Thursday 26th June 2025

(3 days, 6 hours ago)

Westminster Hall
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Jim Shannon Portrait Jim Shannon (Strangford) (DUP) [R]
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I beg to move,

That this House has considered IVF egg donation in young women.

I thank the Backbench Business Committee for granting this debate on adverts targeting young women for their eggs and attendant consequences. I know that another debate was supposed to be happening here, but unfortunately for the hon. Member who secured that debate, it was not able to take place. That was fortunate for myself and others who have come along today, so I thank the Committee for having offered this slot to us on Tuesday.

It is a pleasure to see the Minister in her place. She always seems to come along to answer questions on health issues, and I thank her for that. It is also a pleasure to see the shadow Minister, the hon. Member for Sleaford and North Hykeham (Dr Johnson) and the Liberal Democrat spokesperson, the hon. Member for Chichester (Jess Brown-Fuller), as well as others who have come along to participate.

The issue of adverts for IVF egg donation has been brought to my attention, and we have some people in the Gallery today who have enabled me to prepare this speech—as well as the questions I wish to ask the Minister —in order to highlight this issue and raise awareness. I thank hon. Members for participating in this debate, which could not be more timely, and the Minister for joining us today. I look forward to her response.

This issue is not as widely understood in this House as perhaps it ought to be. When I made representations to the Backbench Business Committee, I was asked what I was trying to achieve. I explained that, and the Committee very kindly offered me the opportunity to have this debate. This issue must be debated. Adverts in public places asking women to donate their eggs for use by others have hugely increased in recent years. They are seen at bus stops, at stalls in university student unions, in shopping centres and on social media sites. It needs to be regularised and there needs to be departmental input into how it happens. There needs to be rules on how it takes place. I hope that my speech will illustrate the clear issues and why they are so important.

All my contributions in this House start in my constituency of Strangford. My constituents have asked me to bring forward this issue, and it has been very kindly supported by others across this United Kingdom of Great Britain and Northern Ireland.

Adverts are not legally required to state the health risks up front, but they should be. This is despite the process for retrieving eggs from a young woman requiring her to be put through the early stages of IVF and an invasive and often painful surgical procedure to remove them. IVF is so important. I read in the paper today about the number of IVF successes, and I welcome that. This is not about stopping IVF treatment. It is not about ensuring that people cannot have babies. Nothing makes our relationships strong like having children. I always think of those who perhaps cannot and who wish they could. IVF gives them an opportunity to do that.

In 2011, the amount a young woman could be compensated for her eggs rose to £750 per cycle. Thirteen years later, in October 2024, following advice from the Human Fertilisation and Embryology Authority, it rose again, this time to £985, with additional expenses payments able to be made in some cases. That shows that there is a cost factor, and payments should be along the lines of cost.

Women as young as 18 can donate their eggs for use by others—either for IVF for older people or for surrogacy —and demand is soaring. According to the HFEA, women can undergo as many as 10 donation rounds—a huge toll on any lady’s body. Later, I will give the price at which fertility clinics sell the eggs on, so hon. Members will see the difference between that and the figure that ladies are given for a cycle of eggs.

In 2024, the Department of Health and Social Care confirmed to me in a letter that it did not undertake an impact assessment before allowing the payments to women for their eggs to rise, nor has it undertaken a long-term study on the effects of egg retrieval on women’s bodies, but I believe it must do so. Clinics do not undertake long-term follow-up checks on donors’ health. Again, I would have thought that that happens, and I am really surprised that it does not. There seems to be no accountability in the process.

Concerningly, between 2021 and 2023, the Scottish Government also targeted women with open adverts for their eggs, and four NHS health boards in Scotland continue to do so as a result of surging demand.

Tracy Gilbert Portrait Tracy Gilbert (Edinburgh North and Leith) (Lab)
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I congratulate the hon. Member on securing this debate. Is he aware that the adverts that the Scottish Government and NHS fertility centres put out do not convey the associated risks, and that some have used disingenuous language? Does he share my concern about those advertising campaigns, and does he believe that they should be immediately stopped?

Jim Shannon Portrait Jim Shannon
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I thank the hon. Lady very much for that point. That is the central thrust of this important debate. There do not seem to be any controls, and donation is almost glamourised, so for those in financial need—I will talk about them shortly—it may look too good to be true. It certainly does need regulating, and I thank the hon. Lady for coming along and making that pertinent point. I very much look forward to the Minister’s response on how the Government can regulate things in a constructive, helpful and safe way.

