Fertility Treatment Regulation

Baroness Pidgeon Excerpts

Thursday 4th June 2026 Lords Chamber

[Baroness Pidgeon (LD)]

My Lords, I thank the noble Baroness, Lady Deech, for bringing forward this important short debate and for her work in this area. I am also grateful for the richness of the debate from noble Lords across the House, and with such expertise, and for the personal contribution from right reverend Prelate the Bishop of Chelmsford.

One in seven couples may have difficulty conceiving, and as the noble Baroness, Lady Nargund, stated, there is now roughly one IVF child in every classroom, with IVF births making up around one in 32 of UK births. The number of patients having fertility treatment has increased over the last 30 years—over 52,000 in 2023.

The noble Lord, Lord Winston, stated that there are more than 100 reasons for infertility, which are not always investigated, but the noble Baroness, Lady Boycott, highlighted for us the issue of plastics and chemicals and their impact on fertility.

As we have heard today, there is a postcode lottery of access to IVF and fertility services across the country, which is undermining the hopes and family life of many couples. Patients in England are struggling to access publicly funded IVF, despite the NICE recommendation that has been in place since 2004 that the NHS should offer an initial three full cycles of IVF treatment to any woman under the age of 40. A briefing from the Progress Educational Trust highlighted that only two out of the 42 integrated care boards in England comply with the NICE fertility guidelines, and 19 offer only a partial IVF cycle, not even a full cycle. This means stopping treatment before all the viable embryos already created have been transferred.

It is therefore crucial that people be able to expect high-quality fertility treatment wherever they live, rather than being priced out of having children just because of their postcode and their local ICB’s policy at that time. Can the Minister advise whether the Government have considered following Wales and Scotland in centralising commissioning for IVF, rather than the current postcode lottery approach?

A specific inequality that has not been mentioned today still exists for the LGBTQ+ community. In England, NHS-funded access to IVF is available only to women who have not conceived after two years of regular unprotected intercourse or 12 cycles of artificial insemination. But in practice, that requires all lesbian couples to pay for artificial insemination cycles before becoming eligible for NHS-funded IVF. That is a considerable financial barrier for many of those couples, given that cycles can cost thousands of pounds.

Despite the previous Government’s women’s health strategy pledging to remove that requirement for lesbian couples, the rollout has been at a snail’s pace. As of April 2024—the last data I could find—only four of the 42 integrated care boards in England have implemented this. There should be equitable access to IVF for all lesbian couples who are looking to start a family. Can the Minister update the House on what work the department is undertaking to ensure that the requirement is rolled out across all ICBs?

As we have discussed, the Human Fertilisation and Embryology Authority was established back in 1991 and was the first regulatory body of its kind in the world. But as we have also been discussing, a lot has changed since 1991—both scientific developments and societal attitudes. Although the Human Fertilisation and Embryology Act was last amended in 2008, there has been no significant change to how the HFEA regulates, despite the significant changes to the UK fertility sector.

As we have heard so clearly today, while much of the original 1990 Act remains fit for purpose, the regulatory framework is not flexible enough and change is required to deal with the shift to fertility services that are being provided online. A greater range of powers to improve compliance and protect patients is needed. Particularly given that there is limited access to IVF on the NHS, with 73% of treatment privately funded, this regulation needs an urgent update.

With groups of private clinics and changes to the types of fertility services and related services being offered—as was outlined by the noble Baronesses, Lady Deech, Lady Owen and Lady Nargund; and the noble Baroness, Lady Gerada, described in detail some of those so-called add-ons—it is very important that patients can have full confidence that the services they are paying for are carefully and thoroughly regulated, safe and adding value, whether it is in a physical clinic or online.

I was surprised to read in preparing for this debate that patient-specific fertility treatment information has an almost exceptional status, with staff at the relevant fertility clinic and at the HFEA being pretty much the only professionals able to access patient-specific fertility treatment information records. However, as we have heard, that may compromise patient safety, and I am not sure how this will fit with the newly proposed single patient record, as the noble Baroness, Lady Nargund, also raised. Perhaps the Minister could comment on that.

As my noble friend Lord Palmer of Childs Hill said, the legislation is now unfit for today. The HFEA proposals for reform relate to a number of areas: patient protection and safety; effectively regulating a changing sector; and effective and proportionate sanctions, including financial.

The HFEA wishes to match its regulatory oversight to the risks involved in a changing sector. That seems like a proportionate approach. As we heard, the HFEA published its proposed changes in autumn 2023—some time ago. Perhaps the Minister can advise when the Government will be responding in full to these proposals. I am sure we would be happy with a season rather than a specific date.

The other side of this is the need for research. There is a clear desire for the HFEA to be able to permit patients to give generic consent for the use of their embryos in research. I think many patients would want their embryos to be used to help science in this area, but currently this is not permitted. It is of course important that we have an ethical framework for embryo research, but will the Government consider any movement in this area regarding general consent?

We have heard today about other important issues such as surrogacy and the current law, which is some 40 years old. This is a complex area and, as the noble Baroness, Lady Shawcross-Wolfson, set out so clearly, it needs careful consideration, along with a discussion on what is going on in the so-called industry. For those who wish to start a family and are having trouble conceiving, are in a same-sex relationship, or are by themselves, the role of IVF becomes an absolute lifeline. We were ahead of the game, with the first IVF baby born in the UK in 1978. We need to update some areas to ensure that they are fit for purpose in the 21st century and the digital world, and to help people to have the child—and children—they desire.

I look forward to hearing the Minister’s response to this important debate.