Helping desperate women to conceive earns these 'unorthodox' specialists more money than even the best-paid plastic surgeons. By Sophie Goodchild and Jonathan Owen

They have made their names achieving miracles for thousands of childless couples. And now fertility doctors have become Britain's new millionaires, according to new figures, outranking even plastic surgeons in the high-earners league.

Top of the list is Dr Mohamed Taranissi, who runs a private clinic in London's Wimpole Street and is estimated to have a £20m fortune, which makes him the country's wealthiest doctor.

A controversial figure in the world of medicine, the Egyptian-born Dr Taranissi runs the Assisted Reproduction and Gynaecology Centre (AGRC), which made a pre-tax profit of more than £4m in 2004, a figure that has more than doubled over the past four years.

Another doctor who has become fabulously rich from the baby-making business is Professor Ian Craft, who runs the London Fertility Centre in Harley Street. As the principal shareholder, the 68-year-old has made more than £9m in fees and pension payments over the past seven years, according to his latest accounts at Companies House.

And in vitro fertilisation (IVF) expert Dr Simon Fishel has seen profits in his clinics, the Centres for Assisted Reproduction (Care), treble over the past three years to £1.9m. As a major shareholder, Dr Fishel, who runs the company along with Dr Simon Thornton and Dr Ken Dowell, was paid dividends of £160,000 in one year alone as well as taking a cut of fees for being on the board of Care's subsidiary companies.

An estimated one in six couples now experience trouble conceiving, and the record profits enjoyed by fertility doctors reflect the huge demand for treatment, especially over the past decade. Most of the 50,000 test-tube babies created in Britain since 1978 were born between 1997 and 2000.

However, experts also warn that the growth in private treatment demonstrates that the NHS is still providing inadequate and patchy treatment for patients and that many desperate couples are being forced to go private, especially those with only a slim chance of getting pregnant.

New research published next month will reveal that the worldwide market in fertility treatment is now worth more than £3bn. Academic Debora Spar, in her book The Baby Business, argues that the potential for exploitation is huge and that more safeguards for patients must be put in place.

"You have a large number of potential customers each of whom is willing to do whatever it takes and pay whatever they can to purchase the product at hand," said Professor Spar, of Harvard Business School.

"When you have this kind of demand some of the suppliers are going to make lots of money."

Her findings will be presented in March at the annual conference of the Human Fertilisation and Embryology Authority (HFEA), which regulates treatment in this country. The HFEA is calling on clinics to publish costed treatment plans in writing so that patients are fully aware of the costs involved and can complain about unreasonable charges.

Unlike other procedures that are limited on the NHS, such as weight reduction operations and breast enhancements, fertility treatment is a gruelling process that often involves more than just one session of treatment. This can put a big psychological and financial strain on couples who already feel defeated by their inability to conceive naturally.

The fees for one cycle of fertility treatment can vary from £800 to £3,000 and these figures can increase dramatically to as much as £20,000 for those who do not get pregnant at the first attempt. At private clinics, costs are obviously higher than the NHS and patients must also pay for fertility drugs as well as extras such as anaesthetic, which can cost up to £300.

In Britain, assisted conception is still regarded as a lifestyle choice, and not a necessity, by some members of the medical profession, which means thousands of couples face a postcode lottery over treatment unless they go private.

John Reid, the former health secretary, did call on NHS trusts to provide at least one free cycle of IVF by April last year. But 23 failed to meet this deadline and 30 are refusing to treat women who are too old, too young or who already have children.

Experts are predicting that the lack of NHS provision will lead to increasing numbers of "fertility tourists", where people travel to countries such as Spain, Greece and Slovenia to get fertility treatment.

They are lured by the promise of "IVF holiday" treatment packages for about £3,000 - cheaper than in Britain - in countries where there are more women willing to donate their eggs to childless couples.

Infertility Network UK, which offers support to couples who are trying to conceive, said that thousands of desperate people would continue to face a big financial burden unless free treatment were made more widely available.

"I'm a great believer in people having a choice but my concern is that the vast majority of people don't have a choice and, if faced with either going private or massive waiting lists, will be forced to go private," said Claire Brown, chief executive.

The All-Party Parliamentary Group on Infertility has written to all MPs urging them to report trusts that turn away patients who are the wrong age or already have children. Dari Taylor, its chair, said that fertility treatment had been the "poor relation" of gynaecology for too long.

"No one is acknowledging the true extent of the problem - it's seismic," said Mrs Taylor, the MP for Stockton South who underwent unsuccessful treatment herself before adopting her daughter.

"People have to borrow on their houses to save this sort of money and private clinics are profiting because the NHS can't provide."

