Connect with us

Insight

Why the UK’s fertility rate keeps falling – and what it means if you’re trying now

Published

on

Article produced in association with Spital Clinic

The UK’s fertility rate has fallen for a third consecutive year to the lowest level ever recorded. That headline gets written every year, and it is easy to read it as a purely demographic story.

For anyone currently trying for a baby, the figure is something more practical: the conditions that produced the statistic are the same conditions shaping your own chances.

The decline has a clear pattern, and it is mostly not about couples being unable to conceive.

The change sits in when people start trying, and in what happens to fertility during the years by which most are now ready to have children.

What the numbers actually show

Figures from the ONS put the total fertility rate in England and Wales at 1.41 children per woman in 2024, down from 1.42 in 2023. The rate has been in overall decline since 2010 and has now recorded its lowest value three years running.

The figure sounds abstract until you compare it with the replacement level of 2.1 – the rate required for a population to sustain itself without net migration.

The UK has been below that line since the early 1970s, but the gap is now wider than at any point on record.

The data also shows where the decline is happening. Age-specific fertility rates for women in their twenties are the lowest of any generation since 1920. Rates for women in their thirties are holding up, and in some parts of the country rising.

Mothers are having babies later, not necessarily in smaller numbers. The average age of a first-time mother in England and Wales is now 31.0, up from 30.9 the year before. Regional variation matters too: London sits at 1.35, the West Midlands at 1.59.

Why the rate is falling

None of this is new. Every decade since the 1970s has seen the same trend, and it has accelerated in recent years. What has changed is the pace.

The shift is primarily social: delayed partnership formation, high housing costs, expensive childcare, and careers structured around full-time work through the exact years fertility is easiest.

The same pattern shows up across the EU, where the total fertility rate sat at 1.5 in 2022.

These forces compound. People meet later, partner later, feel financially ready later, and start trying later.

For many couples, first attempts happen in the early thirties, by which point fertility has begun its slow and uneven decline. A low national TFR is the population-level consequence of millions of individual timing decisions made under real-world constraints.

What this means for individuals trying now

Around one in seven couples in the UK will struggle to conceive naturally.

That figure has been stable for decades; the population of people seeking help, however, has grown – not because fertility itself has worsened, but because more people are trying during the window where it becomes harder.

UK fertility treatment data from the HFEA shows around 52,400 patients had over 77,500 IVF cycles in 2023, making 1 in every 32 UK births IVF-conceived.

The average age of a first-time IVF patient in the UK is now just over 35 – nearly six years older than the average first-time mother in the population overall.

NHS-funded IVF cycles have fallen from 40 per cent of the total in 2012 to 27 per cent in 2022, and to 24 per cent in England in 2023. The private sector has absorbed the rest.

When to get checked – and what it involves

Current NHS advice is to see a GP after a year of regular unprotected sex without a pregnancy, or sooner if you are 36 or older.

That threshold reflects the fact that every additional six months of trying is more clinically informative in the years when fertility is starting to shift.

The first set of investigations is usually straightforward.

For women, this typically covers hormone testing (AMH, FSH, LH, TSH and prolactin), rubella immunity, chlamydia screening, a mid-luteal progesterone and a transvaginal ultrasound.

For men, a semen analysis is the first step.

A private trying-to-conceive screening covers the same ground without the NHS waiting list, with the advantage that results can be reviewed in a single consultation.

The purpose of early screening is not to diagnose infertility – most couples conceive naturally within a year or two – but to identify specific, treatable issues before more time passes.

The fertility window is narrower than most people think

The uncomfortable truth behind the falling TFR is that the biological fertility window has not changed. The subtle decline begins around age 32, and accelerates from the late thirties.

The chance of natural conception in any given month is substantially lower at 40 than at 30, and falls sharply through the early forties.

IVF success rates track the same curve.

For patients aged 18 to 34, the average birth rate per embryo transferred was around 35 per cent in 2022; for those aged 40 to 42, around 10 per cent using their own eggs.

This is why the growth areas in UK fertility care are now pre-conception screening and elective egg freezing – HFEA data shows egg storage cycles rose from 4,700 in 2022 to 6,900 in 2023, one of the fastest-growing treatments in the sector.

A focused fertility consultation earlier in the timeline – in the late twenties or very early thirties, before there is a known problem – tends to produce better decisions than a consultation triggered by a year of trying without success.

The wider picture

The UK’s falling fertility rate is the product of a society that has reorganised when people have children, not one in which couples have become less capable of conceiving.

