The regulatory body for fertility treatment in the UK, The Human Fertilisation and Embryology Authority (HFEA), has been diligently collecting data on fertility treatments since 1991. Over the past three decades, the landscape of fertility treatment has undergone significant transformations. This is what their latest report on trends in fertility treatment say, and our take on these trends.

TL/DR

Over the past 30 years, fertility treatments have seen significant changes. Fresh IVF cycles have decreased, while frozen cycles have surged, thanks to advancements like vitrification. The uptake of embryo and egg freezing has also risen dramatically, reflecting both technological progress and societal shifts.  This post offers insights into these trends and provides key questions to ask your clinic, ensuring you're informed and empowered on your fertility journey.

Fresh vs. Frozen Cycles

Figure 1 compares the uptake of fresh and frozen IVF cycles over the years. Historically, fresh embryo transfers were standard practice for almost all cases of fertility treatment. However, there has been a noticeable shift towards frozen cycles in recent years. In fact, since 2011, fresh cycles have decreased by 13% while frozen cycles saw a staggering 194% increase. This trend is a reflection of our understanding of the uterine environment which has improved in recent years and our confidence in embryo freezing techniques and better stimulation. It turns out that synchronisation of the uterus with the embryo is a key factor in implantation. In other words, the embryo and the uterus need to be in the same time zone for implantation to take place. Getting that timing correct is a bit difficult in a fresh cycle as the embryos restrict us as to when they have to go back into the uterus.

In frozen cycles, there's less external hormonal disruption from injections. Some clinics even attempt to time the embryo transfer with the natural cycle, while others opt for minimal interventions. The uptake of vitrification by the majority of UK clinics around 2011 as the method for cryopreserving embryos marked a pivotal moment. Vitrification turns cells into a glass-like state, reducing the chance of ice crystal formation, which can cause cell death. This method has a staggering 97% survival rate for embryos, a significant leap from the previous 80% survival rate with slow freezing.

Comparison of trends in fresh versus frozen cycles (1991-2021)

Figure 1- Comparison of trends in fresh versus frozen cycles (1991-2021)

Embryo Storage cycles

It comes as no surprise that with the mass uptake of vitrification, we have seen a rise in embryo storage cycles as well (Figure 2). In fact, embryo storage cycles have seen a 4561% surge since 2011. Vitrification, which is also described as rapid cooling, takes between 3-12 minutes. This contrasts starkly with the slow-freezing method that could take up to three hours for a single embryo. This efficiency not only improved survival rates but also enhanced laboratory staff efficiency, making the process less resource-intensive.  

Comparison of trends in embryo storage cycles (1991-2021)

Figure 2- Trends in embryo storage cycles (1991-2021)

Egg Freezing Cycles

The trend in egg freezing has also seen a surge, especially in recent years, as depicted in Figure 3 by a sharp 1030% increase since 2011. This rise can be attributed to a societal shift. More women are now taking control of their reproductive timelines, choosing to delay childbirth for various personal or medical reasons. This trend has been further amplified by increased public awareness of fertility. Conversations around fertility have become more mainstream, with several celebrities, including Kaitlyn Bristowe, January Jones, and Rita Ora, openly discussing their decisions to freeze their eggs. Such candid conversations have played a role in destigmatizing fertility treatments and making them more accessible.

Comparison of trends in egg freezing cycles (1991-2021)

Figure 3- Trends in egg freezing cycles (1991-2021)

Why understanding these trends is important

Navigating the vast landscape of fertility can often feel overwhelming. Yet, with every piece of data we've shared today, we aim to demystify this journey, offering you a clearer roadmap. These figures and trends aren't just statistics; they represent real choices, advancements, and the collective progress we've made in the realm of fertility treatments.

To our community, this post is more than an informational piece. It's a tool, a compass, guiding you through decisions and sparking informed conversations. The shifts in fertility treatments, the rise of certain procedures, and the evolution of techniques all have a role to play in your own personal journey. You can leverage that information by understanding where your clinic stands when it comes to the latest treatments and techniques. Ask your clinic the following questions, and remember, clinics approach treatment differently, but the most important thing in your journey is that you are treated as an individual, and not just another number.

Q1. Would you recommend a fresh or frozen embryo transfer for my specific situation? And why?

Q2. How does the success rate of frozen cycles compare to fresh cycles in recent years?

Q3. Does the clinic use vitrification to cryopreserve embryos/eggs?

Q4. What is the survival rate of embryos/eggs post-thaw?

Q5. What are the costs of treatment? What other costs can arise throughout my treatment?

We hope you find this post informative. If you would like to see more posts like this, please let us know in the comments, and don’t forget to share this article to help others on their journey.

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