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Fertility

Most NHS regions in England limit IVF to single cycle, research finds

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Nearly 70 per cent of NHS regions in England fund only one IVF cycle for women under 40, breaking national guidelines, new research has found.

Twenty-nine of the 42 integrated care boards, which control local NHS budgets, now offer only one round of treatment, after four reduced access in the past year.

National Institute for Health and Care Excellence (Nice) guidelines recommend three full cycles for women under 40 who have been unable to conceive for two years.

Only two of England’s 42 integrated care boards have policies consistent with these guidelines, which they are not legally obliged to follow.

The research was conducted by the Progress Educational Trust, a fertility charity.

Sarah Norcross, the director of PET, said the impact was “devastating” for couples struggling with infertility.

She said: “Infertility is already incredibly stressful for people, and it puts them under even more pressure, because there is so much riding on whether that one NHS-funded cycle is going to work.

“And for some people, that will be their only chance, because private fertility treatment is so expensive.”

The data showed regional variations, with the whole of the north-west offering just one cycle.

“It’s a postcode lottery, and we’re seeing a race to the bottom,” said Norcross.

Of the 29 integrated care boards that offer a single cycle, 19 provide only a partial cycle, where not all viable embryos created are transferred.

There was just one recent example of improved services, from NHS South East London, which in July 2024 went from one partial to two full cycles.

The NHS estimates that about one in seven couples may have difficulty achieving a pregnancy. One cycle of IVF can cost from £5,000 at a private clinic.

Fertility rates in England and Wales have fallen since 2010 to 1.41 children per woman in 2024, the lowest on record and below the replacement level of 2.1 at which a population is stable without immigration.

Health minister Karin Smyth said in a written parliamentary answer last month that it was “unacceptable” that access to NHS-funded fertility services varied across the country.

Revised Nice fertility guidelines are due this spring, but Norcross said changing them seemed pointless.

She said: “Fertility treatment has always been a Cinderella service. It’s always been the one they’ve chosen to cut or to ignore.

“Nice has recommended three full NHS-funded cycles, for women under 40, for more than 20 years. This has never been implemented across England, unlike in Scotland.”

Norcross advocated centralised commissioning and replicating Scotland’s approach, which included financial modelling and a phased implementation starting with two cycles to avoid long waits, moving up to three once capacity was achieved.

“It is a tried and tested plan that England could follow,” Norcross added.

A Department of Health and Social Care spokesperson said: “We recognise access to fertility treatment varies across the country and we are working with the NHS to improve consistency.

“Nice provides clear clinical guidelines, and we expect integrated care boards to commission treatment in line with these.

“Updated Nice fertility guidelines are expected this spring and we will continue to support NHS England to make sure the guidance is fully considered in local commissioning decisions.”

An NHS England spokesperson said: “These clinical services are commissioned by integrated care boards for their area based on the needs of the local population and prioritisation of resources available.

“All ICBs have a responsibility to ensure services are provided fairly and are accessible by different population groups.”

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Fertility

Carea launches digital IVF support tool as UK fertility demand rises

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Carea has introduced a digital support feature for people undergoing IVF, IUI and egg freezing, as clinics across the UK face rising demand and mounting concerns about fragmented care between appointments.

The London-based pregnancy and postnatal platform has added a “Trying to Conceive: IVF/IUI Mode” to its app, designed to support patients with the day-to-day realities of treatment that take place away from clinical settings.

This includes managing medication schedules, administering injections and keeping track of complex protocols at home.

Anastasia Shubareva-Epshtein, founder and chief executive of Carea, said the new feature was shaped partly by her own experience.

“It’s the tool I wish I’d had when I was going through IVF,” Shubareva-Epshtein said, describing the isolation and uncertainty that can accompany treatment.

More than 100,000 fertility treatment cycles were carried out in UK clinics last year, according to industry figures cited by Carea.

Specialists have warned that increasing volumes are contributing to a more transactional experience, with reduced continuity between consultations and limited opportunities for patients to raise questions outside scheduled appointments.

At the core of the new feature is a medication tracker, allowing users to input a personalised treatment plan, set reminders and log doses.

Step-by-step video guidance on medication preparation and self-injection is also included.

The mode offers IVF-focused educational content, such as expert-led articles and podcasts, alongside affirmations tailored to the emotional pressures of fertility treatment.

A visual progress indicator helps users see where they are in their cycle.

The feature was developed with input from women currently undergoing fertility treatment, including those managing multiple medications daily while balancing work and family life.

Although IVF is often portrayed as closely monitored, much of the practical workload falls to patients at home.

Daily injections, precise timing and last-minute protocol changes can add significant stress, particularly during the gaps between appointments.

The launch comes amid ongoing disparities in access to fertility services.

NHS-funded IVF accounts for around 27 per cent of treatments, according to public data referenced by Carea, and many local authorities fund only one cycle for eligible women under 40.

As a result, a substantial number of patients turn to private providers, where costs can run into several thousand pounds per cycle, excluding medication and additional procedures.

Dr Anil Gudi, founder of Fertility Plus and medical adviser at Carea, said many patients report a lack of continuity in care.

He said: “Unfortunately, IVF care in the UK is becoming increasingly impersonal.”

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Open science advances non-hormonal contraceptives

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An open science initiative is accelerating work on non-hormonal contraceptives by targeting a sperm-specific enzyme linked to fertility.

