The UK’s fertility regulator has called for an urgent update to the law around egg freezing as rapidly growing numbers of women choose to undergo the procedure – often without being warned of the full financial, emotional or physical cost.
The intervention by the Human Fertilisation and Embryology Authority (HFEA) came amid warnings of a lack of transparency around clinics offering the relatively new technology, and claims that women, often undergoing the process alone and potentially spending tens of thousands of pounds to do so, are not being sufficiently protected.
Clinics, experts claimed, are adopting “aggressive” marketing tactics, knowingly heaping on additional costs and not taking enough care of patients’ physical and mental wellbeing.
Meanwhile, patients have told the Observer they felt exploited and misled by a lack of clarity over the process and pricing structure. One woman said she was charged almost double the originally quoted price, while another said the process left her feeling so violated that it put her off having children.
The HFEA said the Human Fertilisation and Embryology Act dates back to 1990, long before egg freezing was a lucrative, highly commercialised business.
And yet, more than 30 years on, at a time when egg freezing and IVF babies have become largely mainstream, the regulator is still working under the same law.
“I would say that it’s very good, our legislation, at protecting eggs, sperm and embryos,” Rachel Cutting, a director at the HFEA, told the Observer. “But 30 years ago we weren’t operating in a commercial world and it would be beneficial for patients if that could be updated.”
Criticising the costing methods of clinics, which often follow a pay-as-you-go-style plan that can make pricing unclear for patients, she said they should provide information “up front” and that patients should know how much they will need to pay. “We’re not used to buying medicine in this country,” she said.
In its early days, the market was dominated by individual clinics owned and run by doctors, but now it is run by big business. “For the last 10 to 15 years we’ve seen a shift to having large groups of clinics that are financed through venture capitalists and business,” she said.
In 2020, the Competition and Markets Authority (CMA) raised concerns about the practices of some clinics and the following year published consumer law guidelines, which Cutting said had made a positive difference to egg-freezing patients. But, she said, more needed to be done to improve cost transparency in the future.
In figures seen by the Observer, a health researcher documented the marketed price compared with the actual price of her own egg-freezing and IVF treatment over four years across two London clinics. The marketed price for all of her procedures came to £16,680. But the overall cost from initial egg freezing to eventual pregnancy came to almost double, at £30,754. Additional costs can include medication, consultation fees, further collection rounds, scans, blood tests and egg storage.
Dr Zeynep Gurtin, a lecturer at the Institute for Women’s Health at University College London and an HFEA member, said women should be provided with the information to make “informed decisions”.
“The HFE Act is outdated and one of the main ways is that it has the embryo at the centre of it. Now, 30-odd years later, where we’ve come to is a place where the patient should be at the centre.”
Calling for the HFEA to be granted powers against clinics who are “abusing the commercial aspects of this industry”, she said patients were not being provided with clear information.
“If the price you’re giving is inaccurate, all you’re doing is making it much more difficult for women to plan, and creating stress along the way. So why on earth would you do that, as a responsible clinic?”
Catherine Hill, a spokeswoman for Fertility Network UK, called for women to be provided with a realistic idea of their success according to age and medical circumstances, and clear pricing information. It was, she said, “vitally important that fertility clinics provide clear and accurate information so that women are literally not being sold false hope”.
A Department of Health and Social Care spokesperson said: “Deciding to freeze your eggs is a significant decision, and the HFEA provides women with clear and impartial information. We recognise that parts of the existing legislation are in need of modernisation. As a first step, we have asked the HFEA to undertake a consultation about the priorities for reform, which will be launched shortly.”
‘I felt violated’
At 35 years old and single, Sabina (not her real name) decided to buy herself a birthday present: three rounds of egg collection at a London clinic with egg freezing and two years of storage.
She had always wanted children and had taken six months off work to spend time focusing on herself when she bought what she thought was a £9,500 all-inclusive package.
But she ended up not getting past the first round. When she was called in for egg collection early, neither the process nor the pricing structure had been fully explained, she said, and she left the clinic feeling “violated”.
She woke up alone in a lot of pain, and when she went to the toilet and saw blood, having done a positive pregnancy test and feeling pregnant beforehand, she felt as though she had miscarried.
For three weeks she was unable to leave the house or talk to anyone and it took her a long time to physically recover. Just four eggs were collected. She decided to end her treatment and is no longer sure she wants to have children.
“I just felt like I was a number, not a patient. It was just an in-out tick-box exercise for them.”
‘I ended up in A&E’
Another woman, also single and in her 30s, said the biggest worry for women who have made the decision to spend thousands of pounds on egg freezing is that they might go through the entire ordeal and, when it comes time to use them, not have enough eggs to have a child.
So when, after her first round of egg collection at a London clinic went smoothly, it was suggested that she go through a second round without a break, known as dual stimulation, it felt like a “miracle solution”.
But a few days into the second round she fainted and had to go to A&E. It ended up taking much longer and costing more than predicted. The patient believes her body was exhausted as she suffers from chronic fatigue, which she doesn’t believe was taken into account.
Now, less than a year on, while the chance to have a child feels “priceless”, she regrets having the second round and feels unease about her depleted savings after spending around £10,000 in total on having her eggs frozen and stored for a year.
‘There are always hidden costs’
Despite being comparatively lucky with hidden costs, Sharon Jones, who is a patient volunteer for the infertility and genetic conditions charity PET, still ended up with leftover medication, which she spent £1,500 on, when she froze her eggs aged 32.
Jones, now 37, says: “There is up-sell … it was almost a sales technique to get you to spend more money for a greater chance of being a parent. Yet there are no guarantees and always hidden costs.”