Moving embryos from the UK to the US

Some intended parents turn to surrogacy in the US after coming to the end of their own fertility journey in the UK. As a result, they may have embryos remaining from prior treatment that they want to export to the US for surrogacy. Other parents may wish to create embryos in the UK with a view to exporting them for surrogacy from the outset. 

The first question to unravel is whether the UK clinic where the embryos are stored (or will be created), and the receiving clinic in the US, already have experience of exporting embryos. Both sides will have regulatory requirements to comply with, and it can be helpful if the clinics have been through this process before. 

What information will a US clinic need to be able to import embryos from the UK?

The US clinic will need lots of information about the embryos, and the intended parents may need to sign a release of information form to give permission for the clinics to talk to each other. Common information that is requested includes, but is not limited to:

• The tests and screening done before the embryos were created
• Information about genetic testing that the embryos may have had
• The cryopreservation process that was used to freeze the embryos
• Information about how the embryos are stored

Based on the information received, the US clinic will make an assessment about whether they are able to accept your embryos. 

What guidelines do clinics adhere to?

US clinics must comply with the regulatory requirements of the US Food and Drug Administration (FDA) and, ideally, embryos used for surrogacy should be created in accordance with FDA guidelines. Since most UK clinics are not formally registered with the FDA, it is unlikely this requirement will be met automatically and if so, the US clinic will need to arranging retrospective testing approved by the FDA, or get a waiver. Completing the retrospective tests is usually straightforward, non-invasive and can be done in the UK with guidance from the US clinic on exactly what is required, but usually includes a health questionnaire, a physical exam carried out by a UK doctor, saliva samples and blood tests.

The exporting UK fertility clinic will also have to comply with the regulatory requirements of the UK Human Fertilisation and Embryology Authority (HFEA). This is now generally straightforward as long as the right consents are given and the clinic in the US can provide the necessary information about their accreditation and safety standards. However, until 2020 it was more difficult because the HFEA required exporting clinics to confirm that the surrogacy arrangement planned overseas would not be ‘commercial’. In 2020, working with our sibling organisation NGA Law, we successfully challenged this HFEA guidance and it was amended to make clear that export for commerial surrogacy overeseas was permitted, something which has made a significant difference to easing the export path for all intended parents. 

Exporting embryos created with donor sperm or eggs in the UK

This scenario is a little tricker to navigate, depending on who donated the eggs or sperm. If the donor is known and they are willing to do the retrospective FDA testing and give consent to the export, it may be possible, but it all needs careful planning and it is important to get the right early advice.

Transporting embryos safely

Embryos should always be exported by a courier that specialises in the transportation of human tissue. In most cases, the embryos will be collected from the UK clinic in special dry shipping containers and carried by hand for the whole journey. The courier will also carry clinical paperwork, and most will have customs clearance and x-ray exemptions.

The safety of this very precious cargo is paramount, therefore most couriers will arrange all travel logistics and use major airlines that have experience of facilitating the transportation of embryos. They will make sure that the container is secure and vertical at all times and follow rigorous security protocols every step of the way. 

The costs of exporting embryos for surrogacy

Costs will vary depending on the clinics and courier companies involved, but on average the cost is $4,000 – $7000, which includes courier costs, receiving clinic costs and FDA testing costs. There will be additional fees for storage of the embryos and any subsequent fertility treatment. 

Timescales for exporting embryos for surrogacy

Much depends on the responsiveness of the clinics involved and courier availability, but on average it can take between 6 weeks and 4 months from initiating the process with a UK clinic. Delays most commonly occur with how long it takes each clinic to respond to requests for information and to review reports and information from the other.