The research focuses on developing a pill that works differently from hormonal contraception by temporarily disabling a protein found almost exclusively in sperm, rather than altering a woman’s hormonal cycle.

The target is an enzyme called phosphoglycerate kinase 2, or PGK2, which is critical for energy production and sperm movement.

Researchers believe that blocking PGK2 prevents sperm from generating the energy needed to swim and reach or fertilise an egg. Because the enzyme is largely confined to sperm cells, this approach could avoid many of the systemic side effects associated with hormonal contraceptives.

The work is led by the UNC Structural Genomics Consortium within the University of North Carolina’s Eshelman School of Pharmacy and is funded by the Gates Foundation as part of a broader effort to accelerate women’s health innovation.

Tim Willson, chief scientist for the consortium’s North Carolina programme, said: “Pregnancy is one of the major drivers of poverty in many of these countries.

“Giving women more control over when they conceive is a key area to make a real impact.

“What makes PGK2 so interesting is that it’s almost exclusively expressed in sperm cells. We suspect that if you can selectively inhibit this enzyme, the sperm can’t generate the energy they need to function.”

The consortium plays a central role in the Gates Foundation’s Contraceptive Drug Accelerator, a global network of academic laboratories working to identify and validate new drug targets for non-hormonal contraception.

Scientists from institutions in the US and India meet weekly to share data, compounds and findings.

In line with its open science approach, all aspects of the project are carried out openly, with no intellectual property restrictions.

“That’s where you really see open science at work,” Willson said.

“Every compound we make and every dataset we generate is shared immediately, which allows us to move incredibly fast.”

Since the project began in May 2025, the team has developed five highly selective probe compounds, an unusually rapid pace for early-stage drug discovery.

These compounds are now being distributed across the Gates Foundation’s Contraceptive Drug Accelerator network for testing in sperm function models.

“That specificity is the goal,” Willson said.

“We’re trying to shut down sperm function without interfering with the hormonal cycles that regulate women’s health.”

Researchers note that the work remains at an early stage and that any resulting contraceptive would still be several years away from clinical use.

“At the end of the day, the more we understand about human biology, the better drugs we can make,” Willson said.

“Open science removes barriers and lets the best ideas rise to the top.”

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Fertility

First UK baby born after womb transplant

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A baby boy is the first in the UK to be born after a womb transplant from a deceased donor, a development doctors say could offer hope to women born without a womb.

Grace Bell, in her 30s and from Kent, was born with MRKH syndrome, a condition in which a woman is born without a viable womb. She does not have periods but has normal ovaries.

At 16, she was told she would not be able to carry her own child.

As reported by the BBC, Bell’s womb transplant took 10 hours and was carried out at The Churchill Hospital in Oxford in June 2024.

Several months later, the couple underwent IVF treatment, followed by embryo transfer, at The Lister Fertility Clinic in London.

Her son, Hugo, was born just before Christmas 2025 at Queen Charlotte’s and Chelsea Hospital in west London, weighing nearly 7lbs. He is now 10 weeks old.

Bell said: “It was simply a miracle. I remember waking up in the morning and seeing his little face, with his little dummy in, and it felt like I needed to wake up from a dream.

“It was just incredible.”

Bell and her partner Steve Powell paid tribute to the donor and her family.

Bell said: “I think of my donor and her family every day and pray they find some peace in knowing their daughter gave me the biggest gift: the gift of life. A part of her will live on forever.”

The successful transplant is one of 10 deceased donor womb transplants taking place as part of a UK clinical research trial.

Three have already been carried out, but Hugo is the first baby born.

In early 2025, a baby called Amy was born through the first living womb donation in the UK, at the same London hospital.

Her mother received her older sister’s womb in a transplant operation in January 2023. Five further womb transplants from close living relatives are planned.

Consultant gynaecologist Prof Richard Smith, from Imperial College Healthcare NHS Trust, who began researching womb transplantation more than 25 years ago and was present at Hugo’s birth, said “a huge team of people” had been involved, from the transplant operation to embryo transfer and delivery.

Bell and Powell gave their son the middle name Richard in tribute to Smith, who also founded the charity Womb Transplant UK.

The couple may decide to have a second baby, after which surgeons plan to remove the transplanted womb.

This is to spare Bell from taking a lifetime of strong drugs to prevent the immune system attacking the transplanted organ.

Transplant surgeon and joint team leader Isabel Quiroga said she was “delighted” by Hugo’s birth and described it as a breakthrough for organ transplantation in the UK.

“Very few babies have been born in Europe as a result of their mothers receiving a womb from a deceased donor,” she said.

“Our trial is seeking to discover whether this procedure could become an approved and regular treatment for some of the increasing number of women of child-bearing age who do not have a viable womb.

Smith said the birth showed that girls and young women told they did not have a womb could now have hope of carrying their own child.

A baby born following a womb transplant from a deceased donor has no genetic link to the donor.

More than 100 womb transplant operations have been performed worldwide and more than 70 healthy babies have been born as a result.

Donating a womb for transplant differs from donating other organs, such as kidneys or a heart, as it requires a specific request to families who have already agreed to organ donation.

The donor’s parents, who wish to remain anonymous, said they felt “tremendous pride” in the legacy left by their daughter. She also donated five other organs, which were transplanted into four people.

“Through organ donation, she has given other families the precious gift of time, hope, healing and now life,” her family said.

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