Fertility tourism
Encyclopedia
Fertility tourism or reproductive tourism is the practice of traveling to another country for fertility treatments. It may be regarded as a form of medical tourism
. The main reasons for fertility tourism are legal regulation of the sought procedure in the home country, or lower price. In-vitro fertilization and donor insemination are major procedures involved.
It has been proposed to be termed reproductive exile to emphasis the difficulties and constraints faced by infertile patients, who are "forced" to travel globally for reproductive procedures.
There is generally a demand for sperm donors who have no genetic problems in their family, 20/20 eyesight, with excellent visual acuity
, a college degree, and sometimes a value on a certain height, age, eye colour, hair texture, blood type and ethnicity . Anecdotal evidence suggests that the inventory of taller men who are blonde and blue eyed is most popular.
provide JCI-accredited IVF care aimed at patients from abroad.
to the United States
for sex selection
, because preimplantation genetic diagnosis
(PGD, a potential expansion of IVF), which can be used for sex selection
, is prohibited in the UK, except when it is used to screen for genetic diseases, while the laws in the US are more relaxed in this subject.
and Sweden
, have a shortage of sperm donors. Sweden now has a 18 month long waiting list for donor sperm.
As a consequence, British women travelled to Belgium and Spain in the late 1990s and in the early years of the 21st century for donor insemination, until those two countries changed their laws and imposed a maximum number of children one donor may produce. Prior to the change in the law, the limit in the number of children born to each donor depended upon practitioners at fertility clinics, and Belgian and Spanish clinics were purchasing donor sperm from abroad to satisfy demand for treatments. Anonymous donation was permitted in Belgium and is a legal requirment in Spain. Ironically, at the time, many Belgian and Spanish clinics were buying sperm from British clinics donated by British donors whose local limit of ten families in the UK had not been reached, and they were able to use that sperm according to local laws and limits. British fertility tourists must therefore now travel to other countries particularly those that do not include children born to foreigners in their national totals of children produced by each donor. Britain also imports donor sperm from Scandinavia but can only limit the use of that donor's sperm to ten families in the UK itself, so that more children may be produced elsewhere from the same donor.
At least 250 Swedish sperm recipients travel to Denmark annually for insemination. Some of this is also due to that Denmark also allows single women to be inseminated.
It is illegal to pay donors for eggs or sperm in Canada. Women can still import commercial U.S. sperm, but that's not true for eggs, resulting in many Canadian women leaving the country for such procedures.
is a main destination for surrogacy
. Indian surrogates have been increasingly popular with fertile couples in industrialized nations because of the relatively low cost. Indian clinics are at the same time becoming more competitive, not just in the pricing, but in the hiring and retention of Indian females as surrogates. Clinics charge patients between $10,000 and $28,000 for the complete package, including fertilization, the surrogate's fee, and delivery of the baby at a hospital. Including the costs of flight tickets, medical procedures and hotels, it comes to roughly a third of the price compared with going through the procedure in the UK.
Surrogacy in India is of low cost and the laws are flexible. In 2008, the Supreme Court of India in the Manji's case (Japanese Baby) has held that commercial surrogacy is permitted in India. That has again increased the international confidence in going in for surrogacy in India.
There is an upcoming Assisted Reproductive Technology Bill, aiming to regulate the surrogacy business. However, it is expected to increase the confidence in clinics by sorting out dubious practitioners, and in this way stimulate the practice.
Russian Federation.
Liberal legislation makes Russia attractive for “reproductive tourists” looking for techniques not available in their countries. Intended parents come there for oocyte donation, because of advanced age or marital status (single women and single men) and when surrogacy is considered. Gestational surrogacy, even commercial is absolutely legal in Russia, being available for practically all adults willing to be parents http://jurconsult.ru/publications/reproductiveBioMed.pdf. Foreigners have the same rights as for assisted reproduction as Russian citizens. Within 3 days after the birth the commissioning parents obtain a Russian birth certificate with both their names on it. Genetic relation to the child (in case of donation) just doesn’t matter http://humrep.oxfordjournals.org/content/25/suppl_1/i235.full.pdf+html.
On 4 August 2010, a Moscow court ruled that a single man who applied for gestational surrogacy (using donor eggs) could be registered as the only parent of his son, becoming the first man in Russia to defend his right to become a father through a court procedure http://www.surrogacy.ru/eng/news/news4.php. The surrogate mother’s name was not listed on the birth certificate, the father was listed as the only parent. After that a few more identical decisions concerning single men who became fathers through surrogacy were adopted by different courts in Russia listing men as the only parents of their “surrogate” children and confirming that all prospective parents, regardless of their marital status, sex, sexual orientation or nationality, can exercise their right to parenthood through surrogacy in Russia.
