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MARY EARPS
Investigative reporter Bel Trew uncovers the worrying rise in anti-choice sentiment and US-style protests happening in the UK
s soon as I turned 30, I started to panic. I don’t know if it was the sudden baby shower invites or my mum reminding me, ‘You don’t have forever,’” says Jenna, 34, who is currently undergoing egg freezing. Jenna’s anxiety wasn’t so much about becoming a mother as it was about timing – specifically, the fear that she was running out of it.
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Photo credit: Bel Trew
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How Big Business Took Over Baby-Making
The Fertility
Words: Mischa Smith
DESIGN: ana ospina
Chief Sub-Editor: Nicola Moyne
A maze of unregulated services, hidden costs and unclear outcomes, fertility is a £320m industry in the UK – and it’s vulnerable women who are paying the price
Gold Rush
A
Jenna is far from alone. For the first time since records began in 1920, half of women born in 1990 were childless by their 30th birthday. The number of children born to British mothers has also dropped by a quarter in just 15 years and the fertility rate in England and Wales is at a historic low.
Collectively, we’re having children later – or not at all. But that doesn’t mean we’re thinking about motherhood any less. If anything, we’re thinking about it more. Conversations often turn to fertility; mainstream media debates whether young women should be incentivised to have children to counter the UK’s ageing population; social-media algorithms push fertility preservation, IVF and egg-freezing content daily. And the message is clear: the solution is technological, not societal.
Digital platforms are also shaping how younger generations perceive fertility. Professor Geeta Nargund, a senior NHS consultant and Medical Director of CREATE Fertility and abc ivf, points to a survey conducted by her team that reveals 30 per cent of Gen Z respondents are learning about fertility treatments via TikTok, and nearly half had seen paid-for IVF ads. “This understandably raises concerns about misinformation,” she says. “Over 25 per cent felt misled by these ads, and 22 per cent reported feeling pressured to freeze their eggs or sperm because of what they saw online.”
of Gen Z learn about fertility
treatments via TikTok
%
30
At first glance, the promises of the fertility industry seem revolutionary. Clinics offering egg-freezing, IVF and hormone treatments have given women unprecedented control over their biological clocks. As a result, some have effectively frozen the decision itself, postponing motherhood until they’re more financially secure, professionally accomplished or emotionally ready. This flexibility is often sold as empowerment, a way to “have it all” – something my generation has been told is both possible and expected.
But with access comes pressure. Fertility clinics claim to safeguard women’s futures, yet the reality of egg-freezing is far from simple. The process is expensive, invasive and emotionally draining. It’s also no guarantee of motherhood – whatever the marketing material may say.
The Panic Years
Jenna started researching “fertility over 30” and soon noticed targeted ads for egg-freezing, fertility preservation and hormone tests. She ordered an AMH test [which measures anti-müllerian hormone to estimate the amount of eggs you have] online for around £150, hoping it would put her mind at ease. But when the results came back lower than expected, she panicked – and booked the procedure.
more people are searching for
'Anti-Müllerian Hormone' on Google.
“Just because you’re doing IVF doesn’t mean you’re guaranteed a baby.”
300
The Postcode Lottery
She’s not alone: Google-search data shows a 300 per cent spike in searches for “Anti-Müllerian Hormone” and anecdotal evidence suggests growing awareness of AMH testing. “Egg-freezing is becoming more popular,” agrees Claire Norton, a traditional acupuncturist specialising in women’s health and fertility. She’s noticed a clear link between the rise of egg-freezing and AMH tests. “There’s a real panic; women coming through the door with low AMH results. But a low AMH doesn’t necessarily mean a woman under 40 will struggle to conceive naturally,” she says. Still, a lack of public understanding is fuelling anxiety among women already being told it’s time to worry.
Sandy Christiansen, an embryologist and fertility coach, echoes Norton’s concerns. She explains that while AMH testing is on the rise, it is not a true indicator of fertility – something often unclear from the outset.
Meanwhile, those who undergo IVF soon learn that treatment on the NHS is tightly rationed. While guidelines recommend three full IVF cycles for eligible women under 40, only 7 per cent of Integrated Care Boards (ICBs) provide this. Most patients are offered just one cycle, and even that comes with strict criteria around age, BMI, and whether the patient already has children.
