IVF and Egg Donation in the United Kingdom

IVF and Egg Donation in the United Kingdom

Why should I choose UK for my IVF treatment?

The United Kingdom is the birthplace of in vitro fertilisation – the world’s first baby conceived via IVF was born there in 1978. Today it is one of the biggest IVF markets in Europe, with over 70 clinics across the country, some of the world’s best fertility experts and one of the most comprehensive regulatory mechanisms for assisted reproduction. The additional perks, such as convenient travel arrangements from practically everywhere in the world and the fact that the UK is an English speaking country, only add to arguments ‘for’ choosing it as one’s own IVF destination.

However, it is true that the majority of fertility patients in the UK are still the domestic ones. It happens so mainly because going for IVF treatment abroad still seems as uncharted territory for many people. Another reason may be the fact the UK does have some of the best health care in the world, both privately and through the National Health Service (NHS). The latter also offers funding for fertility treatments – however, it varies depending on where in the UK you live and whether you meet strict NHS eligibility criteria or not.

Nowadays patients taking IVF treatment in the UK into account also have to realise the inevitable – namely, Brexit. Many people have concerns about how leaving the European Union might influence their ability to access fertility treatments (egg donation in particular). The truth is that there are no obvious answers at the moment. What we all can do is to monitor the situation closely to be informed about any changes directly affecting patients’ ability to access IVF programmes in the UK.

IVF in the UK – Frequently Asked Questions (FAQ)

How much does IVF treatment cost in the UK?

In some cases, IVF treatment with own eggs in the UK can be funded by the NHS. However, the rules vary depending on where in the UK you live and whether you meet strict NHS eligibility criteria or not. Egg donation treatment is not covered by the NHS at all.
In private IVF clinics, 1 cycle of IVF with own eggs may cost up to £5,000 or more. While egg donation treatment prices start at around £5,000 per cycle, the advertised cost of donor egg IVF in top UK clinics is generally in the range of around £9,000 all-inclusive per cycle. However, if you take all treatment ‘add-ons’ into account, a final bill may come up to around £12,000.
What kind of IVF treatment is legally allowed in the UK?

The UK offers a wide choice of fertility treatments, including ICSI, surrogacy, embryo donation and IVF (with either own gametes, sperm donation, egg donation or both egg and sperm donation). The access to all of these treatments is offered to infertile heterosexual couples, single women and same-sex couples (both female and male). Embryo freezing is permitted (the standard storage period is 10 years) and preimplantation genetic diagnosis (PGD) is allowed for serious illnesses. The main difference in the IVF legislation in the UK (as compared to other European countries) is the lack of age limit for patients and the rule of donors’ non-anonymity.
What are IVF success rates in the UK?

The Human Fertilisation and Embryology Authority (HFEA), the national body regulating IVF treatment in the UK, publishes annual fertility treatment reports where it presents national pregnancy rates for fertility treatment. According to their publication ‘Fertility treatment 2017: trends and figures’ (released in May 2019), the overall IVF birth rate per embryo transferred (PET) was 22% . Overall birth rate PET for frozen cycles was 23%. In case of patients under 35 years old, birth rates for IVF with own eggs were 30% for fresh and 27% for frozen treatment cycles. The highest birth rate PET for treatments with donor eggs and donor sperm was 30%.
What are the most frequently chosen cities for IVF treatment in the UK?

Although there are over 70 IVF clinics registered across the UK, patients most often choose London for their IVF treatment. The main reason is the fact that it is the capital of the United Kingdom where the leading and longest established units are located.
What major laws are regulating IVF treatment in the UK?

The two main pieces of IVF legislation in the UK are the Human Fertilisation and Embryology (HFE) Act 1990 (as amended) and the HFE Act 2008. In 2004, the Human Fertilisation and Embryology Authority Regulations 2004/1511 enabled donor-conceived children to access the identity information of their sperm/egg/embryo donor after reaching the age of 18.
Where can I find the information on IVF clinics in the UK?

IVF clinics in the UK are strictly regulated and inspected by the Human Fertilisation and Embryology Authority (HFEA). The clinics’ latest inspection reports are to be found here: https://www.hfea.gov.uk/choose-a-clinic/clinic-search/

IVF in the UK – basic information

IVF and Egg Donation in the UK
Maximum patient ageNo limit - not specified by legislation,
decided by each
clinic individually
IVF treatments for single womenAllowed
IVF treatments for lesbian couplesAllowed
Gender selectionNot allowed for family balancing reasons
Allowed only if there are medical reasons
Maximum number of embryos to transfer
IVF with donor eggs
3
(max 2 - 3 embryos depending on the circumstances)
Maximum number of embryos to transfer
IVF with own eggs
3
(max 2 - 3 embryos depending on the circumstances)
Anonymous egg donationnon-anonymous only
Egg donor availabilityMedium
Egg donor age18-36
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IVF clinics in UK

There are over 70 IVF clinics registered across the UK, with the leading and longest established ones located in London.
IVF clinics in the UK are known not only for the world class IVF treatment but also due to the fact that they are strictly regulated by the Human Fertilisation and Embryology Authority (HFEA)1 – HFEA is the UK’s independent regulator of fertility treatment and research using human embryos. In fact, it is said that the way IVF clinics are controlled by HFEA is not replicated anywhere else in the world.

