The following transcript is computer generated

00:00 Mike Dilke: Hi, I’m Mike Dilke and you’re listening to the Relaxback UK show, the show that explores all kinds of health topics relevant to you, your family, and your friends. Each week I talk to expert guests from a range of backgrounds to inform and entertain you. So please do join the Relaxback UK family and stay tuned.
00:21 Mike Dilke: Hi, and welcome to the Relaxback UK show. The topic this week is IVF with a particular focus on egg donation.
00:28 Dr. James Hopkinson: A donor-conceived child can get identifying information about the donor when they are 18, but it is not reciprocal. A donor cannot go to the HFEA or the unit and say, “I want some identifying information about a child.”
00:43 Mike Dilke: Many aspects of egg donation are covered with Dr. James Hopkinson, UK Medical Director at TFP Fertility, and Rachel Allison, who has donated eggs. So please do stay tuned for a great show. Thank you.
01:00 Mike Dilke: My guests are Dr. James Hopkinson, UK Medical Director at TFP Fertility, and Rachel Allison, who has donated her eggs. My first question was a very basic one: what does IVF stand for?
01:19 Dr. James Hopkinson: In vitro fertilization. A generic term for creating embryos in a laboratory to help people get pregnant.
01:27 Mike Dilke: Right. In vitro as opposed to in vivo.
01:29 Dr. James Hopkinson: Yeah.
01:30 Mike Dilke: I guess. Now, it appears to be a growing business. Why? What is going on? James, you might be best for that.
01:45 Dr. James Hopkinson: I started work in the IVF field in the early 90s and it has really increased. There are a huge number of factors as to why IVF is increasing. There were about 100,000 fertility treatment cycles in 2024/25, which is big.
02:08 Mike Dilke: Is that in the UK or England?
02:11 Dr. James Hopkinson: That is in the UK. Those are the HFEA figures. Availability is probably the biggest driver. More people are now fertility aware. There are factors that are increasing rates of demand, such as the increasing age of people thinking about getting pregnant.
02:35 Mike Dilke: Oddly enough, sorry to interrupt, but last night my bedtime reading was Bill Bryson’s The Body. I happened to be on the chapter talking about this and that is exactly the point it made. It said that the age of first pregnancy for six developed nations—Italy, Ireland, Japan, Luxembourg, Singapore, and Switzerland—is over 30.
03:04 Dr. James Hopkinson: Yeah, and we know that the longer you leave trying to get pregnant, the more likely you are going to need some help. One in seven couples need to speak to a doctor about their fertility. It is far more common than people think. Now that society has changed, we are seeing different family structures and we can help far more people. I think people are far more accepting of assisted conception now than they were when I started working in the field of IVF in the early 90s.
03:43 Mike Dilke: You mentioned age, and people are far more accepting. I think most people will know of someone who is going through it. Back to the age thing, why is that an issue?
04:03 Dr. James Hopkinson: Because your fertility declines with age; egg number and egg quality decrease as you get older. There are a number of studies that have looked at when you should start trying to conceive if you want to have three children without resorting to assisted conception, and that should be in your early-mid 20s. It is all to do with reproductive aging. Unfortunately, it is something that we cannot reverse. We can only improve success rates when you get older with the use of donor eggs from somebody who is biologically younger than the recipient.
04:47 Mike Dilke: Humans are designed to have babies in their early or mid-20s.
04:52 Dr. James Hopkinson: That is how nature intended things, but society has changed. Careers, buying houses, and relationships are all very different now. People are leaving it longer to be more financially secure when they start their family.
05:15 Mike Dilke: We spoke about quality of eggs. What about quality of sperm? I have read accounts in the media that sperm quality and counts are decreasing. Is that true?
05:32 Dr. James Hopkinson: There is some evidence to support the fact that environmental factors are affecting sperm. We know that sperm quality also decreases with age, though not quite in the same way that egg quality decreases. Fathers over 50 may have a higher rate of DNA damage in their sperm. There are some studies that suggest higher rates of autism with older fathers. It is not as clear-cut, but certainly, when you are looking at trying to conceive, you want to optimize every factor possible. General health is key.
06:21 Mike Dilke: We have established that there is a growing demand. What is the most common form? Do you use another woman’s eggs, or can you use a woman’s own eggs and fertilize them outside the body?
