Fertility Treatment Regulation: What Parliament’s Debate Means for Families (and Why It Matters Now)
Two weeks ago in the House of Lords, peers held a timely debate on whether the UK’s laws regulating fertility treatment are still adequate for the world we live in today. The short version: the foundations are strong, but the system is showing its age, and the people paying the price are the patients.
For anyone building their family through IVF, donor conception, or surrogacy, this isn’t abstract policy. It’s about safety, transparency, fairness, and whether the law keeps pace with how fertility care is actually delivered in 2026.
The core problem: our fertility law is built for 1990
The Human Fertilisation and Embryology Act was landmark legislation. It created the Human Fertilisation and Embryology Authority (HFEA), the first dedicated fertility regulator in the world, and it helped the UK become a global leader in ethical oversight.
But as Baroness Deech (a former HFEA chair) set out, the sector has transformed beyond recognition since 1990, through new technologies, new family structures, and a market that is now largely privately funded. The HFEA itself has said that while much of the Act remains fit for purpose, there are now technical gaps, outdated consent rules, and insufficient regulatory powers.
That matters because fertility treatment is no longer niche. As several speakers noted, IVF now accounts for around one in 32 births in the UK, with almost 21,000 babies born from IVF in 2023.
What peers agreed on: patient protection must be explicit
One of the clearest themes across the debate was that fertility regulation needs to put patient protection front and centre.
Baroness Nargund spoke powerfully about the reality that while fertility treatment creates families, the burden of treatment falls overwhelmingly on women – physically, emotionally, and financially. She argued that the next generation of reform must explicitly state “safety and protection of the patient” at the heart of the Act.
Baroness Gerada echoed this with a clinician’s perspective, describing how patients can be offered costly “add-ons” during IVF, often with limited evidence of benefit and, in some cases, evidence of harm, at a moment when people are at their most vulnerable.
In plain English: when someone is desperate for a baby, “optional extras” don’t feel optional. And regulation needs to reflect that reality.
The digital gap: when a fertility provider isn’t regulated like one
Another major issue raised was the rise of hybrid and digital-first fertility services.
Baroness Owen highlighted the closure of Apricity Fertility, a concierge-style online provider, and the distress caused to patients who believed they were protected by the HFEA, only to discover the regulator had no remit to step in.
The key point: protection should follow the patient, not the premises. If a service presents itself as part of your fertility journey, patients deserve clarity about what is regulated, what is not, and what happens if that provider fails.
Better enforcement: why “fines not closures” keeps patients safer
Several speakers argued that the HFEA’s enforcement tools are too blunt.
Right now, the HFEA’s principal sanction is to suspend or remove a clinic’s licence. But that can harm the very people the regulator is meant to protect, patients, mid-treatment.
The HFEA has proposed more proportionate powers, including the ability to levy financial penalties. As Lord Palmer put it, the goal should be improving compliance without disrupting ongoing care.
Consent and data: modern care needs joined-up records
Consent rules came up repeatedly, especially the complexity that can arise around relationship breakdown, posthumous conception, and the sharing of records.
Baroness Deech argued for clearer statutory definitions and better record sharing between clinics and the NHS, so patients aren’t left navigating fragmented systems. Baroness Nargund also emphasised that better linkage between HFEA and NHS data could improve safety and help us understand complications and long-term outcomes.
The theme here is simple: fertility care doesn’t happen in a bubble. Patients move between clinics, maternity services, and the wider NHS. The law should support continuity of care.
The postcode lottery: access to NHS-funded IVF remains unequal
Peers across the House raised the ongoing inequity in access to NHS-funded fertility treatment.
Baroness Pidgeon described how access varies dramatically depending on where you live, despite longstanding NICE guidance. She also highlighted a specific inequality affecting LGBTQ+ couples, where lesbian couples can be required in practice to self-fund multiple cycles of artificial insemination before becoming eligible for NHS-funded IVF.
Whatever your views on commissioning structures, the human impact is the same: people’s chance to build a family should not depend on their postcode.
Surrogacy: acknowledged as urgent but treated as “too complex” to move quickly
Surrogacy was discussed throughout the debate, often alongside fertility law reform.
Baroness Deech noted that the UK’s surrogacy law was drafted for a world where surrogacy was rare, and that use has increased significantly. She also warned about exploitation risks, particularly in cross-border arrangements.
Baroness Shawcross-Wolfson called for deeper scrutiny before reform, raising fundamental questions about safeguards for surrogate mothers, the role of money, and what children need.
The Government response was clear: they recognise the importance of surrogacy reform and welcome the Law Commission’s work, but they are not currently able to bring forward reform immediately due to limited parliamentary time.
The Government’s position: reform is needed, but not this Session
In the closing response, Baroness Blake of Leeds acknowledged that targeted reform is required and that the HFEA’s recommendations are practical and ready. But she also said the legislative programme is “very full” and that the Government is not able to pursue immediate reform in the current Session.
For families in the middle of treatment, “not yet” can feel like “not ever.” Time is not neutral in fertility care.
What we hope happens next
This debate showed something important: there is cross-party recognition that fertility regulation must be modernised to reflect today’s realities, commercial pressures, digital delivery, evolving science, and the lived experience of patients.
From where we sit at My Surrogacy Journey, the direction of travel matters:
- Patient protection must be explicit in law – not implied.
- Regulation must keep up with how services are delivered, including digital and hybrid models.
- Enforcement must be proportionate, so patients aren’t collateral damage.
- Access must be fairer, because family-building shouldn’t depend on postcode or privilege.
- Surrogacy reform must be handled with care and compassion, centring the wellbeing of surrogates, children, and intended parents.
Families are not policy problems to be managed. They are people, often carrying years of hope, grief, resilience, and love. The law should meet them with the same seriousness.
If you’re navigating surrogacy and want clear, compassionate guidance, we’re here. Our work is grounded in lived experience and in a commitment to safer, more ethical pathways to parenthood.
