What is the Ethical Assisted Conception Hub? 

White Ribbon Alliance UK (WRA UK) has received funding from the National Lottery to lead a project on equitable and ethical assisted fertility practices, with a particular focus on the LGBTQ+ community. This project is the Ethical Assisted Conception Hub (EACH).  

 

The aim of EACH is to inform and support individuals or couples considering having a child via donor conception or surrogacy; to advocate for the rights and well-being of donors, surrogates and donor conceived people; and to equip health care professionals with the knowledge and tools to support those who are using assisted reproductive technology to build a family. 

 

Find out more about WRA UK's work here. 

 

What is ‘assisted conception’? 

Assisted conception (also sometimes called ‘assisted reproduction’ or ‘assisted reproductive technology’) is an umbrella term for treatments that enable those experiencing fertility issues, solo parents by choice, and those in same-sex, queer, or non-binary relationships, to conceive and have children. 

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The NHS recognises three distinct types of assisted conception: intrauterine insemination (IUI), in vitro fertilisation (IVF), and egg and sperm donation – although in practice there can be overlap between these, such as using a sperm donor for IUI. Surrogacy is also a form of assisted conception; however, it is not available via the NHS.  

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Intrauterine insemination (IUI)

Intrauterine insemination (IUI) is a fertility treatment that involves directly inserting sperm into a uterus. The sperm can be from a partner or a donor. This may be offered on the NHS, if you meet the criteria in your local region, but the wait times can be long. Alternatively, it can be paid for privately at some private fertility clinics.  

 

In vitro fertilisation (IVF)

In vitro fertilisation (IVF) is a fertility treatment that involves eggs being removed from the ovaries and fertilised with sperm in a laboratory. The fertilised egg (embryo) is then returned to the uterus to grow and develop. IVF is done in cycles, with a full cycle being when embryos are replaced into the uterus, and any remaining embryos are frozen. The future use of those frozen embryos is considered part of the same cycle.

 

Intracytoplasmic sperm injections (ICSI)

As part of IVF, those seeking to conceive may also need to undergo intracytoplasmic sperm injections (ICSI). Read more about ICSI here. 

 

Funding for Fertility Treatments 

Local integrated care boards (ICBs) decide the criteria for receiving IVF treatment on the NHS and this can vary widely between areas. Currently most of the IVF treatments in the UK are funded by patients themselves. You should speak to your GP or contact your local ICB to find out more information about the criteria for NHS funded IVF in your area.  

 

Egg or sperm donation 

Egg or sperm donation is a process to help individuals and couples who cannot use their own gametes to conceive. You can find out more information on egg and sperm donation, including ethical considerations and the potential health implications for donors, here. 

 

Surrogacy

Surrogacy is when someone agrees to undergo a pregnancy and give birth to a baby on behalf of a person or couple who are unable to do so themselves. There are two types of surrogacies, one where the pregnant person uses their own eggs (known as traditional or partial surrogacy) and one where they use the eggs of an intended parent or separate egg donor (known as gestational, host or full surrogacy).

 

The UK operates an ‘altruistic’ model of surrogacy, meaning that surrogates are reimbursed for their medical costs and any other pregnancy related expenses, but they do not receive additional financial compensation. ‘Commercial’ surrogacy, where the surrogate is financially compensated for more than their expenses, is legal is some countries, though it can cost considerably more than surrogacy in the UK. 

 

Some UK-based intended parents decide to go overseas to find a surrogate. For more information, you might want to read about the ethical implications of surrogacy and our factsheet on assisted conception and the law. 

 

Additional reading:  

nationality-policy-surrogacy-v2.0ext.pdf (publishing.service.gov.uk) 

Surrogacy overseas - GOV.UK (www.gov.uk) 

 

Who can use assisted conception?  

Assisted conception is for couples or individuals who cannot have a child themselves. It is most often utilised by those with fertility problems, those in same-sex relationships, those looking to raise a child outside of a relationship, or those with certain disabilities or health conditions. 
 

The current NICE guidelines - evidence-based recommendations for health and care in England and Wales – advise that women under 40 who have not managed to conceive after two years of unprotected sexual intercourse or 12 cycles of artificial insemination, should be offered IVF treatment. Click here to read the guidance in full. In practice, treatment options vary by area. 

 

In countries outside of the UK, access to assisted conception may be limited to those who fit certain characteristics. For example, the current law in Greece might allow an opposite-sex couple from the UK to access surrogacy services there but would not allow a solo parent or a same-sex couple to access those same services.  

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What is the history of donor conception? 

The history of artificial insemination in the UK dates to at least the late 1700s, with clinics being set up to offer artificial insemination using a sperm donor from the 1930s. It wasn’t until the 1980s that regulatory frameworks were introduced to oversee the practice of artificial insemination in the UK. You can read more on the laws governing artificial insemination here. Up until 2023 many ICBs in England required same-sex couples to pay privately for up to 12 cycles of Intra-Uterine Insemination (IUI) before they could access NHS services, highlighting the increased barriers that same-sex couples face in accessing assisted conception.  

 

The very first baby born through IVF was born at Oldham General Hospital in England, to a mother who had struggled to conceive due to blocked fallopian tubes.

 

How common is assisted conception? 

Roughly 3% of all children born in the UK are born with the use of some kind of assisted conception. The HFEA dashboard offers a more in-depth look at live births from assisted conception procedures such as IVF, using data from 1991-2021. 55,000 people underwent at least one cycle of IVF treatment in 2021, a number which is growing year on year.  

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Current estimates are that around 500 children are born each year to surrogates in the UK. This is calculated through ‘parental orders’ where parental rights are transferred from the surrogate to the intended parent(s). As parents who use surrogates abroad may not be aware of the need to complete a parental order, it is possible that estimates are missing data from children born to surrogates outside the UK to British parents.  

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Who donates eggs and sperm?

Trends in first time registration to donate eggs have varied hugely year-on-year since the early 1990s, with a recent decline in donations during the Covid-19 pandemic. The last few years have seen a range of between 1,200-1,600 newly registered egg donors per year.  

 

While newly registered UK-based sperm donors have stayed fairly consistent at around 400 new donors per year, imported sperm (primarily from the USA and Denmark) currently accounts for over half of all new registrations. Donor conception led to more than 4,100 births in 2019, accounting for 1 in 170 of all births and for nearly 1 in 6 births using IVF in the UK.  

Source: Trends in egg, sperm and embryo donation 2020 | HFEA 

 

What are the laws on assisted conception in the UK? 

In 1990, the Human Fertilisation and Embryology Act was passed, to oversee the use and storage of embryos outside of the human body, and to set up the Human Fertilisation and Embryology Authority (HFEA). The HFEA was created to be an independent regulator, working on behalf of the UK government, to regulate fertility treatment in the UK. The HFEA carries out inspections and grants licences to all fertility clinics and research centres using human embryos.  

 

Surrogacy is legal throughout the UK and has been regulated under UK law since 1985, when the Surrogacy Arrangements Act was introduced. To find out more, read our law factsheet here. 

 

How do I find out more? 

I want to know more about the Ethical Assisted Conception Hub (EACH). 

I want to know more about the work of White Ribbon Alliance UK. 

I want to know more about donor conceived people. 

I want to know more about becoming an egg/sperm donor or a surrogate.  

I want to know more about the laws on assisted conception.   

I want to read more from the HFEA, the government’s independent body for assisted conception.