued research into this area, to hopefully highlight the benefits in this selected group of patients. ‘
Accessing fertility resources online
Dr. James Hopkisson says ‘Through the pandemic it has become clear that individuals have been using more online resources to get information about their reproductive health and the opportunities to investigate and plan their fertility journey. The pandemic has changed how we all work and video consultations have improved access, availability and the ease of discussing fertility. TFP Fertility clinics have embraced the use of webinars, the Dia App, and other on line resources to deliver easier access to fertility advice and treatment.
New advancements in technology and innovative techniques, processes, treatments to expect over coming years that will help people start families.
Dr. James Hopkisson and Dr. Marco Gaudoin say,‘A study that we are doing now: The VISA study: uses artificial intelligence and a learning algorithm to select out the best embryo for replacement. This study is using the state-of-the-art Embryoscope plus incubator and the technology with in the “Timelapse system” in all of the TFP Fertility clinics to help identify embryos with the best reproductive potential. ‘
One for the future: Non-invasive pre implantation genetic testing.
Dr. James Hopkisson says, ‘Hopefully we will see further advances in the assessment of the embryonic chromosome make up by assessing the DNA found in the culture media used to grow embryos. This hopefully will allow us to move away from the invasive technique of Pre - implantation biopsy of embryos. ‘
Predictions for 2022 and beyond for fertility in the UK.
Waiting Time Pressure
Dr. James Hopkisson says, ‘We will be needing to address the waiting times that have arisen due to the pressures placed on health services in the UK. There will be a significant backlog of work that will affect the investigation, referral, and treatment of patients with a delay in conceiving. Different areas of the United Kingdom will have different priorities when it comes to funding and the delivery of fertility care. Much of fertility treatment and IVF falls to the private sector to deliver care as such patient experience patient safety and satisfaction will be incredibly important. TFP Fertility is ideally placed with their network of clinics across the UK to deliver excellent patient care and timely evidence-based intervention for all patients needing advice and treatment to overcome subfertility. ‘
Treatment for ethnic backgrounds
Dr. James Hopkisson says ‘One key area that has been highlighted by the HFEA in 2021 has been the disparity in treatment for couples and individuals from diverse ethnic backgrounds. It has become clear that access to treatment needs to improve for those from a Black and Asian background. Success rates remain lower for people of colour having treatment and both medical and surgical strategies need to be individualised to improve success. The recruitment of both egg and sperm donors needs to be increased to help treat all. The TFP Donor bank has been successfully recruiting more donors from diverse backgrounds which will help us treat more people each year with our in-house donors, this is due to our wide network of clinics across the UK and the success of our marketing strategy. ‘
Treatment and funding for LBGTQ+ community
Dr. James Hopkisson says ‘The treatment of all from the LBGTQ+ community has increased over the last four or five years unfortunately there is still limited NHS funding for same sex parenting, the treatment of single women and those undergoing gender reassignment. It does at present sadly seems unlikely that access to funding will increase. TFP Fertility clinics are committed to making the ease of access to patients better providing information and cost-effective safe treatment. ‘
Transgender fertility preservation
Dr. Chantal Simonis says, ‘The increase in transgender people seeking fertility preservation options – with greater social acceptance, more transgender people are considering fertility preservation. We are already seeing more young people wanting to freeze eggs and sperm. Although a fairly low proportion go on to use their gametes, it is vitally important that they are given the opportunity to choose this option, in an environment that is inclusive and supportive. ‘
Stem cell therapy/primordial germ cells
Dr. Chantal Simonis says, ‘I think there is a remote chance we will see new research showing a benefit from stem cell therapy/primordial germ cells. Researchers in Japan have made eggs and sperm from mouse pluripotent stem cells (PSC), but this has not been achieved from human PSCs. It would be fascinating if it could be achieved though!’
Fertility benefits from employers
Dr. Chantal Simonis says, ‘BUPA is offering fertility benefits and I think other employers should consider offering fertility benefits. In the current financial climate, post pandemic, many people are struggling financially and fertility treatment can be a massive financial burden, particularly to younger couples/singles.
With a network across the UK and Europe of Fertility clinics, TFP Fertility has recently opened satellite offices in Edinburgh at Cosmedicare, 6 Lochside Place, EH12 9DF and in West London TFP West London Fertility at Ultrasound Direct, 10 Station Road, TW15 2UP as it continues to make fertility treatment more accessible across the UK.