The National Patient Survey 2021, by the Human Fertilisation & Embryology Authority (HFEA), reveals that 72% of fertility patients were satisfied with their care. However, they were least satisfied with the level of support available, such as access to counselling (62%) and their partner’s involvement (70%).
The National Patient Survey, which explores the entire patient journey from accessing GP services, through to patients’ most recent experience of treatment, aims to identify changes in the fertility landscape since the first survey in 2018. The survey will inform the work of the HFEA; helping it achieve its objective of providing high-quality care for everyone using the UK’s fertility service.
The National Patient Survey 2021, which surveyed 1,233 of the UK’s fertility patients between 2 November and 7 December 2021, found:
• Overall satisfaction: Seven in ten (72%) patients were satisfied with their latest experience of fertility treatment (down slightly from 75% in 2018), with patients most positive about the clinic environment (87%) and being treated with dignity and privacy (87%) despite pressures of Covid-19.
• Experience of GPs: Around four in five (78%) patients spoke to a GP prior to starting treatment, usually within one to two years after first trying to conceive. However, less than half (47%) were satisfied with their experience of doing so.
• Clarity of information: Consent forms for treatment were particularly clear (93%), followed by clarity of the treatment plan (83%) and what to do if there was a medical issue or emergency (79%). Fewer (68%) felt that their own chance of success had been made clear.
• Multiple births: Three in ten (30%) had a multiple embryo transfer during any of their treatments, with most doing so on clinic advice. 69% said the clinic discussed the risks associated with multiple births.
• Donation: Around three in ten (28%) had used donated eggs, sperm or embryos, with donated sperm most common. Although a quarter (25%) found them difficult to access. Those who had used donor eggs, sperm or embryos said it was important that the donor’s ethnicity matched their own (82%).
• Treatment add-ons: Two-thirds of patients (65%) had used a treatment add-on, with acupuncture most common (33%). Of those using an add-on, less than half (46%) felt the cost was clear, or that the clinic explained the likely effectiveness of the add-on at increasing the chances of having a baby (46%). A third (33%) said that the clinic had explained the potential risks(s) of the add-on.
Around 53,000 patients a year in the UK access fertility services, and for many, it’s often one of the hardest times of their life. For some patients, Covid-19 has exacerbated this experience further; halting fertility treatments for a short time, causing delays for NHS funded treatment and putting patients at risk of isolation with restricted access for partners. The survey reflects this:
• Support: Respondents were less satisfied that their partner was involved in decisions about care (70%), and satisfaction lowest for the level of support given (including access to counselling), at 62%.
• Treatment delays: 22% of patients who had treatment in the last two years experienced a delay in starting treatment due to Covid-19. NHS patients were more likely to have been affected by delays in referrals due to Covid-19 (32% vs. 18% of private patients).
• Satisfaction: Those who had treatment in the past two years were less satisfied than those whose last treatment was between two and five years ago (70% vs. 81%)
• Donation: Of those who had used donated eggs, sperm or embryos, two-thirds (65%) said they found them easy to access, however those who had treatment in the past two years were more likely to say they had found it difficult (30%).
The National Patient Survey 2021 also aims to answer some of the questions raised in the HFEA’s Ethnic Diversity in Fertility Treatment 2018 report, published in March 2021. Julia says that although these results are not statistically significant, they suggest that differences in some Black and minority ethnic groups remain.
The National Patient Survey 2021 found that:
• White respondents were more likely than Black, Asian, Mixed or Other ethnicity respondents to speak to their GP earlier (77% vs. 72%)
• Black, Asian, Mixed or Other ethnicity were more likely to have had a multiple embryo transfer than White respondents (38% vs. 29%), similar to findings from our Ethnic Diversity in Fertility Treatment report.
• Black, Asian, Mixed and Other ethnicity respondents were more likely to wait more than 18 months (32% vs. 27% of White respondents) for treatment to start.
• Waits for donor eggs, sperm and embryos appear to be longer for Black, Asian, Mixed and Other ethnicity respondents with a lack of donor egg, sperm and embryos meeting their criteria, being the main reason for this.
Julia Chain, Chair of the Human Fertilisation & Embryology Authority (HFEA), commented: “More research is needed to understand why these disparities exist. We urge clinics to update information held on their website to help patients who require donor sperm and eggs to plan their treatment. Meanwhile, we’ll work with clinics to further understand cultural and religious beliefs that may impact on donor recruitment to help overcome any barriers that may exits”.