Dr Caroline Johnson

It is a pleasure to serve under your chairmanship, Mr Efford. I, too, congratulate the hon. Member for Strangford (Jim Shannon) on securing an important debate at such short notice. IVF counts as a medical miracle, in many respects. Since the technique was pioneered in the 1970s, some 12 million babies have been born by IVF or associated procedures. In the UK, there have been more than 70,000 donor births since 1991, when we started counting egg, sperm and embryo donations. Such births now account for one in 170 live UK births. For many families and individuals, those treatments have given hope where they otherwise would have none. Those suffering from fertility problems have been able to pursue their dreams of having a family with the help of IVF, and success rates have increased over recent decades. The children born as a result of these treatments have given great joy, love and happiness to their families. With that in mind, the previous Government committed to broadening access to these services. As the hon. Member for Chichester (Jess Brown-Fuller) said, the women’s health strategy for England, published in 2022, included removing barriers to access for same-sex couples. The previous Government also changed the law so that same-sex couples would not have to go through specific infectious diseases screening before pursuing reciprocal IVF. Those measures were designed to ensure that as many as possible could enjoy safe and equal access to treatment. In my constituency, I was approached by a lady who has medical reasons for her infertility, and is married to a gentleman who had a child many years ago in a previous relationship. She found that she was not eligible for access to IVF. If she said she had no partner, she would be eligible for a sperm donor. If she said she had a female partner, she would be eligible for a sperm donor. Since her partner, however, had a child from a previous relationship, she was not able to have treatment for her medical condition. Personally, I did not think she should be denied access to that, so I have been campaigning with the local ICB, which is currently doing a review. I hope that review is not disrupted by the changes the Government have made to ICB funding. IVF is a highly complex procedure, with several different approaches now available to doctors and patients. One of those approaches involves an intending parent receiving donor eggs from another woman. That can be a lifeline for those who cannot use their own eggs, whether due to age, quality or other physiological factors. It relies on the generosity and selflessness of the donor women who contribute their own eggs so that others may have a chance of raising children. That process contains risk, and although we recognise the huge opportunities that IVF offers and the generosity of the donor women, we must make sure that the procedural risks, advertising and regulation are properly managed. Typically, egg donors must be between 18 and 35, be in good health, have no inheritable conditions, and pass a variety of screening and suitability tests. Those requirements are designed to provide reassurance for intending parents, but in order to find as many potential donors as possible, many companies pursue aggressive advertising strategies to attract eligible donor women. When I first thought about this, I thought, “I haven’t seen any adverts for such a process.” Then I recognised that, of course, I am not in the target audience, because I am too old. With social media, when we think about something, before we know it, it has appeared on our phone or another device, in the corner of the screen as an advert. I am advised by women who are of the right age that they feel they get a lot of adverts to encourage them to be egg donors—more than they would like to see. Does the Minister agree that the guidance on internet advertising in particular needs to be updated, especially in the light of the targeting of adverts at particular demographic groups? Will she commit to investigating how many women are targeted by adverts for a service that they would not consider engaging with, and ways of being able to avoid those? There are also risks to the process. It is especially important that women know the full extent of the risks before they agree to a medical elective procedure, in particular one that is not for their own benefit. Ovarian hyperstimulation syndrome is one of the main risks for egg donors and causes symptoms rising from mild discomfort and bloating to serious respiratory problems, renal failure and, in extreme cases, death. A 2023 review study in the Journal of Assisted Reproduction and Genetics found that severe ovarian hyperstimulation syndrome occurs in 1% to 10% of stimulation cycles. That is quite a wide range of uncertainty, and it is partly why many donors have argued for more research to be done to support informed consent and proper regulation on how the risks are communicated to donors. We have already heard in this debate about the long-term risks. Given that the HFEA will know who all the ladies who have generously given of their eggs are, does the Minister have any plans to look back at that data in an anonymized fashion to see whether any long-term health risks can be identified? Will she also talk about the steps that the Department is taking to ensure that high-quality research is accessible for those considering egg donation, and about whether companies are mandated to conduct and provide it as part of their advertising? We have talked about compensation during the debate. Fertility companies make much of the altruism motivating donors to give their eggs, and that no doubt forms part of the reasoning of donors who admirably wish to help others less fortunate than themselves by contributing their eggs. It is also true, however, that fertility companies provide compensation payments. Those are capped at £986, a limit intended to ensure that women are not enticed to donate eggs due to financial need, but a risk remains that women more in need of financial assistance may be attracted by the payments. Recent coverage has highlighted that some services present donation as a second income stream. Clearly, however, women who put themselves through a lengthy, often uncomfortable and potentially dangerous process in the name of helping others should not be out of pocket as a result. Getting that balance right requires careful attention. The Government must ensure that they review the compensation rates and how it is provided —as a flat sum or on receipt—to ensure that we get this right. Beyond the financial cap, companies are also allowed to advertise benefits in kind, such as discounted egg freezing for women who donate some of their eggs to others. In essence, therefore, they are saying to ladies, “If you come to donate some of your eggs, we’ll allow you to store your own eggs for a much reduced price, in case you need them later.” Some women might see that as a reason to donate eggs—that they cannot afford to freeze their own otherwise. What are the Government doing to manage the kind of additional incentives that might encourage women to donate eggs when otherwise they would not? Does the Minister plan to regulate non-monetary incentives in the future?