However, the doctors who run the private clinics argue that their profits enable them to pioneer new treatments not being developed within the NHS, where helping infertile couples is not a priority.

This includes such procedures as egg freezing, which can be used by young cancer sufferers who might become infertile after having chemotherapy. More controversial is the use of embryo selection to create so-called designer babies. Despite objections from the HFEA, this has already been used by clinics treating couples who want to select the tissue of their unborn baby so that it can be used to save a sick child.

Despite their wealth, fertility experts are unlikely to be found sunning themselves on yachts in the south of France or driving the latest Ferrari. Dr Taranissi, of the AGRC, does own a house in Mayfair but walks to work, does not have a car and lists work as his leisure activity. A poetry and music enthusiast, Professor Craft drives a van, which he has owned for years, and lives in a small mews house.

Industry insiders attribute the success of Dr Fishel, who worked with test-tube baby pioneers Patrick Steptoe and Robert Edwards, to the fact he is not only an astute businessman but "a good scientist".

In an interview with The Independent on Sunday, the doctor admits that the system of fertility treatment provision in this country was "cruel and inequitable" but said that he ploughed Care's profits back into pioneering new treatments to help childless couples.

"I don't think it's unjust that we make a good living out of what we do, but it's appalling that private patients have had to fund advancements in science," Dr Fishel said.

Professor Ian Craft - £10m

Professor Craft was the doctor responsible for the treatment of Britain's oldest mother, 60-year-old Welsh hill farmer Liz Buttle, which provoked outrage at the time among his profession.

Professor Craft specialises in treating older women who have been rejected by the NHS or other clinics. In his view, age should not be a bar to women receiving fertility treatment. He is also unafraid to push what others would consider to be ethical boundaries. His patients have included 57-year-old Jenny Bashford, who became a mother to her own grand-daughter last year. The process was only allowed because Mrs Bashford's daughter, Anneliese, was adopted and was not a blood relative.

Over the past seven years, the scientist has earned more than £9m in fees and pension payments from his clinic, the London Fertility Centre. As well as helping couples become parents, the 68-year-old also holds directorships of at least a dozen other companies, including a breast-screening clinic and one offering laser surgery. Prices start at £2,575 for IVF for couples undergoing assisted conception at his treatment centre. As well as work, his hobbies include sculpture, poetry and photography. Despite his financial success, Professor Craft is not extravagant: his chosen form of transport is a van, not a sports car.

Dr Simon Fishel - £1.9m

According to the latest accounts, Dr Simon Fishel's fertility clinics, Centres for Assisted Reproduction (Care), have trebled their profits to £1.9m over the past three years. As a major shareholder and managing director, Dr Fishel, who runs the company along with Dr Simon Thornton and Dr Ken Dowell, was paid dividends of £160,000 in one year alone as well as taking a cut of fees for being on the board of Care's subsidiary companies. With a reputation for being both a good businessman and scientist, Dr Fishel learnt his craft from Patrick Steptoe and Roberts Edwards, the pioneers of in vitro fertilisation. General Healthcare Holdings, which owns 50 per cent of shares in Care, has assets of over £1bn. He has established his reputation as a leading expert in his field by treating patients like Raj and Shahana Hashmi, who fought a long battle to get permission to create a baby with the same tissue type as their sick son, Zain, who was born with a rare genetic blood disorder. However, in 2000, the distinguished scientist was at the centre of allegations that he had profited from a sideline in overseas embryology clinics. The High Court ruled that he had used staff working for him to make personal profits. The case was eventually settled out of court.

Dr Mohamed Taranissi - £20m

The fertility expert has made an estimated £20m fortune from his work treating infertile couples and his clinic, the Assisted Reproduction and Gynaecology Centre (ARGC), made more than £4m in pre-tax profit in 2004.

A self-confessed workaholic, the 51-year-old does not own a car and instead walks to work from the house he shares in Mayfair with his wife Elly and their two young daughters.

Regarded as a controversial figure in the medical world, Dr Taranissi's clinic won a long legal battle to create Britain's first "designer baby", a 7Ib 1oz girl born last year. Julie and Joe Fletcher spent £10,000 in their attempt to have a child with bone marrow that perfectly matched that of their critically ill son, Joshua. Dr Fishel also won a court ruling to allow him to treat a couple from Leeds who wanted a child with the same tissue type as their sick son. His latest venture is to import stem cells from abroad in a bid to side-step strict laws governing embryo research.

Dr Taranissi, a friend of Mohamed al-Fayed, the Harrods owner, attributes his success to hard work, solid results and utter dedication to his profession.

"Everyone who works expects to get paid for it and I don't think there should be a big stigma [about profiting]," he said.