06:42 Dr. James Hopkinson: The vast majority of people having IVF in the UK use their own eggs and their own sperm. But there is a group of women who will need donated eggs. That is what we are trying to increase knowledge about through our study. What is the knowledge of women about egg donation? How many people would consider egg donation for those who need donor eggs? We have a shortage of egg donors in the UK; we have more demand than supply. The survey was surprising: looking at 2,000 women, half of them suggested they would consider donating eggs, but 70% don’t know enough about it to make an informed decision.
07:45 Mike Dilke: Let’s bring in an expert on that subject. Let’s bring in Rachel because you have donated eggs previously.
07:53 Rachel Allison: Yes. In total I have done it three times now.
07:56 Mike Dilke: Why would you do that? It is not that simple.
08:04 Rachel Allison: I first got in contact with TFP when I was starting my own journey to have a child. I made the decision to have a child by myself via the use of donor sperm. That is when I first became aware that egg donation or egg sharing was an option. I would be sharing my eggs collected for my treatment with somebody else. Once I had done it the first time, I was aware of what the process was. To me, it didn’t feel invasive. After I did it once, I decided to do it again. The third time, someone I had donated to previously was looking to have another child, so I got back in contact via the clinic to see if I would be willing to donate again so that their sibling would come from the same eggs.
09:02 Mike Dilke: Can you take us through the process from start to finish?
09:09 Rachel Allison: It is very similar to the IVF process. You have checks to make sure you can be an egg donor, checking your ovaries and egg quality. You have to wait until you are in the right part of the month with your cycle. Then, you need to take injections to stimulate your ovaries and increase the egg count. I was in for checkups sometimes every day or every other day as I got towards the end of the cycle for the collection.
09:58 Mike Dilke: There is quite a lot of time involved and you are injected with hormones.
10:04 Rachel Allison: Time-wise, yes and no. After the initial visit, the checks towards the end are very quick appointments, usually done in the morning. I would go before work. It wasn’t something taking hours out of my day on a daily basis. When you have the procedure itself, you are going to need a day off work because it is done under sedation. You are not going to be in a fit state to go to work. But I felt okay after it.
10:40 Mike Dilke: For the actual procedure, you say it is done under sedation. Is that a general anesthetic?
10:48 Rachel Allison: I believe not. I’ll let James answer that.
10:52 Dr. James Hopkinson: We don’t use a general anesthetic. We use conscious sedation with an anesthetist, so it is incredibly safe. We give an opiate for pain relief and a drug called propofol, which is used in general anesthesia but at much lighter doses. Conscious sedation can be turned up and down very quickly. An egg retrieval takes about 10 to 15 minutes. We want people to be as comfortable as possible. A needle is passed through the top of the vagina into the ovary, but it is a very quick procedure. People are up and about very quickly—cup of tea, some biscuits, and home within an hour or so.
12:00 Mike Dilke: It is a medical intervention, so there must be some risks involved, James. Can you outline what they are?
12:14 Dr. James Hopkinson: The risks are low. When someone considers being an egg donor, we go through everything in fine detail to make sure they are informed. You can become bloated and uncomfortable as the ovaries get bigger, a condition called ovarian hyperstimulation syndrome (OHSS). Interestingly, the HFEA, our regulator, collects data on severe OHSS, and no egg donors were in that cohort in the last reporting session. We are very careful to make sure they don’t become unwell.
13:03 Mike Dilke: Let’s go back to Rachel. Did it hurt?
13:09 Rachel Allison: No. The injections don’t hurt; the needles are tiny. I never felt or remembered anything from the procedure itself. Afterwards, you get a bit of discomfort, very similar to period pains, which eases in a day or two. There was never any pain or major discomfort for me personally.
13:37 Mike Dilke: You donate your eggs to help someone having trouble having children. You could end up being related to children you don’t know. You could pass a stranger in the street who could be your biological child. Is that something you spent time thinking about?
13:56 Rachel Allison: I don’t see it like that. I know that is the case, but I don’t see it as potentially having three children walking around out there that are mine. Yes, they were my eggs and it is my DNA, but I look at it as having helped somebody else. Measures are taken into consideration so that I am not donating to somebody who lives around the corner. Geography is considered. Otherwise, my daughter could meet someone down the line who is technically her sibling.
14:38 Mike Dilke: Are your donations used in a different clinic?