To make matters worse, NHS fertility clinics are overburdened, so even those who qualify face long waits – a further hurdle for women with diminishing ovarian reserves.
Norton recalls one patient who had waited so long for her NHS referral that by the time her AMH test was done, she no longer qualified for treatment. “Her AMH had dropped too low and she had aged out of eligibility,” she says. The patient is now pursuing private care.
Tessa, 41, counts herself as one of the lucky ones. “Our postcode falls under a major London hospital that still receives funding for fertility treatment,” she says. “Anywhere else in the country, my age might have ruled me out [for IVF].”
Like many millennial women, Tessa met her partner later in life, spent years in shared housing, and delayed family planning through Covid. By 38, she still hadn’t seriously considered having children.
“I’d sort of missed my boat,” she says. That changed after lockdown, though, when the couple’s living arrangements became more stable. “Suddenly we were like, ‘Oh, shit, we do want children – and now it might be too late.’”
Tessa has since accessed a round of NHS-funded IVF, but only just: at every step, she was asked to provide proof of address to confirm she met postcode-dependent criteria.
ICBs across England pay significantly different rates for IVF treatment, effectively creating a national postcode lottery. This inconsistency not only creates unequal access but also puts unnecessary strain on NHS budgets.
“Access to care remains deeply unequal,” says Professor Nargund, who advocates for a national IVF tariff. “[A tariff] would cap the maximum amount ICBs can spend on an NHS-funded IVF cycle – just like we do for other treatments – so public money is used more efficiently and access becomes more equitable across the UK.”
Dr Ippokratis Sarris, Consultant in Reproductive Medicine and Director of King’s Fertility, agrees that the system is deeply fragmented. “Fertility care in the UK is both sophisticated and strained. It can feel like a two-tier system,” he says. Referral pathways are inconsistent: patients referred to King’s College might start IVF within a month, while those sent to district general hospitals can wait for more than a year. “By the time they reach us, they’ve often spent a year on a treadmill of repeat tests and follow-ups,” he says.
Incompetence and inequity
Cassie was 33 when she and her husband started trying for a baby. After a year of unexplained infertility, she began a two-year IVF journey through the NHS – something she says left her feeling “lucky in an unlucky situation”.
Following two failed IVF rounds, Cassie met with a consultant who said the
NHS couldn’t proceed without further tests. The problem? Some had years-long waiting lists, while others weren’t offered at all – despite being required to continue treatment.
“That was handled horrifically,” she says. “The consultant sold me on these tests. I thought, ‘Great, let’s do them’ – only to be told they weren’t available.”
With no clear explanation, the consultant kept recommending new tests, even while admitting she couldn’t confirm their necessity. Looking back, Cassie is stunned by the imbalance in how she and her husband were treated. “He was tested once. Meanwhile, they were ready to put me under anaesthetic and insert a camera into my womb without even asking for a second sperm sample from him.”
“Seeing a pregnant friend felt like
the thing I wanted was sitting right
there between us.”
She says the burden of testing and the pressure to “fix” the issue fell squarely on her. “My husband never felt the same pressure I did.”
Over two years, Cassie radically altered her lifestyle, cutting out alcohol, caffeine and sugar; starting weekly acupuncture and reflexology; and taking a cocktail of fertility supplements. She estimates spending several hundred pounds a month on the new regime, but can’t bring herself to calculate the exact total for fear it’s “depressingly high”.
The process also took its toll mentally. “My husband could distract himself. For me, there was no distraction,” she says. Socially she struggled, too, admitting that “seeing a pregnant friend felt like the thing I wanted was sitting right there between us.”
Exercise – once her go-to stress relief – became another source of anxiety. She was warned that if her BMI dropped too low, she’d no longer qualify for NHS fertility treatment. On one hand, she was told to overhaul her lifestyle; on the other, she was cautioned about doing too much. “It’s a minefield,” she sighs.
“You can go down such a hole with it.”