HFEA is ensuring that fertility clinics and embryo research centres comply with the law and the set standards of high quality care and research. All units in the UK have to comply with the Human Fertilisation and Embryology (HFE) Act 19902 , the HFE Act 20083 and the number of related pieces of legislation. As the UK law on fertility treatment and human embryo research is complex, HFEA produced a document called the Code of Practice4 – its aim is to help clinics understand the legal requirements they have to meet.

In order to carry out their work legally, IVF clinics have to be granted a licence by HFEA. The licence is given on the basis of the inspection during which the authority representatives make sure that clinic’s services meet the standards of HFEA’s Code of Practice. The licence is granted for up to 4 years (new clinics receive a licence for two years).

Additional inspections by HFEA are conducted every two years or more frequently – in case the inspected unit causes some well-justified concerns. The clinics’ latest inspection reports are to be found here.

On the basis of the latest HFEA’s annual compliance publication5 that shows the state of the fertility sector in the UK in 2018/19, we can see that around 80 percent of clinics were issued with a full licence – it is a confirmation that most clinics are meeting expected standards.

IVF treatment options in the UK

Being one of the largest IVF destinations in Europe, the UK offers a wide choice of fertility treatments, including ICSI, surrogacy, embryo donation and IVF (with either own gametes, sperm donation, egg donation or both egg and sperm donation). All of these treatments are offered to infertile heterosexual couples, single women and same-sex couples (both female and male). Embryo freezing is permitted and the standard storage period established by HFEA is 10 years. This period can be extended in certain circumstances for up to 55 years, in 10 year increments. Preimplantation genetic diagnosis (PGD) is allowed only for serious illnesses. When it comes to embryo transfers, nowadays an elective single embryo transfer (eSET) is the best practice. It means that only one embryo is put back in the woman’s womb and the others are frozen. The aim of this practice is reducing the chances of a multiple birth that may be of greater risk to both a woman and her babies. However, in some cases ( of e.g. older women with poor pregnancy prognosis), clinics may decide to put more than one embryo back.

An important aspect of IVF treatment in the UK is the lack of legal age limit for patients. As there is no clear cut-off in law, clinics set their own limits for treatment. Generally, private units allow women up to the age of 55 to try for babies through IVF. Fertility treatments (including IVF) funded by the NHS, on the other hand, are basically offered to women up to the age of 42.

Another – and probably the most important – difference in the IVF legislation in the UK (as compared to other European destinations) is the rule of donors’ non-anonymity. It refers to egg, sperm and embryo donors equally. According to the current law, people conceived through egg donation have the right to apply to HFEA to receive non-identifying information on their donors at the age of 16. When they are 18 years old, they can freely access all of the information the clinic submitted at the time of the donation.

IVF egg donation in the UK

Egg donation in the UK is allowed by the law but – as it was mentioned before – it is non-anonymous. As such, it requires full consent from both the donor and recipient, which ensures all parties involved are fully aware of the implications of their actions. According to the HFEA guidelines, clinical staff should be present when filling out the consent forms, so as to provide an opportunity for any questions to be answered.

Additionally, IVF clinics must offer counselling to help patients realise the risks and consequences of the process. Although paying for egg donation is illegal in the UK, egg donors can receive compensation of up to £750 per donation ‘cycle’ to cover their costs (like travel, accommodation and childcare).

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Egg donor information available in the UK

Egg donation in the UK was made non-anonymous on April 1st, 2005. Since that moment on, egg donors (as well as sperm and embryo donors) have been required legally to be identifiable to any person or persons conceived as a result of their donation. The offspring can have full access to the identity of their donor when they reach the age of 18.

The information submitted by clinics includes the donor’s name, date of birth, current address, ethnicity, NHS number, marital status, physical characteristics, personal description and the number of children. It is important to mention that donors don’t have any legal rights or obligations towards their genetic children but they can decide on the number of infants created from their donated eggs (the maximum number is ten).

Egg donor qualifications in the UK

In the UK, egg donors must be aged 18-35. Older woman may be allowed to donate their eggs only in exceptional circumstances, such as donating to a family member. Egg donors undergo extensive testing for certain genetic disorders and sexually transmitted infections. It is donors’ obligation to share their medical history and inform the clinic about any known medical conditions within their family as well as physical or mental issues they suffer from. Some clinics also set additional eligibility criteria, including minimum and maximum Body Mass Indexes (BMIs). Women who decide to donate their eggs have to restrain from trying for their own pregnancy whilst undergoing treatment.

Embryo donation in the UK

Embryo donation is allowed in the UK as well. If embryos are donated to research or training purposes, then there aren’t any eligibility criteria. In case of donating embryos to fertility treatment, the egg donor is required to be between 18 and 35 years old and the sperm donor – between 18 and 45. In exceptional circumstances, a clinic may accept donors outside this age bracket. Donors need to undergo the same health checks that any other sperm or egg donor would have.

