Ethnic disparities in gamete donors must be tackled

The Human Fertilisation and Embryology Authority (HFEA) launched the fertility data dashboard in January 2024 (see BioNews 1125). The dashboard holds national UK fertility data from 1991 and is thought to be the first of its kind in the world. It is a useful tool for clinicians and researchers as the data can be customised by success rates for a particular group or UK nation and region. In the two months since launching the dashboard, it had been viewed over 27,500 times!

HFEA data has shown that black, Asian and ethnic minority patients and their partners are being left behind when accessing fertility treatment. The HFEA's first Ethnic Diversity in Fertility Treatment report was published in 2021 (see BioNews 1220) and key actions were identified to reduce the disparities highlighted by the data. The latest report shows more needs to be done in order to create lasting change in the fertility sector.

The Ethnic Diversity in Fertility Treatment report 2021 shows that treatment outcomes continue to vary for black, Asian and ethnic minority patients. Some of the figures are shocking with black patients having nearly ten percent lower birth rates from IVF compared to white patients, and single black and Asian patients started fertility treatment at a later age (38-39) compared to white patients (36.2). The report also found that half of sperm used in treatment from donors of mixed, other and black backgrounds from 2017-21 was imported from abroad.

Around 2700 people have fertility treatment every year with the help of a donor. There has been widespread media interest in donation over the last year as the first cohort of people conceived from donation since the law changed in 2005 have turned 18. Families, donors and donor conceived individuals have shared their stories – the recent success of the ITV docuseries Born from the Same Stranger showcases the power of effective storytelling by individuals who have been directly impacted by donation (see BioNews 1128). However, the experiences of black, Asian and ethnic minority donors don't appear to be given the same attention.

Most patients who use donors believe it is important that the ethnicity of their donor matches their own, so the shortage of black, Asian and ethnic minority sperm donors in some areas can mean that patients face further delays to starting their treatment. The recent HFEA report found that over half of mixed, other and black donor sperm used in IVF treatments in the UK was imported from abroad. Based on these figures, finding a donor would be challenging for people from an ethnic minority background who cannot afford to import sperm from abroad.

Donation is an altruistic act that has given many people the chance to start a family – HFEA figures revealed that more than 70,000 children have been born from donation since 1991. However, it is time to highlight the inequities that exist in this area so that people from all backgrounds can have the family they have longed for with the help of a donor. Between 2017-2021, there were only 275 new sperm donors from a black, Asian and ethnic minority background in the UK compared to just under 1600 new sperm donors who were white. Over the past 30 years, there have been less than 1000 sperm donors (950) from a black, Asian, mixed and other and ethnic minority background.

These figures are shocking and prove that disparities in donation have been long-standing. The shortage of sperm donors from an ethnic minority background in the UK could be attributed to a variety of social, economic and structural factors which are believed to contribute to ethnic disparities and wider healthcare inequalities in the UK.

A possible reason for the shortage of sperm donors from an ethnic minority background could be attributed to the representation of donation in the media. Choosing to donate is a big decision and individuals who take an interest in donation need to be able to educate themselves on what it involves and most importantly, what to expect from the process. The lack of stories from ethnic minority donors in the media may discourage people from the same background from becoming donors as they may fall under the assumption that there isn't a need for their donations in the UK.

The HFEA figures highlight the need for more sperm donors from a black, Asian and ethnic minority background. Raising awareness of the disparities in donation is the first step towards creating change and inclusion by ensuring people from all backgrounds are aware of how to get information about sperm and egg donation and make informed decisions.

To tackle the disparities that are impacting fertility treatment outcomes for black, Asian and ethnic minority patients, the HFEA has agreed to a call to action with the Royal College of Obstetricians and Gynaecologists, the British Fertility Society, the Royal College of General Practitioners and Fertility Network UK (see BioNews 1220). We will continue to raise awareness of these disparities and work together to achieve meaningful change.