This continued until she was preparing for her fifth embryo transfer – and discovered she was pregnant naturally. Despite all the private testing and NHS investigations, Cassie never received an explanation for her infertility. Now 37, she doesn’t know if she’ll be able to have a second child.
Hope and high prices
Across the UK, private fertility pricing isn’t centrally regulated. Clinics set their own fees, often advertising low base prices while omitting key costs, such as medication, lab techniques and embryo-freezing – all of which quickly add up. Dr Amit Shah, a gynaecologist and co-founder of the Harley Street-based clinic Fertility Plus, finds this lack of transparency “troubling”.
“What makes fertility so unique in the UK is that it’s one of the few areas of medicine with patchy, often inadequate, NHS funding,” adds Dr Sarris, who notes that while UK working visas typically cover most NHS treatments, there are two major exceptions: dental care and assisted conception.
“It’s strange – you can have a transplant, deliver a baby or be treated in intensive care, but you can’t access IVF,” he says. “Fertility has long been carved out, creating an entirely different ecosystem.”
affects 1 in 6 heterosexual couples, according to the WHO.
Infertility
Dr Shah warns that what’s often advertised as a £3,500–£5,000 IVF cycle rarely includes essentials. “The messaging is unclear and patients don’t always realise what they’re actually paying for.”
Kasia*, 35, experienced this lack of transparency first-hand. After nearly two years of infertility and a diagnosis of stage four endometriosis, she and her husband were still encouraged to keep trying naturally because they were both under 35 at the time.
“It felt like things had to get worse before we’d reach the top of the NHS waiting list,” she says.
Researching private options, Kasia found clinics promising all-inclusive packages for £5,000–£6,000. Ultimately, she chose what she describes as “an extremely expensive clinic,” reasoning that if they were spending thousands, they should get the best treatment available.
“I knew we only had a few years. I’m 35 now, and we’re already infertile – so we’ve poured our savings into it.”
To date, they’ve spent around £11,000. “We’ve paid in instalments and I’ve kind of lost track – maybe it’s £12,000?” she says. If everything goes to plan, including one IVF cycle and one egg retrieval, they expect to spend about £15,000. But each additional IVF cycle could cost another £8,000–£9,000, and each extra retrieval around £2,500–£3,000.
“You just keep handing over your credit card. Eventually, money feels like Monopoly money,” she says. “This is our life savings, but I’m not planning on buying a house anyway.”
Kasia knows she’s privileged to even consider private IVF. But she worries the industry’s focus on high-cost treatment is deepening inequality. After all, can we really call fertility treatment empowering if only the financially privileged have access to it?
Emotional exploitation
Ginanne Brownell, a fertility rights advocate and author of Elusive Mommyhood: An Investigative Reporter’s Personal Journey into IVF and Surrogacy, is deeply concerned about the lack of transparency in fertility care. She says more must be done to manage expectations and protect women from emotional and financial exploitation.
“You’ll do anything to get pregnant. You’ll throw whatever money you can at it,” she says. “But there’s not enough information out there saying, ‘Just because you’re doing IVF doesn’t mean you’re guaranteed a baby’. I think a lot of people still believe that.”
Brownell, who went through egg-freezing and IVF herself, recalls being surprised by how little concrete data she was given. “I was never shown real statistics on success rates. I should have looked into it more, but I was desperate; I just thought, ‘Let’s go for it’.”
Though she eventually had two children via surrogacy in the U.S., Brownell still identifies as an infertile woman – and one acutely aware of how vulnerable others in her position can be.
“They’re making tons of money off very vulnerable women, when it’s probably fairly clear by your third round of IVF that it’s not going to happen,” she says. “It’s an absolute crime that no one steps in and says: ‘Enough. Stop.’”
She believes there’s an urgent need to set clearer boundaries – perhaps even limits – on the number of privately funded IVF cycles couples can undergo. Norton agrees, adding: “When couples go for IVF, clinics are pushing against an open door,” she says. “They’re easily sold IVF, even when it might not be the right solution.”
Meanwhile, Dr Shah believes there’s a case for public policy to subsidise fertility preservation, whether for medical or social reasons, so people have more options before reaching crisis point.
