By Professor Geeta Nargund, Medical Director of abc ivf

As a proud British Asian woman, and fertility doctor with over 25 years’ experience working in the NHS, I am all too familiar with some of the unique challenges facing south Asian communities when it comes to infertility. While around 1 in 7 couples in the UK have difficulty conceiving, there are certain factors that affect rates of infertility and success of fertility treatment that unfairly impact those in these communities.

Whether that be issues impacting access to fertility treatment; a higher prevalence of certain medical conditions impacting fertility amongst Asian women; or cultural stigmas surrounding infertility – more needs to be done to improve access to treatment and destigmatise these conversations.

Access and success

In 2021, the HFEA (Human Fertilisation & Embryology Authority) published its first ever report on the inequalities facing ethnic minority patients undergoing IVF treatment in the UK. The report revealed that 52% of Asian couples pursuing IVF treatment had to use a white donor egg due to only 4% of egg donors being Asian. The findings also showed that for those aged 30-34, people from Asia had an average birth rate of 25% compared to 30% for white and mixed patients. Ultimately, this highlights the stark inequalities faced by Asian communities in the UK, emphasising the strong need for a national effort to tackle the lower rates of both access and success of fertility treatment.

Causes of infertility

The HFEA report also confirmed that there is a greater prevalence in Asian women of certain conditions impacting fertility such as Polycystic Ovary Syndrome (PCOS) and ovulation issues. PCOS is one of the leading causes of irregular ovulation and infertility, and symptoms include weight gain, irregular periods and excessive facial hair. Having a PCOS diagnosis does not mean that you won’t be able to conceive, but you may need additional support and IVF treatment to start your family.

Whilst the findings of the report can make for disheartening reading, knowledge is power and action can be taken to target education and early treatment programmes to address the factors impacting fertility and mitigate their impact amongst Asian patients.

Cultural barriers

Culturally speaking, it can in some Asian families and communities be very difficult to discuss infertility openly, as there are often negative feelings such as shame attached to being infertile, something that is perhaps made worse when friends and family around you are having children seemingly effortlessly. However, opening up the conversation is a critical first step in taking action, thereby increasing chances of seeking medical help at an early stage. With the biological clock playing a part when it comes to fertility, for both men and women, earlier diagnosis can make the difference in enabling you to conceive. Early diagnosis also means that the necessary lifestyle changes or treatment can be started sooner, optimising your chances of success in finally starting your family.

Affordability

A key obstacle when it comes to accessing IVF treatment is affordability. Unfortunately, the NHS still faces a postcode lottery when it comes to IVF treatment provision and the criteria for gaining access to treatment varies by region across the country. Whilst positive intentions have been laid out in last year’s Women’s Health Strategy to remove non-clinical criteria, these proposals will take time to implement and many people will have to turn to the private sector in the meantime. The need to improve accessibility and affordability of IVF is why I founded abc ivf – the UK’s affordable IVF service – offering treatment to those who may have undergone their free cycles on the NHS, or who are ineligible for NHS treatment, but priced out by many other clinics in the private sector.

Ultimately, education is critical to shifting cultural attitudes and defeating stigmas associated with infertility issues. For example, many people don’t realise that lifestyle factors can impact your fertility, such as your age, BMI and how active you are. For this reason, it is critical that we drive education and awareness of fertility amongst the south Asian community – a key part of this is encouraging couples to seek earlier diagnosis to increase their chances of success in treatment. In this way, we can transform success of and access to fertility treatment for Asian communities across the UK. Opening up the conversation and tackling the stigma around infertility lies at the heart in levelling the playing field.