New report from the HFEA

The HFEA has  launched its first-ever “state of the sector” report yesterday, providing an overview fertility treatment in the UK, including the success in reducing multiple birth rates to just over 10% of all IVF births.

The report, which brings together previously separate reports on incidents, inspection findings and patient feedback, records how fertility clinics and research laboratories performed in the financial year 2016-17 across a range of criteria. It is designed to give both clinics and patients a rounded view of the health of the UK’s fertility sector.

It shows that through working with the UK’s licensed clinics, the HFEA has reduced the national multiple birth rate from 24% in 2009 to 11% today, a fantastic achievement which has increased the safety of IVF for mothers and their babies and reduced the burden on NHS ante- and neonatal services. This has come without a reduction in birth or pregnancy rates, with the latter rising from 24% in 2008 to 32% today.

The report also shows that in 2016-17 there were 132 treatment and research clinics working under licence in this country, of which 34% are privately run, 29% are in public/private partnership, and 22% are NHS only (the remaining 15% are research only). During that same year the HFEA carried out 81 inspections as part of its yearly inspection cycle.

There is also specific focus on how patients experience treatment, and the new ways being developed to receive patient feedback and pass it on to clinics. A new star rating system has recently been launched on the HFEA website, giving patients the chance to rate their clinic directly and which has already been used over 700 times.

Sally Cheshire CBE, Chair of the HFEA welcomed this new report as a sign of open and healthy governance, and a continuing commitment to improving patient care:

“This report shows the full range of work, undertaken by both us and clinics, that lies behind the more than 76,000 treatment cycles performed in the UK each year, and outlines the importance of us working together to ensure patients, donors and the donor-conceived get the highest possible quality care.

“It is particularly pleasing to see that the multiple births rate has fallen consistently across the vast majority of the sector and is now very close to the 10% target we set for clinics some years ago, without a reduction in births. And it is heartening to be able to discuss with clinics real examples of patient experiences. It’s so important that patients have a voice, and I hope that the UK’s clinics will listen to what is being said.”

The report also details non-compliances, including adverse incidents, and areas for improvement. In many ways, there has been good progress, with fewer than 10 instances of non-compliance identified by inspectors in 14 main areas of the Code of Practice across all clinics in 2016-17. And of the 299 reported non-compliances overall (a slight rise from the previous year), almost all were resolved within the deadline set. This shows a sector that is open to constructive feedback and continuous improvement.

However, performance wasn’t all positive and the report reveals some areas for concern. The number of reported incidents increased from 497 in 2015 to 540 in 2016. Of these, 325 were categorised as ‘grade C’, 176 were classed as ‘grade B’, with one ‘grade A’ incident – the most severe.

Sally Cheshire CBE urged clinics to consider the impact incidents have on patients, and ensure Britain’s IVF sector maintains the highest standards:

“While the number of incidents and non-compliances must be placed in the context of the many thousands of treatments being performed in the UK each year, the fact is that all incidents, whatever the category, can be very upsetting for patients and must be avoided wherever possible. Non-compliances risk undermining the hard-won reputation for quality and rigour that the UK’s fertility sector has established over the last 25 years.

“In line with our commitment to open, frank and constructive regulation, we will continue to work with all our licensed clinics so that they strive to continually improve and maximise the chances of success for patients seeking their much longed-for families.”

The full report can be read on the HFEA website: https://www.hfea.gov.uk/

Fertility milestones

In support of National Fertility Awareness Week, the HFEA or Human Fertilisation and Embryology Authority which regulates the fertility sector, has published data which reveals some new milestones for UK fertility treatment.

More than 300,000 children in total have now been born in the UK from licensed fertility treatment since 1991. Fertility treatment has grown markedly since 2010, with almost a third of all IVF and DI babies since 1991 arriving in the last six recorded years (2010 to 2015).

The total number of treatment cycles carried out in UK clinics also passed a significant milestone in 2015, breaking through the million barrier. The overall number of treatments carried out since 1991 is 1,034,601.

The new data – drawn from The HFEA Register, the oldest and largest fertility database in the world – also reveals that fertility services are used mainly by younger women. The average age of women having fertility treatment is 35 years, which has remained largely static over recent years.

Treatments involving women aged 18-34 remain the largest single group, accounting for 43% of all treatments, while treatments for women aged 40 and over account for just 20% of all treatments with very few treatments being provided to women over 45.

Looking at the different regions in the UK, the data shows that most treatments continue to take place in London and the South East of England, accounting for 42% of all cycles. However, there is a strong representation of large northern clinics in the figures, with the North West now providing more treatments per clinic than any other region, including London. Total clinic numbers vary according to region, ranging from three in Northern Ireland to 22 in London.

HFEA Chair Sally Cheshire CBE welcomed this new data as a sign of a thriving and successful fertility sector: “The figures we have released today show that the UK’s fertility sector continues to be one of the most vibrant and successful in the world. Families using assisted reproduction services across the UK are better served than ever before, and we will continue to encourage all who work in the sector to offer the highest quality support for patients who are both successful and unsuccessful.”

Susan Seenan, chief executive of patient charity Fertility Network UK said “We welcome the publication during National Fertility Awareness Week of the new IVF milestones from the HFEA. The extraordinary growth of IVF in the last six years shows the pressing need for practical and emotional support and advice for the many people facing fertility issues. It is also significant to note that this data underlines that fertility services are used mainly by younger women – aged under 35 – who will have been trying for a baby for at least two years and often more. National Fertility Awareness Week is about challenging perceptions and we hope this helps to dispel any misconceptions about IVF and female age.”

