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'Fertility tourism': risk or choice?

5 July 2004
By Dr Kirsty Horsey
Reproduction Editor, BioNews
Appeared in BioNews 265
Last week, the European Society of Human Reproduction and Embryology (ESHRE) released data on IVF and ICSI success rates across Europe. This showed, among other things, that fertility clinics in some eastern European countries that have recently joined the European Union have success rates equal to or better than those in the UK. While the data collected from some of these countries may be collected differently from that in the UK (therefore not necessarily reflecting an accurate comparison), two countries in particular, Hungary and Slovenia, have what ESHRE called 'a good system of collecting data' and reported very good pregnancy rates after embryo transfer.

Good news, one might think, especially when fertility treatments are also cheaper in these countries. But the media - perhaps unsurprisingly given the title of ESHRE's own press release - pounced on the fact that impressive success rates, together with reduced cost, may encourage infertile people to travel abroad for treatment. Generally, such 'fertility tourism' from West to East was presented negatively in the media reports, with 'hidden risks' and 'threats' cited in headlines. But why should this be? What is wrong with travelling to another country for IVF treatment, when you may have as much chance of being successful, for less financial cost?

Suzi Leather, chair of the Human Fertilisation and Embryology Authority (HFEA), was worried that 'fertility tourists' may not receive the same standard of care in foreign clinics. 'I can understand why people would want to go abroad', she said, but qualified this, saying 'But where treatment is not regulated there is no way that patients can be sure of the safety or the results advertised by clinics'. And, according to some reports, doctors warned that 'the experience of spending many weeks in a foreign country during treatment might be 'miserable' and increase stress. Professor Karl Nygren, co-author of the ESHRE report, said 'the general care of a patient is just as important as the treatment, and this can be disrupted if you go abroad'.

None of the arguments presented seem to be a good reason to stop - or even to try and stop - people travelling for treatment. Cheap flights and cheap, but successful, fertility treatment, seem like an attractive option. And reports in last week's Lancet show that Slovenia, for one, has an excellent healthcare record and the highest healthcare expenditure in central and eastern Europe. Hungary follows not far behind, coming third out of the fifteen countries compared. So exactly what are the increased risks? The risk of having your luggage lost by a no-frills airline? The risk of struggling with the language while abroad and being a bit more stressed because of it? Perhaps even the risk that in clinics regulated differently, or who collated their results differently, the success rates aren't quite what they seem?

When balanced against the potential benefits, not least actually having a baby, this is an area where patient choice should prevail. For some patients, the risks may be ones worth taking. They might consider that it is better (or less stressful) to go abroad for treatment than to spend years on a waiting list for free IVF treatment (if it's even available in their area at all), or to pay around £4000 for private treatment. Travelling to eastern Europe for treatment might enable a couple to afford three cycles of treatment, for the same price as one in the UK.

4 November 2009 - by Ben Jones 
US company 'The World Egg Bank' has signed a deal with IVI fertility clinics in Spain to provide US consumers with 'IVF vacations' to Spain. The company, which provides the world largest online registry of egg donors, specialises in services involving the extraction, storage and sale of cryopreserved eggs. The company touts the tours as costing the same or less than the price of IVF in the US but with the added benefit of a vacation in Alic...
26 August 2008 - by Professor Guido Pennings 
The European Society for Human Reproduction and Embryology (ESHRE) has been concerned about the development of cross-border infertility treatment for some time. There are three reasons for this: the frequently negative publicity for infertility treatment presented as 'reproductive tourism', the increasing numbers and the risks for patients. ESHRE has taken...
4 July 2007 - by Sandy Starr 
It is essential that fertility regulation be standardised across Europe, according to Professor Paul Devroey of Brussels Free University. Speaking in Lyons, France at the annual meeting of the European Society of Human Reproduction and Embryology - of which he is chair - Professor Devroey made a provocative contribution...
30 April 2006 - by BioNews 
The UK's Human Fertilisation and Embryology Authority (HFEA) has urged couples seeking fertility treatments to 'think twice' about travelling to other countries for an 'IVF holiday'. The HFEA, which was set up in 1991 to regulate, license and monitor the provision of fertility treatment in the UK, said that couples...
20 June 2005 - by BioNews 
BioNews reporting from ESHRE conference, Copenhagen: Guido Pennings, professor of ethics and bioethics at the University of Ghent, Belgium, says that we should not condemn 'reproductive tourism' in Europe but regard it as a 'safety valve' that can help to avoid moral conflict. He told the annual conference of the...
1 July 2004 - by BioNews 
The European Society of Human Reproduction and Embryology (ESHRE) has suggested that the recent expansion of the European Union (EU) could lead to a rise in UK and other western European couples travelling to eastern Europe for fertility treatment. Data revealed at the ESHRE annual conference in Berlin, Germany, shows...
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