Katie Rollings
Founder/CEO, Fertility Action
Roughly 2.1 children per woman is what’s plainly called the ‘replacement rate’ at which we shouldproduce children for the UK population to hold steady from births and deaths alone.1
In 1900, the UK replacement rate was 3.4. In 1964, at the peak of the baby boom in 1964, it was 2.95.
In 2025, England and Wales reported a dramatic fall to 1.39.1 Many factors are driving this cratered birth rate.
Fertility’s hidden barriers
A recent UK poll found 44% of adults aged 18 to 50 are delaying children or deciding against them altogether.2 Many more people want children but are crashing into barriers they didn’t anticipate.
NICE recommends three funded cycles for eligible women under 40
According to the Human Fertilisation and Embryology Authority’s own data, around one in six couples experience fertility problems in the UK, with female and male factors contributing at broadly similar rates.3 PMOS affects an estimated one in 10 women, and endometriosis a further one in 10, both conditions that often go undiagnosed for years.4 For those who actually have a diagnosis and turn to IVF, there’s a brutal postcode lottery waiting.
Postcode determines parenthood
NICE recommends three funded cycles for eligible women under 40. Yet, only two of England’s 36 Integrated Care Boards actually offer that. Nearly 70% offer just one cycle, and several regions, including Greater Manchester, cut their funding from three cycles to one in the past year alone.5 Scotland funds three cycles nationally, Wales funds two. How can it be fair that where you live in the UK, not your medical need, is currently what decides how much support you get?
The result is a system in which the postcode on your driving licence has an influence on whether, and how, you become a parent. It is difficult to think of a more personal example of inequality. This is exactly the injustice Fertility Action exists to end. The charity was founded by Katie Rollings out of her own experience of infertility and IVF. We now work alongside patient advocates, clinicians and MPs to close the gap between what NICE recommends and what people actually receive.
Fighting for fertility care access
In January 2025, we took that fight to Parliament with MP Andrew Griffith, pushing for nationwide IVF access and better early diagnosis of male subfertility in primary care too, because this isn’t only a women’s issue. Fertility is a medical need, not a lifestyle choice, and treatment shouldn’t depend on a postcode. We keep pushing because nobody should be denied the chance of a family simply because of where they happen to live.
[1] Closer, 2025. Total Fertility Rate (TFR). closer.ac.uk/contextual-data/total-fertility-rate/
[2] Ipsos, 2025. Half of British women aged 18-50 have delayed or decided against having future children, with cost concerns main factor. tinyurl.com/5eupbhww
[3] Stanton AL & Woodward JT, 2014. Infertility. In: Ayers S, Baum A, McManus C, et al., eds. Cambridge Handbook of Psychology, Health and Medicine. Cambridge University Press; 2007:756-758.
[4] Endometriosis UK, 2024. Years of being “dismissed, ignored and belittled”; Endometriosis UK urges improvement to deteriorating diagnosis times. endometriosis-uk.org/diagnosis-report
[5] Coffey H, 2026. Amid the panic about the birth rate crisis, access to IVF is being quietly decimated. The Independent. tinyurl.com/5ac3s3hs
