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Abstract Study question What are the experiences of patients accessing fertility treatment from licenced clinics within the UK? Summary answer While patients were generally (73%) satisfied with treatment overall, there remain areas for improvement including communication, information provision and coordination of treatment. What is known already While birth rates and the number of patients undergoing fertility treatment is increasing, research has shown that patients have varied experiences in the clinic. Additionally, experiencing infertility and undergoing treatment has been shown to have significant emotional impact, often lasting beyond the end of treatment. This survey builds on previous work conducted by the Human Fertilisation and Embryology Authority (HFEA) and aims to benchmark fertility patient’s experience in the UK. Identifying the factors that play a role in patient experience forms an essential part of not only measuring quality of care but directing action for improvements in the sector. Study design, size, duration An online mixed methods survey was conducted between September and October 2024. Participants were recruited via the HFEA website, support groups, social media, or via clinics. 2,046 participants accessed the survey. After applying eligibility criteria and removing incompletes, 1,500 were included in analysis. In addition to evaluating experience of treatment, experience accessing GP services, using donor gametes, and using treatment add-ons was assessed. Demographic information including age, region, ethnic background and treatment type was collected. Participants/materials, setting, methods The survey was open to patients over 18, who had undergone fertility treatment at an HFEA-licenced clinic in a five-year period. Both close and open-ended questions were used to evaluate patient experience. Descriptive statistics were used to analyse numerical data in PowerBI. Verbatim free text responses were coded and factors affecting patient experience identified using thematic analysis (NVivo13, QSR international). Main results and the role of chance Satisfaction with treatment remains consistent (73%, n = 1094/1495). Patients who either had a live birth or were currently pregnant were more likely to be satisfied (88%, n = 726/827) than those who did not have a live birth (50%, n = 181/362). White (75%, n = 993/1325) and Mixed (71%, n = 32/45) ethnicity patients reported higher levels of satisfaction compared to Black (59%, n = 20/34) and Asian (50%, n = 36/72) patients. Patients aged 37 or younger were more likely to report being satisfied than those over 40 (76%, n = 736/969 vs 67%, n = 190/285). Patients were most satisfied with their understanding of what they were consenting to (89%, n = 1328/1494) and least satisfied with the level of support available (69%, n = 1003/1458). Analysis of patient’s reflections identified ten key factors that played a role in experience of treatment. Factors that negatively affected experience were issues with coordination/administration of treatment, a lack of empathy or difficulty communicating with staff, particularly after adverse outcomes and difficulty accessing support services. Positive experiences were associated with perceived high quality of care, closely linked to personalised treatment, experiencing empathetic, sensitive care and clear, prompt communication. A commonality across most factors was calls for increased access to high quality information to support with patient choice and decision making. Limitations, reasons for caution As the data was self-reported, there is a risk of recall bias, particularly considering participants may have had treatment up to five years ago. Additionally, as the survey was run by the regulator of fertility treatment in the UK, there may be a risk of respondent bias. Wider implications of the findings While satisfaction with treatment is high, patient experience is complex, and multifaceted. This survey identified several factors that play a role in patient experience. Further work should be conducted to share learnings widely and to consider where actions should be targeted to improve patient experience. Trial registration number No