Fertility treatment abroad

The HFEA regulates clinics in the UK only. Before going abroad for fertility treatment, the HFEA advises that you find out about the standards and regulations in the country where you will be treated.

We cannot provide specific advice about fertility clinics outside the UK. Foreign clinics are subject to the laws and standards which are in force in that country and these may be quite different to those in the UK.

The HFEA cannot regulate treatment that is carried out abroad even when UK clinics have arrangements to refer patients to specific clinics outside the UK.

There are many issues that should be considered before going abroad for fertility treatment. These include:

Standards of quality and safety

UK clinics are inspected and monitored regularly to ensure they maintain standards set out by the HFEA Code of Practice

A set of standards introduced by the EU Tissues and Cells Directive (EUTD) applies to most countries in Europe (those within the European Economic Area) although this has not yet been fully implemented in all countries. Within the UK, there are additional standards in place that help protect patients and ensure quality and safety.

Clinics in other countries may be subject to local standards and regulations, and these can vary across the country. Outside the EU, the standards of testing donors for disease and inherited disorders may be different from those applicable in the UK or Europe. Counselling must be offered by UK clinics, it may not be offered in other countries. Why is counselling important?

The HFEA produces guidance for clinics on the number of embryos that may be transferred, as a multiple pregnancy increases the risk to both the mother and the babies. We also publish a patient factsheet Multiple pregnancies: considering the risks which you may find useful. We would also advise you to discuss the number of embryos you will have transferred with your clinic before commencing treatment.

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Success rates

Foreign clinics may not be subject to the same external examination of their success rates as clinics in the UK. The law requires UK clinics to inform the HFEA about the treatments they carry out and this information is published by the HFEA.

How success is calculated may also be different, making it difficult to compare like with like. The success rates reported by UK clinics and the HFEA are the number of live births as a percentage of cycles started. So, for example, a success rate of 22 % means that for every 100 cycles started at that clinic, 22 of these resulted in a live birth.

Some foreign clinics report their success rates as a percentage of embryo transfers carried out.  This calculation does not include those cycles that were stopped before embryos were transferred and so will give a higher "success rate" figure.

Read more about HFEA success rates

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Patient information

Confidentiality - it is worth researching the clinic and finding out what happens to your patient information, and who will be able to access it.

Safeguarding information - can the clinic ensure that important records will not be destroyed?  And what will happen to your patient information or the information about the donor used in your treatment should the clinic close down?

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Donor information

The HFEA holds a central register of donor information so that when offspring reach the age of 18 years they can obtain details about their donor. You should be aware that donation is anonymous in most countries outside the UK and not all will have a central register of donor information.

If an overseas donor is to be identifiable when the child reaches 18, the systems for recording and retaining the donor's details over that period may not be as strict as those in the UK. Some individual clinics may hold donor information. It is important to find out in advance whether the clinic you are being treated at is one of these or not.

The law in the UK also states that the donor does not have any responsibility to children born as a result of the donation. This may not be the case in other countries. The HFEA therefore recommends you seek your own legal advice to clarify your position.

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Complaints and legal issues

Should anything go wrong with your treatment you should find out how your concern or complaint would be followed up and resolved. Clinics in the UK are required to have a complaints process.  If a patient is unhappy with the way a clinic has responded to their complaint, they may refer the matter to (depending on the issue) the HFEA or another professional or statutory organisation.

The law in the UK states that the donor does not have any responsibility to children born as a result of the donation. This may not be the case in other countries. The HFEA therefore recommends you seek your own legal advice to clarify your position.

You might need independent legal advice to clarify the enforceability of contracts and agreements between you and a clinic outside the UK.

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Ethical issues

Before donations are accepted all UK donors are interviewed, offered counselling and screened. There are also clear limits set out on the extent to which a donor may be paid for expenses, loss of earnings or inconvenience. The process is different in every country and you may wish to find out more about this before undergoing treatment with donor gametes.

The HFEA Code of Practice sets a limit for the number of live births that can be achieved by one donor. This may not be the case in other countries and it can be left to the discretion of the clinics. You may wish to investigate this further before you begin treatment.

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Exporting eggs, sperm or embryos abroad

If you have fertility treatment abroad and export sperm, eggs, or embryos from the United Kingdom, information about your treatment cannot be held on the HFEA Register.

This means that the HFEA cannot supply you or your children with information from the HFEA Register about your donor or any donor-conceived half brothers or sisters.

A set of standards introduced by the EU Tissues and Cells Directive (EUTD) applies to most countries in Europe (those within the European Economic Area) although this has not yet been fully implemented in all countries. This may affect patients wishing to import or export eggs, sperm or embryos to or from these countries.

Further information about importing or exporting eggs, sperm or embryos.

 

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Other information

It may be worth trying to speak to someone or a group of people who have been treated at the clinic or in the country to where you are intending to go to find out about their experiences. 

A list of patient organisations in other countries can be found on the Infertility Network UK website.

If you are going abroad to enter into a surrogacy arrangement abroad, you should find out how the law in that country and the UK will apply to you. Read more about surrogacy arrangements where the child is not born in the UK. 

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Last updated: 24 July 2008