UK peers call for urgent review of fertility and surrogacy laws amid concerns over outdated regulation

Peers in the House of Lords have urged the Government to review UK fertility, surrogacy and embryo research laws following two linked debates held on 4 June 2026 during a single sitting in the Lords Chamber.

The discussions raised concerns about outdated legislation, inconsistent NHS access to IVF, and the UK’s declining birth rate. The first debate focused on fertility treatment regulation, while the second examined declining birth rates. Both were conducted as general (balloted) debates, allowing peers to raise wider policy concerns rather than vote on specific legislation.

The fertility and surrogacy debate was opened by crossbench peer Baroness Ruth Deech, former chair of the Human Fertilisation and Embryology Authority (HFEA), who set out concerns about the Human Fertilisation and Embryology Act (first created in 2010, with updates in 2008), surrogacy regulation, and proposals for reform from both the Human Fertilisation and Embryology Authority and the Law Commissions of England and Wales and Scotland.

The discussions centred on whether current frameworks governing assisted reproduction remain fit for purpose in light of rapid advances in reproductive medicine, as well as evolving social attitudes towards family creation and changing family structures, donor conception and surrogacy. It was the view of Baroness Deech that Parliament should take a more proactive role in shaping future fertility regulation.

Baroness Deech said:

“Parliament should plan by setting up a Select Committee to examine the HFEA’s proposals to expand regulatory powers, simplify consent rules, modernise donor information provisions and create a flexible framework for future scientific developments.”

Her intervention followed proposals from the HFEA, alongside recommendations from the Law Commission of England and Wales and the Scottish Law Commission, which have suggested reforms to modernise both fertility law and the Surrogacy Arrangements Act.

Baroness Deech also called for “automatic record sharing between clinics and the NHS central records system”, arguing that greater integration of fertility data could improve oversight and patient care.

Pressure mounts for legal reform

According to parliamentary discussions and recent analysis of the UK fertility regulatory system, peers are urging ministers to reconsider how fertility treatment and surrogacy are governed, including whether existing legislation adequately protects patients, donors and children born through assisted reproduction.

The UK’s fertility sector is regulated primarily by the Human Fertilisation and Embryology Authority (HFEA), which oversees licensing of clinics, embryo research and donor conception records. The regulator has previously acknowledged that the current legal framework is showing its age and may need modernisation to reflect developments in reproductive science and clinical practice.

Lawmakers argue that despite incremental updates over the past decades, core legislation has not kept pace with innovations such as expanded genetic screening, evolving donor anonymity rules, and emerging reproductive technologies.

Debate over definition of infertility

Former fertility specialists and medical experts contributed strongly contrasting views during the debate. Professor Lord Robert Winston, a Labour peer who founded the IVF service at Hammersmith Hospital in London, told peers:

“Infertility is not a disease; it is actually a symptom of something wrong.”

However, Professor Baroness Geeta Nargund, a Labour peer and former medical director of CREATE Fertility, disagreed, stating:

“Infertility is a disease, as stated by the World Health Organisation.”

Concerns over unequal access to IVF in England

Significant attention was also given to disparities in NHS-funded fertility treatment across England. Liberal Democrat peer Baroness Caroline Pidgeon cited figures from the Progress Educational Trust’s NHS Fertility Funding Tracker, indicating that only two of England’s 42 integrated care boards (ICBs) comply fully with National Institute for Health and Care Excellence (NICE) fertility guidelines.

ICBs are NHS organisations responsible for planning and funding local healthcare services. Baroness Pidgeon said many areas were offering only partial IVF cycles rather than full treatment courses as defined by NICE guidance.

A full IVF cycle typically includes ovarian stimulation, egg collection and transfer of all suitable fresh and frozen embryos created during treatment. Crossbench peer Professor Baroness Clare Gerada, former president of the Royal College of General Practitioners, said: “The proportion of NHS-funded IVF cycles has fallen to just under 30 per cent, the lowest level since 2008.”

She added: “In relation to IVF, the NHS system has collapsed.”

Liberal Democrat peer Lord Monroe Palmer described the situation as ironic, noting: “It is very ironic that it is difficult for many patients to access publicly funded fertility treatment in the very country where IVF was originally pioneered.”

