CMA Calls on the Government for Regulatory Reform to Better Protect Fertility Patients in UK

On 18 July 2025, the Competition and Markets Authority (CMA) issued a comprehensive letter to Baroness Merron - the Parliamentary Under-Secretary of State for Patient Safety, Women’s Health and Mental Health - urging the UK Government to pursue regulatory reforms in the fertility sector to better protect patients as consumers.

In the letter, Emma Cochrane, Executive Director for Consumer Protection and Markets at the CMA, outlines the authority's multi-year investigation into the fertility sector, culminating in a formal recommendation to modernise regulatory oversight through updates to the Human Fertilisation and Embryology Act 1990.

The fertility sector has undergone rapid commercialisation, with more than three-quarters of IVF patients in England self-funding their treatment.

According to CMA research, many patients face significant financial, emotional, and informational pressures, often navigating a complex landscape of clinics, treatments, and pricing structures with limited transparency or regulatory recourse.

“Buying fertility treatment is a major decision,” Cochrane wrote. “It can be complicated, stressful and very expensive, with no guarantee of success. Our research shows that individuals considering fertility treatment often find themselves in a vulnerable position.”

Key Concerns and Findings

The CMA’s investigation revealed persistent issues across the fertility sector:

• Lack of pricing transparency: Patients often struggle to compare clinics due to inconsistent pricing structures and hidden costs, especially from unproven “add-on” treatments.

• Consumer vulnerability: Patients typically engage emotionally and financially with clinics before receiving clear and comprehensive pricing or success rate information.

• Unregulated marketing practices: Some clinics were found to use potentially misleading success rates and promotional material.

• Inadequate consumer protections: The current legal framework does not equip the Human Fertilisation and Embryology Authority (HFEA) with the necessary powers to act swiftly or proportionately in response to consumer protection issues.
  

CMA’s Recommendations for Reform

Cochrane’s letter calls for several significant reforms:

1. An expanded duty for the HFEA to explicitly include patient protection and consumer fairness.

2. Enhanced information-gathering powers for the HFEA, particularly around clinic pricing and treatment add-ons.

3. More flexible enforcement tools, including the ability to issue fines and take early regulatory action without needing to revoke clinic licences.

4. Greater enforceability of the HFEA’s Code of Practice, with suggestions to integrate it directly into clinics’ licensing conditions.
   

The CMA had also explored the feasibility of a voluntary pricing transparency initiative, but concluded it was unviable due to limited clinic participation, lack of reliable data, and high implementation costs.

Positive Changes and Sector Cooperation

Despite the challenges, the CMA reports meaningful improvements following its guidance on consumer law issued in 2021. Many clinics enhanced their website information, improved contract terms, and removed misleading claims.

However, persistent disparities remain, particularly in how add-on treatments are marketed and priced.

Government Response Pending

The CMA has now concluded its formal programme of work in the sector but has made clear it stands ready to support the Department of Health and Social Care should the government move forward with reform.

“Although we are not currently prioritising further work in this sector,” Cochrane added, “we would be very willing to engage with you and support your officials should the UK government wish to take action to address challenges in this market.”

Background

Over the past five years, the fertility sector in the UK has seen a trend toward consolidation, with an increasing number of clinics owned by private equity-backed groups. In 2022, over 76% of IVF treatments in England were self-funded — a significant increase from 68% in 2019.

The CMA’s research shows patients often make decisions based on incomplete or unclear pricing information and are heavily influenced by the first clinic they consult.

Outlook

With fertility treatment becoming increasingly commercialised, the CMA’s recommendations place significant pressure on the government to update legislation that has remained largely unchanged for over three decades. The proposed reforms could signal a shift toward greater accountability and fairness in a market that affects thousands of hopeful families each year.

Download the full CMA letter and annex here