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Fertility treatment continues to become safer as serious incidents continue to fall

Fertility treatment is continuing to become safer with quality of care improving across UK clinics, despite the impact of the pandemic, according to the fertility regulator’s annual compliance report.

The HFEA’s State of the Sector report shows that 77 inspections carried out in 2020/21, with category B incidents falling by 24% compared to the previous year.

While clinics were temporally closed between April and May 2020 due to unprecedented strain on the healthcare system during the first wave of the pandemic, most clinics were able to recommence treatments quickly, with 94% of private clinics and 76% of NHS clinics reopening by June 2020.

Julia Chain, Chair of the HFEA, said:

The COVID-19 pandemic had a serious impact on the availability of fertility treatment for a short time last year, which meant that we had to adapt our regulatory oversight to ensure the safety of patients and their sperm, eggs and embryos could be maintained.

While inspections of clinics were suspended during the first national lockdown, we used this time to design new ways of working and modify our approach to inspections to allow continued close oversight of the fertility sector as the pandemic continued.

Although the numbers of onsite inspections were reduced, we are pleased to see that the level of compliance is broadly similar to the previous year and it’s encouraging to see a continued trend of fewer serious incidents, including an ongoing decline in serious cases of OHSS.

Over the years we’ve worked hard with the sector to reduce the number of OHSS cases, which is the single biggest complication from fertility treatment, and clinics were encouraged to have an even more cautious approach to OHSS to reduce any additional burden on the NHS during the pandemic.

In 2020/21, 548 incidents (including near misses) were reported to the HFEA, compared to 569 in 2019/20. Cases of severe cases OHSS continues to decrease with 43 cases reported in 2020/21, a reduction of 35% on the previous year.

A total of 103 fertility clinics were licensed by the HFEA in the UK to provide fertility treatment in 2020/21, with two-thirds of clinics being standalone, and the rest being owned by nine private clinic groups. Of the 103 licensed clinics that offered fertility treatment, 59 clinics (57%) are privately owned. The largest concentration of clinics offering fertility treatment were based in London (31 clinics), followed by the Southeast of England (10 clinics) and the West Midlands and the North West (9 clinics each).


Notes to editors

The HFEA is the UK’s independent regulator of fertility treatment and research using human embryos.

Set up in 1990 by the Human Fertilisation and Embryology Act, the HFEA is responsible for licensing, monitoring, and inspecting fertility clinics to ensure patients and everyone born through fertility treatment receives high quality care.

The HFEA is an ‘arm’s length body’ of the Department for Health and Social Care, working independently from Government providing free, clear, and impartial information about fertility treatment, clinics and egg, sperm and embryo donation.

The HFEA is funded by licence fees, IVF treatment fees and a grant from UK central government. For more information visit,

Incidents are graded as:

  • Grade A: involve severe harm to one person, or major harm to many
  • Grade B: involves serious harm to one person, or moderate harm to many
  • Grade C: involves minor harm
  • Near miss: an event not causing harm but has the potential to cause injury or ill health.

Review date: 24 November 2023