There is no need for alarm in that finding. The practical takeaway is that the old default of ‘wait and see’ assumes a timeline no longer matching the one most people now live.

For anyone currently trying, or planning to try soon, the single most useful move is to understand your own numbers earlier than previous generations did.

The national trend is not going to reverse quickly.

A clear picture of your own fertility window – and the information to use it well – is within reach in a way the headline statistics are not.

If you are trying to conceive or thinking about starting, a structured pre-conception review is a reasonable first step.

Disclaimer: This article is produced for informational purposes only and does not constitute medical advice, diagnosis or treatment. Clinical guidance referenced reflects published NHS, ONS and HFEA data as at April 2026. Individual circumstances vary; readers are advised to consult a qualified healthcare professional before acting on any information in this article. This piece was produced in association with Spital Clinic, which provided background clinical information for editorial purposes. Hyperlinks to external sources are included for reference only and do not represent an endorsement of any product, service or organisation.

News

Women shouldering hidden burden of navigating healthcare system – study

Published

on

Women face a hidden burden navigating healthcare, with many repeatedly retelling their medical history, a national study suggests.

The findings indicate that Canadian women are taking on cognitive, emotional and administrative work alongside managing their health, including coordinating providers and advocating for care.

More than half of women surveyed, 53 per cent, reported a past or current chronic condition, while 64 per cent said there were health topics they struggled to raise with their doctor.

Sarah Hoffman, president and CEO of Pacific Blue Cross, said: “These findings challenge us to think differently about women’s healthcare and highlight the hidden work required to navigate the system.

“For many women, managing their health has also come to mean managing the healthcare system itself.

“They are acting as project managers of their own care, shouldering the invisible labour of coordinating between providers, retelling their medical history and advocating to be heard.

 “The gap between men and women is meaningful and raises important questions about why younger women report lower levels of confidence and support.

“It also challenges us to consider whether we are actually making progress in women’s care, and whether the next generation is being equipped with the confidence and voice to advocate for their health.”

Overall, 71 per cent of Canadians described their doctors as supportive and 88 per cent expected their appointments to go well.

Among women living with chronic conditions, 71 per cent reported having to repeat their complete health history multiple times a year.

Younger women were particularly likely to report difficulties discussing their health. The study found 81 per cent of Gen Z women aged 18 to 30 and 73 per cent of Millennial women aged 31 to 45 had health topics they struggled to raise with their doctor.

Among Gen Z women with chronic illness, 92 per cent reported having to repeat their complete health history.

The study also found differences between young women and men. While 95 per cent of Gen Z men expected a doctor’s appointment to go well, the figure was 82 per cent among Gen Z women.

Similarly, 82 per cent of Gen Z men said they felt supported by their family doctor, compared with 66 per cent of Gen Z women.

Reasons for holding back health concerns varied between generations.

Among Gen Z women, 30 per cent cited fear of dismissal and 29 per cent fear of judgement.

Embarrassment was the most common barrier among Millennial, Gen X and Boomer women, reported by 29 per cent, 27 per cent and 35 per cent respectively.

Women who felt they needed to prove themselves to be taken seriously said they adapted how they approached appointments.

Strategies included researching medical information, repeatedly describing or justifying symptoms, bringing written notes or documentation, tracking symptom timelines, making repeat visits and emphasising how symptoms affected their daily lives.

The study also found an association between feeling supported by a doctor and expecting appointments to go well.

Canadians who described their physician as supportive were nearly four times more likely to expect appointments to go well than those who felt unsupported, at 98 per cent compared with 25 per cent.

Overall, 66 per cent of Canadians said they described their symptoms accurately. This fell to 48 per cent among those who said they felt unsupported by their doctor.

The 2026 Blue Cross Women’s Health Study surveyed 2,045 adult Canadians online in March 2026 through independent research company Research + Knowledge = Insights.

The survey had a reported margin of error of plus or minus 2 per cent, 19 times out of 20.

Continue Reading

Insight

Court recognises radiation as factor in flight attendant’s breast cancer

Published

on

A French court has linked cosmic radiation to a former flight attendant’s breast cancer for the first time.

Sophie Lainault, 59, had sought to have her cancer recognised as an occupational disease linked to her working conditions.

The court in Bayonne ruled that cosmic radiation was one of three carcinogenic, or cancer-causing, hazards arising from her profession, alongside passive smoking and prolonged night work.

Smoking was authorised on Air France flights until 2000.

The ruling means Lainault, who is in remission, can take early retirement and have any further treatment fully reimbursed by the French health system.