I do not know of any other Government in the world who ask women to donate their eggs for use by others, so why are we doing it here in a way that can undermine women’s health? It does not seem to be regulated in any way, and there do not seem to be any rules. That needs to be changed.

Research from Surrogacy Concern cited HFEA data showing that between 1991 and 2000, there were 736 egg donors aged between 18 and 25. Further research has shown that between 2000 and 2022, there were at least 78 women across the UK aged just 18 who registered to donate their eggs, 283 aged 19, and 468 aged just 20. That gives an indication of the age that this starts, and I will outline some of the reasons why this can have an impact later down the line.

Between 2000 and 2022, the HFEA registered 5,158 new donors across the UK aged 18 to 25 for egg donation. I say all those things because I believe that this is such an important issue, and that we are on the cusp of uncovering a major public scandal in the way egg donation is advertised.

The issue gets worse when we look at the socioeconomic background of the donors. In 2024, the Government confirmed to me that between 2011 and 2020, 4,147 donors came from the three most deprived deciles of the index of multiple deprivation. In stark contrast, there were 3,007 donors from the least deprived deciles. Again, as I will explain, those who may feel pressurised may see donation as a method of income without understanding all the potential side effects. Between 1991 and 2022, 23,522 new British egg donors were registered across the UK by the HFEA—21,020 from England, 1,315 from Scotland, 954 from Wales and 245 from Northern Ireland. In 2022 alone, 1,645 new British donors were registered in the UK.

Campaigners are concerned about the developing societal entitlement to women’s eggs, and that eggs are becoming a tradable commodity. They should not be, but that is the perception—indeed, that is the reality. Eggs for donation need to be of high quality, so only women aged 18 to 35 are targeted by fertility clinics. I believe that a power imbalance is developing between young and old, between poor and rich, and, in many cases, between female and male. The majority of egg donors are also not mothers, raising concerns about the psychological impact of a woman’s own genetic offspring being raised by others, which may only be realised years after donation. There is also a concerning development whereby young women’s bodies seem to be commodified resources to be assessed for the benefit of others. That concerns me greatly.

One London egg centre has an online catalogue—my goodness me—where donors can be searched for by their ethnic background, their hair colour, the colour of their eyes, their height, their skin tone and their educational attainment, raising further concerns about the development of designer babies. In other words, people think, “We’ll pick through this catalogue, and we’ll see which one we’d like to have.” It should never be that way.

Despite women supposedly not being paid for their eggs, donors have reported receiving payment, which the industry terms “compensation”. Originally £750 but now £985, it is paid into their bank accounts directly after egg retrieval, with no expenses claims or receipts needed to be submitted to the clinic. There are no rules. There are no guidelines. There is nothing to follow. Meanwhile, campaigners have seen plenty of examples of payments quoted up front and adverts directly incentivising young women to undergo the procedure for money, raising the likelihood of exploitation; the hon. Member for Edinburgh North and Leith (Tracy Gilbert) made that point very clearly. There is a significant risk to low-income, working-class women and to students. It also stands in stark contrast to expenses payments for British kidney donors, which must be strictly itemised with receipts provided. If that is the way to do it for kidney donors, it is the way to do it for egg donors.

The HFEA claims that egg donors largely state they are undergoing the procedure for altruistic reasons, but we must acknowledge the risk that some young women’s desire to help others, often at a cost to themselves, is being used against them. Eggs are sold in packages for thousands of pounds by egg banks and fertility clinics. The London Egg Bank offers six frozen eggs for sale at £5,500, and the Manchester Fertility clinic offers a package of eight frozen eggs starting from £11,000. That £985 against those prices gives an indication of where the real money is. The majority of British fertility clinics are now owned by private equity firms—again, there is little or no regulation, no rules and no safety measures. Something needs to be in place.

The process of egg donation is gruelling, which is sometimes overlooked. Women must inject hormones in a process known as downregulation, which switches off the pituitary gland in order to stop the ovaries working temporarily and allow the lady’s cycle, in its totality, to be controlled by the clinic. In cases of fresh egg donation to another woman, the donor’s cycle is synchronised with that of the recipient.

The donor then takes follicle-stimulating hormones to overstimulate the ovaries into producing an artificially high number of eggs at the same time. The clinic wants extra eggs, wants the donation to be larger than the lady would normally produce, and the woman then injects human chorionic gonadotropin, or HCG, which helps eggs to mature, ready for retrieval. This maturation mimics the natural process that normally triggers ovulation.