A ticking time bomb
Interest in egg-freezing has surged, especially among women in their late 20s to early-30s looking to “future-proof” their fertility, says Dr Shah. The 2021 policy change allowing clinics to store frozen eggs, sperm and embryos for up to 55 years (the limit had previously been 10) has driven this growth, with many clinics rapidly expanding cryopreservation services.
But Dr Sarris warns the promise of egg-freezing may be misleading. “Until 2013, egg-freezing was still considered experimental,” he explains. “We’ve only had just over a decade of treating it as a standard, safe procedure – and that’s a short window of time.”
He argues that major private equity-backed clinics have marketed it aggressively, adding: “Big corporations are incentivised to keep women from having children earlier so they can maximise productivity. To be honest, some clinics are pushing it hard.”
Dr Sarris believes this marketing has blurred the line between medical treatment and financial products. A single egg-freezing cycle can cost between £3,000 and £5,000, plus annual storage fees. “It overpromises; people don’t always understand its limitations,” he says.
A 2021 policy change extended the storage limit for frozen eggs, sperm, and embryos from 10 to 55 years—driving a surge in demand.
“I believe there’s a ticking time bomb – women freezing their eggs assuming it's a guarantee, delaying pregnancy, and then returning years later to find that it isn’t”
He raises ethical concerns, too: wealthier women can afford to delay childbearing, while those with fewer financial resources face difficult decisions.
“Egg-freezing is being sold as a wonderful innovation,” he adds. “But much of that hype comes from marketing strategies driven by growth targets, not necessarily science.”
Another unknown? The long-term viability of frozen eggs. “We don’t have reliable data on whether an egg stored for 20 years is more likely to degrade than one stored for five,” says Dr Sarris.
“I believe there’s a ticking time bomb – women freezing their eggs assuming it's a guarantee, delaying pregnancy, and then returning years later to find that it isn’t.”
The medical Wild West
Long NHS wait times and uncertain results are driving many women toward what Dr Sarris describes as the “non-regulated” fertility space: a booming market of alternative therapists and unqualified providers.
“Fertility plays on fear and anxiety, and that can be exploited,” he says. “We’re seeing a mushrooming of add-on services trying to cash in because they see money in the game. [But] infertility is not a lifestyle choice – it’s a WHO-defined condition. It’s devastating. It becomes all-consuming”.
Amy, 34, who had twins via IVF, agrees: “It became an obsession,” she says. While waiting for NHS treatment, Amy tried every non-medical route she could find, cutting out toxins, overhauling her diet, even making her own cleaning products. After 10 months and two private treatments she was finally offered IVF. By then she estimates she was spending £350 a month on supplements, acupuncture, and holistic remedies. “You feel so out of control. Spending on these things was about regaining some mental stability.”
55
t0
““Fertility plays on fear and anxiety, and that can be exploited…We’re seeing a mushrooming of add-on services trying to cash in because they see money in the game”
Yet many of these ‘extras’ are of questionable value. Dr Vikram Murthy, a GP and co-founder of Murthy Health, notes that supplements are unlikely to drastically improve fertility on their own: “They’ve gone from fringe to mainstream, but that comes with a risk of overuse and blind trust,” he says.
Dr Sarris is even more sceptical. He warns that the fertility sector is unique in how it markets directly to vulnerable consumers, stating: “I’ve had to research products I didn’t even know existed because patients came in asking about them; I often have to explain why they don’t work.” He calls the space around clinics an “uncharted, unregulated Wild West.”
Are current protections enough? “No. Not even close,” says Dr Sarris. Many practitioners operate outside clinic walls, often with dubious credentials. And those outside medical regulation? “They’re untouchable. You can’t strike off someone who was never on a register.”
In the face of this, Dr Shah stresses the need for ethical responsibility: “Innovation should be encouraged, but not at the cost of vulnerable patients.” He advises every patient to “interrogate every line of their treatment quote.”
Still, as acupuncturist Norton points out: “These women are vulnerable.
It’s incredibly sensitive. And the burden shouldn’t fall on them alone.”
Dr Sarris says medical bodies have little sway, though, as much of the misinformation originates from companies operating outside of medicine altogether. “The Competition and Markets Authority? They’ve got bigger fish to fry,” he says.