Latest report on clinic incidents

4cell_embryo.tifThe fertility regulator, the Human Fertilisation and Embryology Authority, has just published its report on the number of incidents in fertility clinics. These incidents can be all kinds of things going wrong in a clinic from a patient suffering from hyperstimulation to a letter sent to the wrong person by mistake.

Incidents in fertility clinics are rare – they occur in less than one percent of the treatments performed in the UK fertility clinics – but each incident is one too many.

The HFEA’s annual report on fertility clinic incidents shows that the total number of incidents increased slightly but for the first time since the HFEA began publishing incidents reports, there were no A grade (the most serious) incidents reported at all.

HFEA Chair Sally Cheshire called on fertility clinics to substantially reduce the rate of incidents next year. She said “The UK’s fertility sector is one of the most developed in the world, and the high level of professionalism in the sector is highlighted by both the fact that fewer than 600 incidents were reported out of more than 72,000 treatments, and that no ‘grade A’ incidents were reported in the last year. We want to ensure clinics give patients the best possible treatment, so that they have the best chances of having the families they so dearly want. So, while incidents are already occurring infrequently, we want to see them reduce even further. I’m setting the challenge to all clinics in the UK to make sure that the overall number of incidents has decreased by this time next year. It’s not only ‘grade A’ incidents that can have an adverse effect on patients. All incidents, whether it’s a letter sent to the wrong address, or a case of ovarian hyper-stimulation, can have serious consequences for patients, and more has got to be done to make sure that fewer people are affected in the future.”

The report can be found here: www.hfea.gov.uk/9449.html.

Fertility Fest – when art meets science

images-6It will be the first event of its kind in the UK taking place in London and Birmingham, and it’s called Fertility Fest. The event, devised by writer Jessica Hepburn and producer Gabby Vautier, will bring together some of the country’s leading writers, visual artists, theatre-makers, film-directors and composers alongside some of the country’s foremost fertility experts for a day of performance, discussion and debate. Topics under the artistic microscope include facing the diagnosis of infertility, IVF, donation, surrogacy, the male experience, egg freezing, involuntary childlessness and alternative routes to parenthood.The full day of events concludes with a performance of a new play from award-winning writer Gareth Farr called The Quiet House about one couple’s journey when they enter the world of IVF.

Fertility Fest is in London on Saturday June 11 at the Park Theatre in Finsbury Park and in Birmingham on Saturday May 28 at Birmingham Repertory Theatre. The artists involved in the days include Aaron Deemer, Amanda Gore, Amy Rosenthal, Fergus Davidson, Fiona Duffelen, Gabby Vautier, Gareth Farr, Jessica Hepburn, Jo Ind, Jody Day, Julia Copus, Jude Christian, Kazuko Hohki, Katie Barlow, Louise Ann Wilson, Matthew Dunster, Paula Knight, Peter Guttridge, Stander Chohan, Ronke Adekoluejo, Sarah Esdaile, Somalia Seaton, Steve Ball, Tabitha Moses, Tina Reid-Persin and Yann Seznec. The experts in the field joining them for the day will include Professor Allan, Pacey, Professor Geeta Nargund, Laura Witjens, Professor Jacky Boivin, Janine Elson, Juliet Tizzard, Kate Brian, Natalie Silverman, Sally Cheshire, Dr Sofia Gameiro, Dr Sue Avery, Professor Susan Bewley, Professor Susan Golombok, Tracey Sainsbury and Victoria MacDonald.

Tickets cost £25 a day which include all workshops, talks and a performance of The Quiet House – for more details and booking, visit the website www.fertilityfest.com

Report on incidents in fertility clinics

images-6If you’re having treatment at a fertility clinic, you may be interested in a new report from the Human Fertilisation and Embryology Authority which looks at the number of incidents or mistakes that happen in the UK’s fertility clinics. It may sound alarming, but sometimes things don’t go exactly to plan and encouraging clinics to report to the HFEA when this happens can help them to prevent problems occurring in the future and to share experiences so that others can learn from what has happened too.

The new report shows that the number of incidents at fertility clinics is going down, and that they occur in less than one percent of treatment cycles.  However, that does mean a total of 465 occasions when something went wrong, and it can be distressing if this happens to you. Only two of these were in the most serious grade A category, and the largest group were in category C, the lowest grade, which might sometimes mean an administrative error, for example a patient being sent a letter meant for someone else.

The HFEA Chair Sally Cheshire urged clinics to use the practical help available from the HFEA to that we can offer to do more to improve patient care: “Whilst every incident that takes place is one too many, I particularly want clinics to concentrate on reducing their grade B and C incidents. Such mistakes are often distressing to patients, largely avoidable and frankly shouldn’t happen. The small reduction in incidents is a step in the right direction but more can and must be done by clinics, and we can help. Since our last report, we have worked with clinics to improve their systems and practices. For example, where clinics are struggling to recognise what changes need to be made to avoid future incidents, our clinical governance team offers bespoke incident training to individual centres. It is for clinics now to step up and make the necessary changes so that everyone affected by assisted reproduction receives the best possible care. I want to see these improvements realised by the time of our next annual report.”

You can download the report itself here