Finally, eggs are collected from the woman using a needle that punctures the vaginal wall and perforates the ovary, gathering fluid from each follicle—the fluid containing the eggs. Donors in the UK have reported that dozens of eggs, and often even more, have been retrieved in just one donation round. One British donor reported 42 eggs being retrieved in one cycle; another reported 46 eggs being retrieved in the next cycle. That stands in stark contrast to the one egg a month that the female body naturally ovulates. I hope that those who are here today will understand that if a lady’s natural ovulation rate is one egg a month, but 42 or 46 eggs are produced and farmed, that is very much going against what the body does naturally, which has a detrimental effect on some people.

Nobody fails to have sympathy for those who struggle to have a child and who therefore embark on fertility treatment. I know quite a number of ladies who have embarked on such treatment, and their joy at having their wee baby is something that words cannot describe. The look of happiness on the faces of the mum and dad is great, as is the fact that the wee child has been born. However, the use of donor eggs has real societal consequences and potentially there can be a very negative long-term physical and psychological impact on young women who donate their eggs.

We must rebalance this conversation to take into account the impact on the young women who undergo these procedures. We need to have regulation; we need to have rules in place. The process needs to be controlled, rather than the matter just being seen from the point of view of those who want access to donor eggs.

We know from the experience of women who underwent forced adoption in mother and baby homes in the 20th century that often it takes years for women to come forward and report harm done to them in the past. Some donors have reported needing hysterectomies as a result of the damage they sustained during egg retrieval. Other donors have said that when they discovered they had genetic diseases, the clinics refused to take further action and put the onus back on the donor themselves to report to the HFEA. Those checks should have been done before donation, not afterwards.

Similarly, donors are not required to undergo enhanced carrier screening, leading to a risk that some genetic diseases might be unknowingly passed on in the donor eggs and ultimately on to the wee baby who will be born. Another donor has reported donating eggs in her early 20s, only to find when she tried to start her own family in her early 30s that she was unable to do so. Other donors report endometriosis and adenomyosis developing after donation. Quite simply, the long-term risks to women’s health from egg donation are unknown and largely unstudied. Today, I am hopefully outlining where the problems are, why regulation is needed and why I believe that the Government need to step in.

Women who have undergone egg retrieval for their own IVF have reported complications and side effects, including sepsis, abscesses, perforated bowels, severe pain during or after retrieval, and even slipping into a coma as a result of developing ovarian hyperstimulation syndrome.

All this risk is borne by young people so that older people can purchase eggs from fertility clinics and egg banks. According to the HFEA, between 1991 and 2022 —some 31 years—44,760 IVF cycles involving donor eggs were made for people aged 40 or over.

Young donors are at higher risk of ovarian hyper- stimulation syndrome because of the higher number of eggs that they have compared with older women. The Royal College of Obstetricians and Gynaecologists has said that as many as 30% of women aged under 30 who undergo egg retrieval may develop ovarian hyperstimulation syndrome. Complications arising from OHSS can kill. That is why there needs to be regulation and consideration of safety as part of the process.

Two women died in England from such complications in 2005-06. In 2023 there were 53 severe or critical cases of OHSS reported to the HFEA. Yet nowhere in the adverts, online or anywhere else are the risks stated, and they should be. Those donating eggs should be aware of the risks. Donors have reported that clinics mention the risks and likely side effects only briefly and not in depth. They should be stated in depth, but they are not. Counselling for donors is offered, but is not mandatory.

We must look at international comparators. I always like to see what has been happening elsewhere. In Germany there is no egg donation at all. German legislation specifically prohibits the “splintering”—that is the word used—of motherhood that egg donation and surrogacy create. In Italy, donors cannot be compensated at all so that women are not incentivised to undergo the procedure because of financial need.

We must also consider the donor-conceived child. Egg and sperm donations are not meant to create more than 10 families. How many times have I read in the press about men who have fathered, through their sperm, perhaps as many as 100-plus children in the United Kingdom and across the world? One day a young boy and girl could meet, marry, and actually be brother and sister. There needs to be a limit, which is 10, but it is clear that some clinics do not have the control that perhaps they should have.

As gamete donation and use rapidly increases, the likelihood of genetic half-siblings across multiple households, often in close geographical proximity to one another, increases. That is what I fear no controls means. Although British clinics must ensure that donor identities can be revealed to children at 18 years of age, many people resident in the UK still travel abroad for IVF, including to jurisdictions where anonymous gametes and sex selection of embryos are legal. That means hundreds, if not thousands, of children are growing up in the United Kingdom of Great Britain and Northern Ireland unable ever to trace their genetic parents.

