How to Choose a Fertility Clinic: What to Check First

Start where the regulator starts

The HFEA licenses and inspects every fertility clinic in the UK, and its advice on choosing between them contradicts almost every clinic advertisement you will see. Its words: it may be tempting to rely solely on success rates, but the reality is that most clinics are broadly all as good as each other, and small differences in rates are usually down to the different types of patients treated.

That is not a modest disclaimer. It is the regulator telling you that the metric the industry markets on is the one least able to answer your question.

Why clinic success rates mislead

The HFEA gives three separate reasons, and they compound.

They describe a selected population

Success rates depend on the patients being treated and the reason for their infertility. Some clinics specialise in older patients or in more complex diagnoses, which lowers their rate without saying anything about their competence. A clinic can raise its published figures by treating easier cases.

Small differences are noise

The HFEA states that differences of just one or two percentage points are often down to chance rather than a reflection of a clinic's abilities, and that a clinic performing particularly well one year may have lower rates the next. This is why the HFEA publishes a reliability range alongside each clinic's rate — a wider range for smaller clinics, because a handful of extra successes or failures moves their number a long way. Clinics performing very small numbers of cycles are not published at all, because the results would be misleading.

The denominator varies

The HFEA publishes births per embryo transferred and births per egg collection procedure. A clinic may quote either, or a pregnancy rate rather than a birth rate, or a figure for a favourable age band. Whichever measure you look at, the HFEA says it cannot tell you your individual chance of success — only your doctor can discuss that.

What to compare instead

The HFEA's own list of factors to weigh:

• Treatments offered and whether the one you need is among them.
• Eligibility criteria. There are no age limits for fertility treatment in UK law, so each clinic sets its own policy, and clinicians weigh whether your health allows treatment and a pregnancy.
• Cost, compared like with like using a fully costed treatment plan.
• Location. Underrated. You will make multiple trips, sometimes at short notice.
• How our inspectors rate the clinic — published for every licensed clinic.
• How other patients rate the clinic, across five areas the HFEA asks about.
• Birth rate and multiple birth rate together, not birth rate alone.
• Waiting times for donated eggs or sperm, if relevant to you.
• Counselling provision. Every licensed clinic is required by law to give you the chance to receive counselling.

The multiple birth rate is a safety measure, not a bonus

This is the comparison people get backwards. The HFEA describes multiple birth as the single greatest health risk of fertility treatment, with twins six times more likely than single babies to be born prematurely, ten times more likely to be admitted to a neonatal unit, and a six times higher risk of cerebral palsy among those who survive. The risk to the mother of dying is 2.5 times higher.

The regulator's policy is that only 10% of IVF births should be multiple births, and the UK average has fallen from 14.4% in 2014 to 3.2% in 2024 — among the lowest in the world — largely because 84% of transfers in 2024 were single embryo transfers, while birth rates continued to rise. A clinic with a high success rate and a high multiple birth rate is not outperforming its peers. Look for a low multiple birth rate alongside a rate consistent with the national average.

Consent, and the paperwork nobody reads

The HFEA singles out consent as a vital part of treatment because it affects how long your embryos can be stored, what happens in the event of your death, and in some cases who is considered a legal parent of your child. Mistakes with consent have led to embryos, eggs and sperm being destroyed, and to couples going to court after their child was born so that legal parenthood could be declared. Ask how the clinic handles consent forms, whether you get copies, and how it keeps your contact details current.

What happens when things go wrong

Serious problems are rare, but the route to resolving them is worth knowing before you need it. The HFEA publishes its latest decisions on clinics, so you can see what regulatory action, if any, has been taken. It also has a process for complaints about a licensed clinic, and clinics themselves must have their own.

Two further checks are worth making at the outset. Every licensed clinic is required to carry out a welfare of the child assessment before starting treatment, looking at factors likely to cause serious physical, psychological or medical harm to the child to be born or to an existing child of the family. And because there are no age limits in UK law, the clinic's own eligibility policy — and the clinician's judgement about whether your health allows treatment and a possible pregnancy — determines whether you will be treated at all. Ask about both early, rather than after tests have been paid for.

Before you commit

A short, practical checklist:

• Look the clinic up on the regulator's own search tool, not only its website.
• Read the inspection rating and the most recent decisions on that clinic.
• Ask for a fully costed treatment plan covering tests, drugs, freezing and storage.
• Ask which add-ons they routinely offer and what the HFEA rating for each is.
• Ask what counselling is included and how to access it.
• Ask how a complaint would be handled, and what happens if you want to move clinic.

The HFEA's summary of a good clinic is not about laboratory equipment: compassionate staff, clear pricing, seamless administrative processes and exceptional emotional support. Those are the things you will actually experience, and unlike a percentage they are things you can assess before you pay.