By Geeta Nargund, Medical Director at abc ivf and CREATE Fertility
Recent data from the Human Fertilisation and Embryology Authority (HFEA) has revealed a paradigm shift in the fertility treatment landscape, with more single and female same-sex couples seeking fertility treatments to start their families than ever before.
In 2012, 93.9% of fertility patients were women in heterosexual relationships, with just 3% being single women and 3% same-sex couples. By 2022, however, lesbian couples accounted for 6.3% of those undergoing fertility procedures, while single women made up almost 9%.
With the UK’s birth rate declining and our society facing significant demographic challenges, this trend is a hopeful sign of increased reproductive choice for women, regardless of their relationship status or sexual orientation, and growing acceptance towards different family structures in our society.
However, despite this progress for single and lesbian women the reality of accessing fertility treatments remains riddled with inequality and systemic hurdles.
The barriers
It is essential that every woman who wants to create a family is supported fairly and equally by the NHS, yet single women and same-sex couples continue to face unjust barriers to the fertility treatments they need, specifically IVF.
Currently, LGBTQ+ couples and single women face an unfair postcode lottery, where their access to NHS-funded fertility treatments depends on where they live and is often subject to strict non-clinical criteria. Despite government promises in 2022, many lesbian and single women still have to privately fund treatment before they can access NHS provision, as local NHS governing bodies, known as Integrated Care Boards (ICBs), have failed to deliver on proposals.
Indeed, a large number of ICBs impose unfair additional criteria for single women and same-sex couples, with only five out of forty-two having policies officially under review.
Over half of ICBs don’t even include single women in their IVF policies, and the rest require them to pay for between three and 12 cycles of artificial insemination before they can access NHS care. Meanwhile, over half require same-sex couples to self-fund six or more cycles of artificial insemination. In 2023, the HFEA reported that the NHS funded 39% of IVF cycles for heterosexual couples, but only 14% for women in same-sex relationships received funding.
This is unacceptable. With equal and fair access to care being one of the founding principles of our NHS, reproductive rights for all should be a cornerstone of its future policy vision. This must include single women and same-sex couples, whose only path to biological children is through fertility treatments.
Moving the dial
Ultimately, cost and access remain the biggest barriers for single women and LGBTQ+ couples hoping to conceive.
There are practical solutions that can address this disparity. Firstly, we need to see faster progress in ICB policy and provision to deliver on the proposals promised in the Government’s 2022 Women’s Health Strategy. Moreover, introducing a national IVF tariff to tackle the postcode lottery is crucial. Price caps on other medical treatments exist, and a tariff on the upper limit ICBs pay for a single IVF cycle will stretch the NHS budget further and reduce access inequalities across the UK.
Greater awareness and understanding of fertility treatment options for the LGBTQ+ community and single women are also essential to further remove stigmas and give hopeful parents the chance to start a family. The opportunity to create inclusive and diverse families is here, and the time to act is now.
As fertility rates in England and Wales hit their lowest point on record, ensuring fair and equal access to NHS-funded fertility treatment has never been more crucial. To foster true diversity, inclusion, and equality in our society, we must guarantee that everyone has the opportunity to build a family, regardless of their circumstances.
Featured image: DragonImages, Canva