The evidence is strong enough to call on the Government to raise the minimum age for egg donors to 25, because of the effect it has on those under that age who donate eggs. Secondly, we should ban adverts asking for women to donate eggs—the very thing that the hon. Member for Edinburgh North and Leith referred to and which we are all very aware of. Advertising for surrogate mothers is already banned, so why not ban adverts asking for women to donate eggs? Thirdly, we should end payments to donors to ensure they are not donating because of financial need. In other words, their financial circumstances could put them in a quandary when it comes to doing what they are doing. At a minimum, adverts must state the health risks up front and the minimum donor age must rise. I sincerely hope that the Minister will take the issue back to the Department and that the Government will act quickly to protect and prioritise young women and their health.

--- Later in debate ---
Karin Smyth Portrait The Minister for Secondary Care (Karin Smyth)
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It is a pleasure to serve under your chairmanship, Mr Efford. I thank the hon. Member for Strangford (Jim Shannon) for securing this debate on egg donation in young women. He raises a number of important points, which the Government take seriously. I absolutely assure him that there are rules and regulations around egg donation in this country. Hon. Members in this debate have talked about the potential concerns of the long-term impact of egg retrieval, and the potential incentive of the compensation offered for egg donation, particularly for young women on low incomes. I hope to address those points in my remarks.

For people who are struggling to conceive, which may be for a variety of reasons, receiving donor eggs can be life-changing—as we have heard in this debate—and enable them to start a family of their own. Donating eggs should be a purely altruistic act, and choosing to become a donor is a complex decision. In the UK, the average egg donor is between 31 and 32 years of age. That average has remained stable since records began in 1991. Egg donors are typically UK-based, with around 3% of donor eggs imported from abroad. There were around 3,800 IVF cycles using donor eggs in 2023, which is an increase from around 3,600 in 2019. Those donors support around 2,000 to 3,000 people a year who would otherwise not be able to have a baby. I recognise their generosity, although, as my hon. Friend the Member for Newcastle upon Tyne East and Wallsend (Mary Glindon) said, we also recognise that egg donation procedures come with risks, and they should not be undertaken lightly.

The HFEA ensures that licensed fertility clinics are following law and guidance in relation to egg donation. The Government agree with the point made in this debate that young women should be fully informed of any risks when making the decision to donate their eggs, and that clinics must ensure that women are fully informed and supported throughout the egg donation process. It is mandatory for clinics to provide counselling to women before egg donation to ensure that they understand all the potential risks, and legal and social implications, of donation. Donating eggs is generally very safe, and most women do not experience any health problems beyond discomfort during the stimulation of the ovaries and the egg collection procedure.

I do not want to minimise that experience of discomfort, but where women wish to donate eggs, the HFEA and the Government are committed to making it as safe and accessible as possible. In the short term, there is a potential risk of having a reaction to the fertility drugs used for the donation procedure. If that happens, the effects are normally mild, and can include headaches, nausea or feeling bloated. Donors are advised to let their clinic know if they experience any of those side effects.

In some very rare cases, as we have heard, women develop OHSS. It is a serious and potentially fatal reaction to fertility drugs, which happens about a week after eggs have been collected. Fortunately, it is rare, occurring in less than 0.1% of cycles. Because of the serious nature of OHSS, all severe or critical cases must be reported to the HFEA within 24 hours by the patient’s clinic. They are categorised by the HFEA as grade B incidents. A grade B incident involves serious harm to one person, or moderate harm to many. The HFEA’s latest “State of the fertility sector” report found that fewer OHSS incidents were reported in 2023-24, with 53 severe and critical cases reported by UK clinics.

In recent years, there has been widespread interest in donation, and figures show that the number of egg donors is rising. We heard from my hon. Friend the Member for Newcastle upon Tyne East and Wallsend and the Opposition spokesperson, the hon. Member for Sleaford and North Hykeham (Dr Johnson), about the importance of having conversations and asking questions about the long-term impact on women’s health, which is generally an under-researched area. The Government recognise that and would welcome studies in this area. If there is anything I can add to that following this debate, I will follow up with hon. Members on the opportunities for understanding the wider long-term implications for women’s health in this area.

At the public board meeting last year, the HFEA discussed the rates of compensation offered to egg and sperm donors. Since 1 October 2024, egg donors have received £985, which is up from £750. That increase in donor compensation was the first since 2011, and reflects the rise in inflation. The compensation offered to them is intended to reflect their time and the nature of the procedure, rather than being an attempt to monetise donation in the UK.