14:41 Dr. James Hopkinson: They can be. All donors go through implications counseling to address those concerns. We are also regulated so that each donor is allowed to create 10 family units. Eggs now are predominantly frozen and can be distributed across the UK. It is all highly regulated by the HFEA. We screen donors, quarantine them to ensure no risk of STIs, and perform genetic tests and questionnaires. Regarding the use of those eggs, there is no comeback to the donor in terms of legal parenting. A donor-conceived child can get identifying information about the donor when they are 18, but it is not reciprocal. A donor cannot ask for identifying information about a child. We have a very rigid regulatory framework in the UK.
16:18 Mike Dilke: Have you ever had someone volunteer to donate but then decided it was best if they didn’t because of the counseling system?
16:31 Dr. James Hopkinson: Yes, most definitely. We are meticulous in making sure it is the right thing for both donors and recipients. The process of counseling through the British Association of Infertility Counselors ensures this. As clinicians and nurses, we make sure it is the right thing for all concerned because you do not want a donor to regret their donation. Donors can come out of the program at any stage and remove their consent up until the eggs are allocated and used in treatment.
17:29 Mike Dilke: Rachel, your reason for going ahead is purely to help someone have a child.
17:40 Rachel Allison: Yeah. I’d like to think if I were in that situation where I needed help to have a child, there would be someone out there to help me. For me, it is purely just to help somebody else.
17:58 Mike Dilke: So there is no payment or financial gain involved?
18:04 Dr. James Hopkinson: Egg donors can receive reasonable expenses capped by the HFEA. Compensation for egg donation increased last year from £750 to £985. I don’t think one can say it is a massive financial incentive. Interestingly, the HFEA research suggests egg donation often comes from more affluent areas of the UK, which suggests more altruism than financial gain. In the case of egg sharing, you can reduce the cost of your own IVF treatment by donating some of your eggs to another couple.
18:58 Mike Dilke: Are there statistics for the percentage of egg donors who are egg sharers?
19:05 Dr. James Hopkinson: It is lower. We have far more altruistic egg donors than egg sharers. Because you are looking at the treatment of two people, you need to make sure there is a sufficient yield of eggs for both the donor and the recipient. The criteria are very tight. You are not allowed to do a cycle where you donate to a bank and then compensate with a second cycle for your own treatment. The HFEA is clear that you are not allowed to do that because it puts you at risk of two egg collections and stimulation regimes. In an egg share agreement, you have to ensure the patient gets enough eggs to not compromise their own treatment.
20:15 Mike Dilke: In the States it is different; people get paid between $5,000 and $10,000 for egg donation.
20:30 Dr. James Hopkinson: Yes, they do. In Spain, Eastern Europe, and Northern Cyprus, the compensation is very different. We are seeing more people going abroad to access donor eggs, which is why we want to drive this information piece so we can make egg donation more accessible in the UK. For some of our patients, we will import eggs from abroad, but those donors must be screened in line with UK regulations and donate with the same compensation and anonymity regulations as a UK donor. Only 3% of egg donation cycles in the UK use imported eggs. The US has big markets; there are banks that present Ivy League donors who are paying their way through university by donating eggs.
21:46 Mike Dilke: That throws up potential questions about the quality of the eggs if they are being sold.
21:56 Dr. James Hopkinson: When looking at egg donation, a third of donors in the UK have proven fertility and children. But you are always concerned if a batch of eggs from a donor will be good if that person hasn’t got proven fertility. These are the risks we go through with couples individually, explaining that this process isn’t 100% successful. People have to look at success rates, convenience, and costs.
22:42 Mike Dilke: What are the statistics for success rates?
22:56 Dr. James Hopkinson: IVF success rates are related to age. If you are using your own eggs at 40, you have around a 20 to 25% chance of success. By 43, it is about 5%. All donors must donate before their 36th birthday. We would quote around a 40% success rate with donor eggs. It is the age of the egg that is important, not the age of the uterus. When looking at ways to improve success for older patients, you either screen embryos for chromosomal normality—a process called PGTA—or you use donor eggs. That decision must be made through counseling and being given the statistics.
23:59 Mike Dilke: Statistics can be used to reach any conclusion, so they have to be handled with care. You have to be upfront with the chances of success.
24:28 Dr. James Hopkinson: Yes. I have a stuffed Eeyore on my desk that a patient gave me, saying I was more “cup half empty” than “cup half full.” I feel strongly that if we are putting people through treatment, they must be fully informed. They are investing a huge amount physically, emotionally, and financially. NHS provision for assisted conception is decreasing; the number of NHS cycles is down from what it was five or six years ago.