What’s clear is that fertility has become more than a medical issue. The National Childbirth Trust (NCT) has called for progressive reforms to address the UK's falling birth rate, demanding real support for prospective parents, including extended paternity leave and better-funded fertility care. After all, as treatments advance, so too must the policies and culture surrounding parenthood.
Crucially, women need to feel empowered not by the equivocation of big tech, but a social infrastructure that champions – rather than commercialises – their fertility choices. Our future might just depend on it.
*Names changed
1o
%
Festility over 30
Fertility clinics are overburdened, so even those who qualify face long waits – a further hurdle for women with diminishing ovarian reserves.
The Fertility
Since turning 30 almost five years ago, I’ve
tried to make sense of my uneasy feelings about motherhood. I can’t picture how children would fit into my life, let alone my one-bedroom rented flat. I feel paralysed by indecision about whether I want to be a mother, but, in many ways, it doesn’t feel like a decision that’s fully mine to make.
The fertility rate in England and Wales is at a historic low. The number of children born to British mothers has dropped by a quarter in just 15 years. For the first time since records began in 1920, half of women born in 1990 (like me) were childless by their 30th birthday.
Collectively, we’re having children later – or not
at all. But that doesn’t mean we’re thinking about motherhood any less. If anything, we’re thinking about it more. Conversations often turn to fertility; mainstream media debates whether young women should be incentivised to have children to counter the UK’s ageing population; social-media algorithms push fertility preservation, IVF and egg-freezing content daily. And the message is clear: the solution is technological, not societal.
Digital platforms are also shaping how younger generations perceive fertility. Professor Geeta Nargund, a senior NHS consultant and Medical Director of CREATE Fertility and abc ivf, points to a survey conducted by her team that reveals 30 per cent of Gen Z respondents are learning about fertility treatments via TikTok, and nearly half had seen paid-for IVF ads. “This understandably raises concerns about misinformation,” she says. “Over 25 per cent felt misled by these ads, and 22 per cent reported feeling pressured to freeze their eggs or sperm because of what they saw online.”
At first glance, the promises of the fertility industry seem revolutionary. Clinics offering egg-freezing, IVF and hormone treatments have given women unprecedented control over their biological clocks. As a result, some have effectively frozen the decision itself, postponing motherhood until they’re more financially secure, professionally accomplished or emotionally ready. This flexibility is often sold as empowerment, a way to “have it all” – something my generation has been told is both possible and expected.
But with access comes pressure. Fertility clinics claim to safeguard women’s futures, yet the reality of egg-freezing is far from simple. The process is expensive, invasive and emotionally draining. It’s also no guarantee of motherhood – whatever the marketing material may say.
%
30
of Gen Z learn about fertility
treatments via TikTok
“As soon as I turned 30, I started to panic. I don’t know if it was the sudden baby-shower invites or my mum reminding me, ‘You don’t have forever,’” says Jenna, 34, who is currently undergoing an egg-freezing procedure. Her anxiety wasn’t so much about becoming a mother as it was about time – or, rather, her lack of it.
As Jenna researched “fertility over 30”, she began noticing targeted ads for egg-freezing, fertility preservation and hormone tests. She ordered an AMH test [which measures anti-müllerian hormone to estimate the amount of eggs you have] online for around £150, hoping it would put her mind at ease. But when the results came back lower than expected, she panicked – and booked the procedure.
“As soon as I turned 30, I started to panic. I don’t know if it was the sudden baby-shower invites or my mum reminding me, ‘You don’t have forever,’” says Jenna, 34, who is currently undergoing an egg-freezing procedure. Her anxiety wasn’t so much about becoming a mother as it was about time – or, rather, her lack of it.
As Jenna researched “fertility over 30”, she began noticing targeted ads for egg-freezing, fertility preservation and hormone tests. She ordered an AMH test [which measures anti-müllerian hormone to estimate the amount of eggs you have] online for around £150, hoping it would put her mind at ease. But when the results came back lower than expected, she panicked – and booked the procedure.