Lawyers said the decision has also cleared the way for similar claims by recognising breast cancer as an occupational risk for flight crews.

Lainault said: “My dearest wish is that the decision encourages other women who up until now have not had the courage to take this step.”

Lainault worked as a stewardess and later a purser on Air France aircraft, recording 12,600 flight hours between 1989 and 2019. More than half of those hours were at night.

Many of her long-distance, high-altitude flights from Paris would have taken her near the North Pole, where exposure to cosmic radiation is most intense.

Cosmic radiation consists of particles originating from the sun and other stars.

A study this month at Harvard Medical School in the US involving more than 500 professions found that flight attendants and pilots had the highest proportions of radiation-related cancer deaths.

About 6.9 per cent of deaths among flight attendants and 6.7 per cent among pilots were from radiation-related cancers, according to the analysis.

The proportions were higher than in other professions, including nuclear technologists, who are routinely exposed to radiation from non-cosmic sources and ranked 12th in the analysis.

It has long been known that high-altitude air travel exposes people to cosmic radiation, although the dose received by most travellers is regarded as statistically insignificant. Exposure is higher at the poles because elsewhere the Earth’s magnetic field acts as a shield.

Lainault’s lawyer Elisabeth Leroux said: “In France the link between breast cancer and certain hazards has been established for a number of professions, such as nurses … but this is the first time for an air-hostess.”

Air France said it had not been involved in Lainault’s legal case and had not seen the reasoning behind the court’s decision.

“The health and security of our staff is an absolute imperative,” the airline said. “Every employee has a medical accompaniment that goes well beyond the regulatory minimum.”

Continue Reading

Insight

Study to tackle years-long delays in endometriosis diagnosis

Published

on

A study is examining where delays occur in diagnosing endometriosis  – a condition that can take seven to twelve years to diagnose.

Endometriosis affects an estimated 1.5 million women and people in the UK, but there is currently no consistent way of measuring where and why diagnostic delays happen.

The research aims to develop the first standardised framework for understanding the diagnostic journey and identifying points where interventions could improve care.

The international project involves researchers from the University of Sheffield, University of Liverpool, University of Oxford, Aarhus University in Denmark and the University of Edinburgh, alongside Endometriosis UK.

Dr Rebecca Mawson, NIHR clinical lecturer in primary care at the University of Sheffield, is part of the research team.

She said: “Our project asks: where exactly are people getting lost or let down on their journey to diagnosis, and how can we map those points in a systematic way to identify where interventions could make a real difference.”

The project is led by Dr Babu Karavadra, NIHR academic clinical fellow in general practice at the University of Liverpool, who has been awarded a World Endometriosis Society Early Career Investigator Award as lead principal investigator at the University of Liverpool.

Researchers will review existing evidence, gather experiences from people living with endometriosis and bring together an international panel to map the diagnostic pathway and agree common definitions for key points along the journey.

The work will focus particularly on people whose experiences are often missing from research, including Black women, people living in rural or deprived areas, LGBTQ+ communities and disabled people.

Primary care will also be central to the research because it is often where people first seek help with symptoms.

Mawson said: “Primary care needs to be at the heart of this work. Primary care is often where people first seek help with their symptoms, so it has a crucial role in understanding diagnostic delay.

“If we only look at what happens once someone reaches specialist gynaecology, we risk missing some of the barriers that shape the journey long before that point.”

Unlike cancer research, where internationally recognised standards exist for studying diagnostic delays, endometriosis research has been more fragmented, with studies measuring different parts of the diagnostic journey in different ways.

The researchers hope to create an ‘Endometriosis Diagnostic Pathway Framework’ to help identify where people are falling through the gaps and where healthcare could be improved.

They will also develop a ‘Snakes and Ladders’ style visual representation showing how systemic barriers, chance and individual experiences can influence whether someone reaches a diagnosis.

The project forms part of the PEARL network, Primary care Endometriosis and Adenomyosis Research and Learning, an international collaboration of primary care and community researchers and clinicians.

Mawson said: “Endometriosis diagnostic delay isn’t inevitable. If we can understand where and why people are experiencing barriers, we have a much better chance of designing interventions that actually make a difference.

“The scale of the problem demands that we look at the whole journey, listen to the people experiencing it and build an evidence base that can lead to real change.”

The framework could provide the foundations for future research, clinical guideline development, healthcare professional training and NHS service improvements, with potential applications to related conditions such as adenomyosis and chronic pelvic pain.

Continue Reading

Trending

Copyright © 2025 Aspect Health Media Ltd. All Rights Reserved.