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The HFEA publishes annual ‘State of the Fertility Sector’ report

Patients can be reassured of safe fertility care, says UK fertility regulator.

Patients who undergo fertility treatment in UK licensed clinics can continue to be reassured that their care is safe and of a high quality, the regulator has found.

The Human Fertilisation and Embryology Authority’s (HFEA) State of the Fertility Sector 2022/23 report reveals that out of the almost 100,000 treatment and storage cycles which took place, more than 99% were conducted without any incidents occurring.

The annual report summarises HFEA compliance work for 2022-23 as well as information recorded in incident reports, on its Register of fertility treatments and through patient feedback mechanisms.

Peter Thompson, Chief Executive of the Human Fertilisation & Embryology Authority (HFEA), said:

“Fertility treatment within UK licenced clinics has yet again proven to be safe. Patients and can continue to be reassured that the risk of an incident in their care is very low, with more than 99% of treatment and storage cycles carried out without incident.

“Following each clinic inspection, a report identifying areas of good practice and those which require improvement is published on the HFEA website. We monitor incidents in clinics to make sure that everything is done to understand what went wrong and, crucially, to take steps to ensure it does not happen again. We also share learning and notify other clinics of potential issues.”

The State of the Fertility Sector 2022-2023 report, which provides an overview of the sector-wide compliance, reporting on inspection, incidents, complaints, and non-compliances, found that:

  • About 100,000 treatment and storage cycles were conducted with more than 99% of taking place without any incident.
  • The number of inspections has decreased compared to previous years from 105 in 2021/22 to 85 in 2022/23. This is because more inspections took place in 2021/22, as inspections were deferred from 2020/21 during the COVID-19 pandemic.
  • The HFEA has worked with clinics to ensure they do everything possible to prevent and manage OHSS. In 2022/23, there were 64 cases of severe and critical OHSS reported by UK clinics, occurring in less than 0.1% of cycles.
  • There were 517 incidents and 89 near misses reported to the HFEA in 2022/23 (Figure 5). In 2022/23, most incidents were Grade C (291), followed by Grade B incidents (226 incidents). Both Grade B and C incidents in 2022/23 decreased, consistent from previous years. There were no Grade A incidents from 2020/21 to 2022/23.
  • The number of patient complaints decreased from 76 in 2021/22 to 59 in 2022/23.
  • Of the 107 licensed treatment clinics, 66 (62%) were privately owned, an increase from 62 in 2021/22. It should be noted that most HFEA licensed clinics, whether private or NHS, treat both NHS and self-funded patients.

The HFEA is the independent regulator of fertility treatment and human embryo research in the UK. It aims to ensure that everyone receives high quality care in UK fertility clinics by licensing, monitoring, and inspecting clinics - and taking enforcement action where necessary - and providing free, clear and impartial information about fertility treatment, clinics, and egg, sperm and embryo donation.

You can view the State of the Fertility Sector 2022-23 report on the HFEA’s website.


For more information or for interviews with a HFEA spokesperson, please contact or call 020 7291 8226.

For out of hours requests, please call the duty press officer on 07771 981920.

Notes to editors

  • The COVID-19 pandemic had a significant impact on the availability of fertility treatment in 2020/21 and this, combined with the changes made to the HFEA inspection approach during the year, means that data in this report may not be directly comparable with treatment in the previous years.
  • 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.
  • For more information about the HFEA regulatory response to COVID-19 and the subsequent changes made to inspections, read the Impact of COVID-19 on fertility treatment 2020 report and the State of the fertility sector 2021/22.

About the HFEA

  • 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 - and taking enforcement action where necessary - to ensure everyone accessing 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 collects and verifies data on all treatments that take place in UK licensed clinics which can support scientific developments and research and service planning and delivery.
  • Around 4,100 children in the UK are born each year through the help of a donor (2019). The HFEA holds records of all donors and children born since 1991.
  • The HFEA is funded by licence fees, IVF treatment fees and a grant from UK central government. For more information visit,

Review date: 12 September 2025