The Panic Years
Meanwhile, those who undergo IVF soon learn that treatment on the NHS is tightly rationed. While guidelines recommend three full IVF cycles for eligible women under 40, only 7 per cent of Integrated Care Boards (ICBs) provide this. Most patients are offered just one cycle, and even that comes with strict criteria around age, BMI, and whether the patient already has children.
To make matters worse, NHS fertility clinics are overburdened, so even those who qualify face long waits – a further hurdle for women with diminishing ovarian reserves.
Norton recalls one patient who had waited so long for her NHS referral that by the time her AMH test was done, she no longer qualified for treatment. “Her AMH had dropped too low and she had aged out of eligibility,” she says. The patient is now pursuing private care.
Meanwhile, those who undergo IVF soon learn that treatment on the NHS is tightly rationed. While guidelines recommend three full IVF cycles for eligible women under 40, only 7 per cent of Integrated Care Boards (ICBs) provide this. Most patients are offered just one cycle, and even that comes with strict criteria around age, BMI, and whether the patient already has children.
To make matters worse, NHS fertility clinics are overburdened, so even those who qualify face long waits – a further hurdle for women with diminishing ovarian reserves.
Norton recalls one patient who had waited so long for her NHS referral that by the time her AMH test was done, she no longer qualified for treatment. “Her AMH had dropped too low and she had aged out of eligibility,” she says. The patient is now pursuing private care.
A postcode lottery
of Gen Z learn about fertility
treatments via TikTok
Cassie was 33 when she and her husband started trying for a baby. After a year of unexplained infertility, she began a two-year IVF journey through the NHS – something she says left her feeling “lucky in an unlucky situation”.
Following two failed IVF rounds, Cassie met with a consultant who said the NHS couldn’t proceed without further tests. The problem? Some had years-long waiting lists, while others weren’t offered at all – despite being required to continue treatment.
“That was handled horrifically,” she says. “The consultant sold me on these tests. I thought, ‘Great, let’s do them’ – only to be told they weren’t available.”
With no clear explanation, the consultant kept recommending new tests, even while admitting she couldn’t confirm their necessity. Looking back, Cassie is stunned by the imbalance in how she and her husband were treated. “He was tested once. Meanwhile, they were ready to put me under anaesthetic and insert a camera into my womb without even asking for a second sperm sample from him.”
Cassie was 33 when she and her husband started trying for a baby. After a year of unexplained infertility, she began a two-year IVF journey through the NHS – something she says left her feeling “lucky in an unlucky situation”.
Following two failed IVF rounds, Cassie met with a consultant who said the NHS couldn’t proceed without further tests. The problem? Some had years-long waiting lists, while others weren’t offered at all – despite being required to continue treatment.
“That was handled horrifically,” she says. “The consultant sold me on these tests. I thought, ‘Great, let’s do them’ – only to be told they weren’t available.”
With no clear explanation, the consultant kept recommending new tests, even while admitting she couldn’t confirm their necessity. Looking back, Cassie is stunned by the imbalance in how she and her husband were treated. “He was tested once. Meanwhile, they were ready to put me under anaesthetic and insert a camera into my womb without even asking for a second sperm sample from him.”
Incompetence
and inequity
more people are searching
for 'Anti-Müllerian
Hormone' on Google.
Across the UK, private fertility pricing isn’t centrally regulated. Clinics set their own fees, often advertising low base prices while omitting key costs, such as medication, lab techniques and embryo-freezing – all of which quickly add up. Dr Amit Shah, a gynaecologist and co-founder of the Harley Street-based clinic Fertility Plus, finds this lack of transparency “troubling”.
“What makes fertility so unique in the UK is that it’s one of the few areas of medicine with patchy, often inadequate, NHS funding,” adds Dr Ippokratis Sarris, a consultant in reproductive medicine and Director of King’s Fertility. He notes that while UK working visas typically cover most NHS treatments, there are two major exceptions: dental care and assisted conception.
“It’s strange – you can have a transplant, deliver a baby or be treated in intensive care, but you can’t access IVF,” he says. “Fertility has long been carved out, creating an entirely different ecosystem.”