25:16 Mike Dilke: Can a couple go to the NHS for help?
25:27 Dr. James Hopkinson: They can, but it is still a postcode lottery. NICE guidelines from 2004 said this would standardize IVF access, but 20 years later, we are still in the same position with different integrated care boards offering different levels of access. I work in the East Midlands with five different integrated care board contracts, all with different age and treatment criteria. In Scotland and Wales, you get three cycles of IVF on the NHS, depending on childlessness, BMI, and age.
26:30 Mike Dilke: You do some work on the NHS and some privately?
26:34 Dr. James Hopkinson: In my unit in Nottingham, about 40% of our cycles are NHS-funded and 60% are self-funded.
26:49 Mike Dilke: As a private clinic, you have to charge for the processes, but the raw material—the eggs—you get for “free.”
27:14 Dr. James Hopkinson: It is not free because you have to do the tests, screening, and storage. We run storage programs 365 days a year with on-call systems. It is an expensive process. The difficulty is how to make assisted conception affordable and accessible. It is a battle we have with the government and the NHS for better funding and easier access criteria. We are transparent with the costs.
28:14 Mike Dilke: Rachel, you’ve been through the process and got something from it. Would you do it again and would you recommend it to other women?
28:33 Rachel Allison: I would do it again, but I turned 36 in January, so I don’t think I would be able to. If you are in a position to do so, definitely look into it. I have spoken about it openly on social media and had people ask questions and look into it themselves. If it is spoken about more, it will encourage others. People are aware of blood and organ donation and sperm donation, but not as much about egg donation.
29:25 Mike Dilke: If people want to look into this, can you suggest a solid, trustworthy resource?
29:53 Dr. James Hopkinson: The TFP Group website has a lot of validated information written by clinicians and embryologists: www.tfp-fertility.com. The HFEA website, hfea.gov.uk, has a load of information, FAQs, and a “find a clinic” tool. There are also good charities like the IVF Network UK. My advice is to be careful with fertility advice on TikTok or Instagram; the majority of those people are not medically qualified and it is experiential or opinionated. Even AI algorithms like ChatGPT sometimes do not provide the best information. Stick to good quality IVF units, the regulator, and recognized fertility charities.
32:00 Mike Dilke: James and Rachel, thank you very much for taking the time to chat. This affects many people and they will find this very useful.
32:16 Dr. James Hopkinson: It was a pleasure.
32:17 Rachel Allison: Thank you.
32:19 Mike Dilke: Thank you to my guests, Dr. James Hopkinson and Rachel Allison. Thank you for listening. Join me again next week for more fascinating interviews. If you are listening to the podcast, please subscribe, like, and share. Have a healthy week.
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3. Key Points Summary
This podcast episode features host Mike Dilke discussing In Vitro Fertilization (IVF) and egg donation with Dr. James Hopkinson of TFP Fertility and three-time egg donor Rachel Allison.
Growth and Demand
IVF demand is rising significantly, with roughly 100,000 cycles annually in the UK. Dr. Hopkinson attributes this to greater fertility awareness and a societal shift where people delay parenthood for career and financial stability. Many developed nations now see the average age for a first child rise above 30. However, biology remains a constraint; fertility peaks in the early-to-mid 20s. For older women, the “age of the egg” is the primary factor in success, often necessitating donor eggs.
The Donation Process
Rachel Allison describes the donation process as similar to IVF: hormonal injections to stimulate the ovaries followed by a quick retrieval procedure under conscious sedation. She emphasizes that the process was not painful or overly invasive. Dr. Hopkinson clarifies that while risks like Ovarian Hyperstimulation Syndrome (OHSS) exist, they are extremely low for donors due to rigorous monitoring.
Ethics and Regulation
The UK has a strict regulatory framework managed by the HFEA. Donors are limited to creating 10 family units to manage potential biological relationships within the population. While children can access identifying information about their donor at age 18, the process is not reciprocal. Unlike the US, where donors may receive up to $10,000, UK donors receive capped expenses (currently £985). This ensures the motivation remains largely altruistic.
Access and Information
Access to IVF on the NHS remains a “postcode lottery,” with different regions offering varying levels of support. For reliable information, the guests recommend the HFEA website, TFP Fertility’s validated resources, and established charities, warning against unverified advice from social media or AI.