Conservative peer Edward Howard, Earl of Effingham, also raised concerns, saying: “Access remains highly variable across England, because ICBs are not required to implement that guidance.” He described this as: “A clear gap between guidance and enforceable entitlement.”

Surrogacy law under scrutiny

Surrogacy regulation is a particular focus of concern. Under current UK law, surrogacy arrangements are legal but tightly controlled, with commercial surrogacy prohibited and legal parenthood only transferred after a post-birth court process.

Critics say this framework can create legal uncertainty for intended parents and surrogates, especially in cases involving international arrangements or complex family structures.

The Law Commission of England and Wales and the Scottish Law Commission have previously proposed reforms aimed at simplifying legal parenthood arrangements and strengthening safeguarding measures, but implementation remains under consideration by Government.

Peers are now calling for renewed urgency in assessing whether the current system remains fit for purpose, particularly given the growing number of families formed through assisted reproduction.

Alongside parliamentary debate, campaigners have further added renewed pressure for reform through a public petition led by entrepreneur and advocate Adam Frisby, founder of In The Style and Reasn, who has spoken publicly about his experience of becoming a parent through surrogacy.

The petition calls on the Government to modernise UK surrogacy law, arguing that the current system is no longer fit for purpose and can place unnecessary emotional, financial and legal burdens on intended parents and surrogates.

Frisby has argued that the legal process for establishing parenthood after birth is too slow and does not reflect how surrogacy is practised in modern family building, particularly where medical and administrative arrangements are already agreed in advance. Supporters of the petition say reform is needed to reduce delays in securing legal parenthood and to provide greater clarity and protection for all parties involved.

Calls for reform of consent and embryo research rules

Baroness Deech urged in the debates for reforms to be brought in for consent and data-sharing rules, including greater transparency and flexibility in how fertility clinics handle patient information.

Baroness Nargund supported the idea of improved data integration, linking it to the Government’s proposed Single Patient Record under the Ten-Year Health Plan for England and the Health Bill currently before Parliament.

Baroness Pidgeon, however, warned that current IVF governance is characterised by unusually strict confidentiality rules. She also highlighted calls for reform to allow broader consent for embryo use in research, noting that patients cannot currently give generic permission for unspecified future studies.

Wider concerns over declining birth rates

A second debate focused on broader demographic trends, including falling birth rates and their implications for an ageing population. Baroness Nargund asked what assessment had been made of the UK’s declining birth rate, warning that access to fertility treatment remains uneven across the country.

She said:

“We still have a postcode lottery for IVF provision, with nearly 70 per cent of ICBs funding only one cycle of treatment.”

Responding for the Government, Labour peer Lord Philip Wilson said ministers remained committed to improving access:

“The Government are committed to improving fair and equitable access to fertility services, recognising the significant emotional and health impacts of infertility.”

Concerns over donor conception and consent

Another key issue highlighted in ongoing debate is access to donor information and consent frameworks.

The HFEA has previously recommended reforms intended to improve transparency for donor-conceived people, including better access to genetic and identifying information, as well as clearer consent processes for donors and patients.

Supporters of reform argue that modern fertility treatment increasingly involves donor gametes and complex reproductive arrangements, making outdated consent rules potentially inadequate for today’s clinical reality.

Government under pressure to respond

The House of Lords is expected to continue debating fertility law reform in the context of wider scrutiny of UK family law and assisted reproduction policy.

Recent parliamentary briefings indicate that ministers are actively considering recommendations from the HFEA, though no timetable for comprehensive legislative reform has yet been confirmed.

Advocates say the issue is becoming increasingly urgent as fertility treatment demand continues to rise and scientific developments - such as laboratory-created gametes - pose new ethical and regulatory questions for lawmakers.

Responding for the Government in the debates, Labour peer Baroness Judith Blake said that immediate reform was unlikely due to pressure on the legislative timetable: “Immediate legislative reform is not possible because the legislative programme for this Parliamentary session is very full.”

In response, Baroness Deech insisted that preparatory work should begin regardless, saying: “It might well take some years, but the Government really needs to set up that Select Committee and do the legislative scrutiny right now.”

Outlook

While there is broad agreement that the UK remains a global leader in fertility regulation, peers and sector experts argue that the underlying legal framework is under growing strain.

Calls for reform are expected to intensify as Parliament weighs how to balance patient safety, ethical safeguards and scientific innovation in one of the fastest-evolving areas of modern medicine.