Infertility, despite being recognised by the World Health Organisation as a medical condition affecting one in six heterosexual couples (and many more LGBTQ+ couples and would-be parents), has been treated differently. Dr Sarris believes this has enabled a booming commercial market.
“A lot of UK clinics are now owned by private equity firms,” he explains. “They’ve seen huge growth in the sector.”
Across the UK, private fertility pricing isn’t centrally regulated. Clinics set their own fees, often advertising low base prices while omitting key costs, such as medication, lab techniques and embryo-freezing – all of which quickly add up. Dr Amit Shah, a gynaecologist and co-founder of the Harley Street-based clinic Fertility Plus, finds this lack of transparency “troubling”.
“What makes fertility so unique in the UK is that it’s one of the few areas of medicine with patchy, often inadequate, NHS funding,” adds Dr Ippokratis Sarris, a consultant in reproductive medicine and Director of King’s Fertility. He notes that while UK working visas typically cover most NHS treatments, there are two major exceptions: dental care and assisted conception.
“It’s strange – you can have a transplant, deliver a baby or be treated in intensive care, but you can’t access IVF,” he says. “Fertility has long been carved out, creating an entirely different ecosystem.”
Infertility, despite being recognised by the World Health Organisation as a medical condition affecting one in six heterosexual couples (and many more LGBTQ+ couples and would-be parents), has been treated differently. Dr Sarris believes this has enabled a booming commercial market.
“A lot of UK clinics are now owned by private equity firms,” he explains. “They’ve seen huge growth in the sector.”
Hope and
high prices
affects 1 in 6 heterosexual couples, according to the WHO.
Ginanne Brownell, a fertility rights advocate and author of Elusive Mommyhood: An Investigative Reporter’s Personal Journey into IVF and Surrogacy, is deeply concerned about the lack of transparency in fertility care. She says more must be done to manage expectations and protect women from emotional and financial exploitation.
“You’ll do anything to get pregnant. You’ll throw whatever money you can at it,” she says. “But there’s not enough information out there saying, ‘Just because you’re doing IVF doesn’t mean you’re guaranteed a baby’. I think a lot of people still believe that.”
Brownell, who went through egg-freezing and IVF herself, recalls being surprised by how little concrete data she was given. “I was never shown real statistics on success rates. I should have looked into it more, but I was desperate; I just thought, ‘Let’s go for it’.”
Though she eventually had two children via surrogacy in the U.S., Brownell still identifies as an infertile woman – and one acutely aware of how vulnerable others in her position can be.
“They’re making tons of money off very vulnerable women, when it’s probably fairly clear by your third round of IVF that it’s not going to happen,” she says. “It’s an absolute crime that no one steps in and says: ‘Enough. Stop.’”
She believes there’s an urgent need to set clearer boundaries – perhaps even limits – on the number of privately funded IVF cycles couples can undergo. Norton agrees, adding: “When couples go for IVF, clinics are pushing against an open door,” she says. “They’re easily sold IVF, even when it might not be the right solution.”
Meanwhile, Dr Shah believes there’s a case for public policy to subsidise fertility preservation, whether for medical or social reasons, so people have more options before reaching crisis point.
Emotional exploitation
“Just because you’re doing
IVF doesn’t mean you’re guaranteed a baby’. I think a
lot of people still believe that.”
Interest in egg-freezing has surged, especially among women in their late 20s to early-30s looking to “future-proof” their fertility, says Dr Shah. The 2021 policy change allowing clinics to store frozen eggs, sperm and embryos for up to 55 years (the limit had previously been 10) has driven this growth, with many clinics rapidly expanding cryopreservation services.
But Dr Sarris warns the promise of egg-freezing may be misleading. “Until 2013, egg-freezing was still considered experimental,” he explains. “We’ve only had just over a decade of treating it as a standard, safe procedure – and that’s a short window of time.”
He argues that major private equity-backed clinics have marketed it aggressively, adding: “Big corporations are incentivised to keep women from having children earlier so they can maximise productivity. To be honest, some clinics are pushing it hard.”
Dr Sarris believes this marketing has blurred the line between medical treatment and financial products. A single egg-freezing cycle can cost between £3,000 and £5,000, plus annual storage fees. “It overpromises; people don’t always understand its limitations,” he says.