IVF and egg donation cost in the UK

It has been already said that, in some cases, IVF treatment in the UK can be funded by the NHS. In case of England and Wales, the National Institute for Health and Care Excellence (NICE) states that free IVF treatment should be offered to women under the age of 43 who have been trying to get pregnant naturally for 2 years, or who have had 12 cycles of artificial insemination. However, the final decision on who can have the access to the funded treatment in England is made on the strict criteria set by local clinical commissioning groups (CCGs). Egg donation treatment, on the other hand, is not covered by the NHS at all.

If patients go for IVF treatment privately, they have to remember that the costs may vary depending on the IVF clinic. Generally, 1 cycle of IVF with own eggs may cost up to £5,000 or more. In case of egg donation treatment, prices start at around £5,000 per cycle.
However, let’s not forget that price offers clinics share with public may not always include all the important additional services. In order to know beforehand what you’re getting into, always check if there are not any shortcuts or hidden extras. It is definitely worth enquiring if the presented price contains the following components:

  • the donor’s fee, her medications and screening (if you’re interested in egg donation)
  • egg retrieval
  • sperm collection and preparation
  • ICSI
  • assisted hatching (or any other IVF procedure you require)
  • blastocyst transfer
  • vitrification (freezing) and storage of embryos/blastocysts

When we take all these ‘add-ons’ into account, it may happen that a final bill comes up to around £12,000. Fortunately, treatment prices seem to be more or less at the same level within the whole UK, e.g. the advertised cost of donor egg IVF in top London, Manchester, and Edinburgh clinics is always in the range of around £9,000 all-inclusive per cycle. Nevertheless, it is good to realise that every patient’s case is unique and prices may differ depending on individual circumstances.

IVF success rates in the UK

HFEA is not only responsible for licensing, monitoring and inspecting fertility clinics in the UK – it also collects individual clinic success rates and publishes them on its website. Although individual clinic rates are not going to give you the answer of your individual chances of success, the fact that they are always calculated in exactly the same way can give you an overall view of the clinic’s performance and be a good starting point in your own research.

Additionally, HFEA publishes annual fertility treatment reports where it presents i.e. national pregnancy rates for fertility treatment. According to the publication ‘Fertility treatment 2017: trends and figures’ (released in May 2019), the overall IVF birth rate per embryo transferred (PET) was 22% . Overall birth rate PET for frozen cycles was 23%. In case of patients under 35 years old, birth rates for IVF with own eggs were 30% for fresh and 27% for frozen treatment cycles. The highest birth rate PET for treatments with donor eggs and donor sperm was 30%.

IVF Success Rates in Latvia (ESHRE 2014)
IVF in LatviaESHRE European average
IVF donor eggs - success rates
(pregnancies/embryo transfer)
50.9%50.3%
IVF with own eggs - success rates
(aspirations - egg retrievals / embryo transfer)
29.8%27.2%

Your individual chances for a successful IVF treatment in the UK

Remember that average success rates shouldn’t be the primary deciding factor for your choice of clinic. Each patient is different – they have place different emphasis and importance on infertility diagnoses and medical histories. As such, the prognoses for each patient can vary greatly and usually are different from the presented average success rates of each clinic. If you want clarification about a clinic’s success rates, call the clinic before scheduling an appointment – describe your medical history in detail, including your age, weight, height, the infertility diagnosis, the number of failed cycles, performed tests and procedures etc. and ask for your individual success prognosis.

IVF in the UK – Law and Clinics Accreditation

The two main pieces of IVF legislation in the UK are the Human Fertilisation and Embryology (HFE) Act 1990 (as amended) and the HFE Act 2008. The former established the Human Fertilisation and Embryology Authority (HFEA) and addressed licensing conditions, code of practice, and procedure of approval involving human embryos. The latter was the update of the existing IVF law, adapting it to the requirements of the 21st century.

In 2004, the Human Fertilisation and Embryology Authority Regulations 2004/1511 enabled donor-conceived children to access the identity information of their sperm/egg/embryo donor after reaching the age of 18. The Regulations were implemented on April 1, 2005.
Nowadays, UK fertility clinics and human embryo research centres have to comply with both of the HFE Acts, as well as with the HFEA’s Code of Practice which provides guidance to help clinics deliver safe, effective and legally compliant treatment and research.

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Resources:

1 Human Fertilisation and Embryology Authority – HFEA is the UK’s independent regulator of fertility treatment and research using human embryos – https://www.hfea.gov.uk/

2  The Human Fertilisation and Embryology (HFE) Act 1990 – https://webarchive.nationalarchives.gov.uk/20130103041211/
http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsLegislation/DH_080205

3 The HFE Act 2008 – http://www.legislation.gov.uk/ukpga/2008/22/contents

4 The Code of Practice – https://portal.hfea.gov.uk/knowledge-base/read-the-code-of-practice/

5 The State of the fertility sector 2018 – 2019 – https://www.hfea.gov.uk/media/2974/state-of-the-fertility-sector-2018-19.pdf

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