COVID delays in IVF treatment has biggest impact on women over 40

Delays to IVF treatment brought about by the COVID-19 pandemic could reduce the amount of live births in women over 40 by almost a quarter.

COVID 19 triggered a worldwide suspension of fertility treatments and in the UK between March and May and a reduced capacity from June onwards. A new study from the University of Aberdeen has demonstrated that the delay disproportionately affects older women and the researchers suggest clinics should prioritize treatment for over 40s and those with a known cause of infertility when IVF treatment resumes fully.

Published in Human Reproduction, researchers used data from almost 10,000 women who had undergone IVF treatment to explore the impact of delays and the best approach to dealing with the backlog of untreated couples

Their findings show the potential impact of a delay in treatment of six months and 12 months on five age categories, from under 30 years olds, to 40-42 years olds.

The delay affected every age group but, the older the age group, the greater the impact on the number of estimated live births.

The most pronounced impact on a particular age group was the 40-42 years old group who were estimated to have an 11.8% reduction in live births if IVF treatment was delayed for six months and a 22.4% reduction if there was a 12 month delay.

The figures also clearly show that the increased reduction in live births affects all age groups.

Six month delay in IVF - % reduction in live births

Under 30 — 0.4%
30-35 — 2.4%
36-37 — 5.7%
38-39 — 9.5%
40-42 — 11.8%

12 month delay in IVF - % reduction in live births

Under 30 — 0.9%
30-35 — 4.9%
36-37 — 11.9%
38-39 — 18.8%
40-42 — 22.4%

The study also examined how a six or 12 month delay would impact women with known causes of infertility, tubal infertility and male factor infertility as well as women with unexplained fertility.

Professor Abha MaheshwarI, clinical director of the Aberdeen Fertility Centre and one of the authors of the study said: "A delay in starting IVF reduces success rates in all couples. For the first time, we have shown that while this results in fewer babies in older women and those with a known cause of infertility, it has a less detrimental effect on couples with unexplained infertility, some of whom conceive naturally whilst waiting for treatment.

"Post COVID-19, clinics planning a phased return to normal clinical services should prioritize older women and those with a known cause of infertility."

Professor Siladitya Bhattacharya, chair in obstetrics and gynecology, from the University of Aberdeen, added: "It is critical that any plans to restart fertility treatment are based on a prioritization system, which aims to identify women who should be treated early in a manner that does not disadvantage those who may need to wait longer.

"This is the first study to use national data to predict the consequences of delaying the start of IVF in different groups of women, whilst incorporating the chances of natural pregnancy in couples with different categories of infertility.

"We anticipate that our results will help to inform a process of phased access to IVF in post-COVID 19 recovery and hope it will help patients understand the rationale for decisions made by clinics, funders and policy makers in formulating a strategy for re-starting IVF treatment."