I want to address some of the points raised by Members to do with the variability of access to fertility services more broadly. Infertility affects one in six women of reproductive age worldwide. It is a serious condition that impacts wider family, relationships and mental health, as we heard from the Liberal Democrat spokes- person, the hon. Member for Chichester (Jess Brown-Fuller). I congratulate her friends, Lottie and Marvin, on the arrival of their child.

This Government expect integrated care boards to commission fertility services in line with the National Institute for Health and Care Excellence guidelines. NICE is currently reviewing the fertility guidelines, and will consider whether the current recommendations for access to NHS-funded treatment are still appropriate. I look forward to the guidelines being published; we will work with integrated care boards to determine how best to improve their local offer and ensure equity of access for affected couples.

Jim Shannon Portrait Jim Shannon
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I thank the Minister for her very comprehensive review. I have three quick questions. First, will the Government commit to undertaking a long-term study into the long-term health outcomes of women? That is one of the things I hope to see happen when it comes to egg retrieval. Secondly, will the Government review the safety of offering £985 per donation, which is sometimes said to be compensation? Thirdly—I hope I am not pressing the Minister too hard; I am quite happy for her to come back to us on this—everyone who has participated in the debate has expressed concern about the adverts, so we are keen to hear her thoughts on banning those.

Karin Smyth Portrait Karin Smyth
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I have addressed the issue of compensation. It rose in response to inflation, for the first time since 2011. We have no further plans to start a study specifically on health. As I said in my remarks to others, we understand that broader outcomes in women’s health is an under-researched area. Bringing forward trials is the usual response. If we need to add anything else to that, I will make sure we do so, but there are no other plans currently.

Advertising is governed in this country by the Advertising Standards Authority, which issued a joint enforcement notice in 2021 with the HFEA to ensure that fertility clinics and others were aware of the advertising rules and treating customers fairly. I am afraid I cannot comment on Scotland, where I understand there has been a large advertising campaign. That is not in my ken, although it is covered by the HFEA, which is a UK-wide body, so that is a bit of a complication. If there is anything to report back on with regard to Scotland, without me stepping on devolved issues, I will make sure we do so.

I again thank hon. Members for securing the debate and acknowledging the altruism of the women who choose to donate their eggs and help to give others a much longed-for baby. I assure Members that this Government will monitor the issues raised this afternoon. Women’s health and tackling inequalities are central to the priorities that we will take forward in the 10-year plan.

Jim Shannon Portrait Jim Shannon
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I thank all Members for their contributions to the debate. The hon. Member for Edinburgh North and Leith (Tracy Gilbert) referred in an intervention to the advertising issue, which is really important. She talked about Scotland, as I did, but there is also advertising elsewhere that needs to be controlled.

The hon. Member for Newcastle upon Tyne East and Wallsend (Mary Glindon) and I had a discussion at some length before the debate today, and the very things that she wants to see, we all wish to see. We all recognise that IVF gives potential mothers the opportunity to have a child; the joy that can bring can never be emphasised enough. However, we must ensure that all the risks involved are known beforehand. She referred in particular to ovarian cancer and egg donation.

The hon. Member for Pendle and Clitheroe (Jonathan Hinder) referred to the issue of compensation. When ladies give eggs as a donation, their reasons for doing so are above board. Whenever eggs are donated for compensation, which is the word that is used, unfortunately it can lead to other things as well.

I also thank the hon. Member for Chichester (Jess Brown-Fuller) for her contribution and for the example she gave, which showed the joy that having a child can bring. She referred to those who donate eggs willingly, without any financial obligations. She also talked about surrogacy, which is a different issue.

I thank the shadow Minister, the hon. Member for Sleaford and North Hykeham (Dr Johnson), for her contribution. She brings a wealth of knowledge, through her doctorship. I also thank her for outlining all the cases that she did. She gave the example of one of her constituents, which perhaps highlighted what the issues are.

As always, I thank the Minister for taking the time to come along. My request to her is this: whenever we have a chance to look over this debate and check the Hansard report, we might have further questions, so would she be agreeable to coming back to us if we do?

It is very obvious to me that the Government recognise that there are issues that are outstanding and that must be resolved. With that in mind, I again thank all hon. Members, particularly the Minister, for their contributions, and I also thank those in the Public Gallery, who have come along to listen to our contributions today.

Question put and agreed to.

Resolved,

That this House has considered IVF egg donation in young women.