Interest in egg-freezing has surged, especially among women in their late 20s to early-30s looking to “future-proof” their fertility, says Dr Shah. The 2021 policy change allowing clinics to store frozen eggs, sperm and embryos for up to 55 years (the limit had previously been 10) has driven this growth, with many clinics rapidly expanding cryopreservation services.
But Dr Sarris warns the promise of egg-freezing may be misleading. “Until 2013, egg-freezing was still considered experimental,” he explains. “We’ve only had just over a decade of treating it as a standard, safe procedure – and that’s a short window of time.”
He argues that major private equity-backed clinics have marketed it aggressively, adding: “Big corporations are incentivised to keep women from having children earlier so they can maximise productivity. To be honest, some clinics are pushing it hard.”
Dr Sarris believes this marketing has blurred the line between medical treatment and financial products. A single egg-freezing cycle can cost between £3,000 and £5,000, plus annual storage fees. “It overpromises; people don’t always understand its limitations,” he says.
A ticking time bomb
“I believe there’s a ticking time bomb – women freezing their eggs assuming it's a guarantee, delaying pregnancy, and then returning years later to
find that it isn’t”
“
Fertility care in the UK is both sophisticated and strained.
“A lot of UK clinics are now owned
by private equity firms... They’ve seen huge growth in the sector.”
Infertility, despite being recognised by the World Health Organisation as a medical condition affecting one in six heterosexual couples (and many more LGBTQ+ couples and would-be parents), has been treated differently. Dr Sarris believes this has enabled a booming commercial market.
“A lot of UK clinics are now owned by private equity firms,” he explains. “They’ve seen huge growth in the sector.”
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Tessa, 41, counts herself as one of the lucky ones. “Our postcode falls under a major London hospital that still receives funding for fertility treatment,” she says. “Anywhere else in the country, my age might have ruled me out [for IVF].”
Like many millennial women, Tessa met her partner later in life, spent years in shared housing, and delayed family planning through Covid. By 38, she still hadn’t seriously considered having children.
“I’d sort of missed my boat,” she says. That changed after lockdown, though, when the couple’s living arrangements became more stable. “Suddenly we were like, ‘Oh, shit, we do want children – and now it might be too late.’”
Tessa has since accessed a round of NHS-funded IVF, but only just: at every step, she was asked to provide proof of address to confirm she met postcode-dependent criteria.
“Seeing a pregnant friend felt like the thing I wanted was sitting right there between us.”
Across the UK, private fertility pricing isn’t centrally regulated. Clinics set their own fees, often advertising low base prices while omitting key costs, such as medication, lab techniques and embryo-freezing – all of which quickly add up. Dr Amit Shah, a gynaecologist and co-founder of the Harley Street-based clinic Fertility Plus, finds this lack of transparency “troubling”.
“What makes fertility so unique in the UK is that it’s one of the few areas of medicine with patchy, often inadequate, NHS funding,” adds Dr Sarris, who notes that while UK working visas typically cover most NHS treatments, there are two major exceptions: dental care and assisted conception.
“It’s strange – you can have a transplant, deliver a baby or be treated in intensive care, but you can’t access IVF,” he says. “Fertility has long been carved out, creating an entirely different ecosystem.”
Long NHS wait times and uncertain results are driving many women toward what Dr Sarris describes as the “non-regulated” fertility space: a booming market of alternative therapists and unqualified providers.
“Fertility plays on fear and anxiety, and that can be exploited,” he says. “We’re seeing a mushrooming of add-on services trying to cash in because they see money in the game. [But] infertility is not a lifestyle choice – it’s a WHO-defined condition. It’s devastating. It becomes all-consuming”.
Amy, 34, who had twins via IVF, agrees: “It became an obsession,” she says. While waiting for NHS treatment, Amy tried every non-medical route she could find, cutting out toxins, overhauling her diet, even making her own cleaning products. After 10 months and two private treatments she was finally offered IVF. By then she estimates she was spending £350 a month on supplements, acupuncture, and holistic remedies. “You feel so out of control.
Spending on these things was about regaining some mental stability.”