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.