Medical tourism
Medical tourism is a term initially coined by travel agencies and the mass media to describe the rapidly-growing practice of travelling across international borders to obtain health care...
. The main reasons for fertility tourism are legal regulation of the sought procedure in the home country, or lower price. In-vitro fertilization and donor insemination are major procedures involved.
It has been proposed to be termed reproductive exile to emphasis the difficulties and constraints faced by infertile patients, who are "forced" to travel globally for reproductive procedures.
There is generally a demand for sperm donors who have no genetic problems in their family, 20/20 eyesight, with excellent visual acuity
Visual acuity
Visual acuity is acuteness or clearness of vision, which is dependent on the sharpness of the retinal focus within the eye and the sensitivity of the interpretative faculty of the brain....
, a college degree, and sometimes a value on a certain height, age, eye colour, hair texture, blood type and ethnicity . Anecdotal evidence suggests that the inventory of taller men who are blonde and blue eyed is most popular.
IVF destinations
About 20,000 to 25,000 couples annually seek assisted reproductive technology services abroad. Israel is the leading fertility tourism destination for In-vitro fertilization (IVF) procedures, having the highest number of fertility clinics per capita in the world. The United States is chosen by many Europeans because of the higher success rates and lenient regulations. In turn, India and Asia are the main destinations for U.S. women leaving the country for their fertility care, being the destinations for 40% of U.S. women seeking IVF and 52% seeking IVF with donor eggs. Many travel from countries like Germany and Italy, which are very restrictive of the number of eggs that may be fertilized and how many embryos can be used for implantation or cryopreservation. Even small countries such as BarbadosBarbados
Barbados is an island country in the Lesser Antilles. It is in length and as much as in width, amounting to . It is situated in the western area of the North Atlantic and 100 kilometres east of the Windward Islands and the Caribbean Sea; therein, it is about east of the islands of Saint...
provide JCI-accredited IVF care aimed at patients from abroad.
Risks
Many countries have no restriction on how many eggs may be implanted into the uterus at the same time, increasing the risk of multiple pregnancy and resultant potential complications. The burden of multiple births generated by placing too many embryos is carried by the patients and the home country.Egg donation
Egg donation is illegal in a number of European countries including Germany, Austria, and Italy. Many couples then will seek help in places where the procedure is allowed such as Spain and the United States where donors are paid for their service. Almost half of all IVF treatments with donor eggs in Europe are performed in Spain. IVF with anonymous egg donation is also the main assisted reproductive technology sought by Canadians traveling to the U.S, and is the sought procedure for 80% of cross-border treatments by Canadians.Sex selection
There is fertility tourism from the United KingdomUnited Kingdom
The United Kingdom of Great Britain and Northern IrelandIn the United Kingdom and Dependencies, other languages have been officially recognised as legitimate autochthonous languages under the European Charter for Regional or Minority Languages...
to the United States
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...
for sex selection
Sex selection
Sex selection is the attempt to control the sex of the offspring to achieve a desired sex. It can be accomplished in several ways, both pre- and post-implantation of an embryo, as well as at birth...
, because preimplantation genetic diagnosis
Preimplantation genetic diagnosis
In medicine and genetics pre-implantation genetic diagnosis refers to procedures that are performed on embryos prior to implantation, sometimes even on oocytes prior to fertilization. PGD is considered another way to prenatal diagnosis...
(PGD, a potential expansion of IVF), which can be used for sex selection
Sex selection
Sex selection is the attempt to control the sex of the offspring to achieve a desired sex. It can be accomplished in several ways, both pre- and post-implantation of an embryo, as well as at birth...
, is prohibited in the UK, except when it is used to screen for genetic diseases, while the laws in the US are more relaxed in this subject.
Donor insemination destinations
Some countries such as United KingdomUnited Kingdom
The United Kingdom of Great Britain and Northern IrelandIn the United Kingdom and Dependencies, other languages have been officially recognised as legitimate autochthonous languages under the European Charter for Regional or Minority Languages...
and Sweden
Sweden
Sweden , officially the Kingdom of Sweden , is a Nordic country on the Scandinavian Peninsula in Northern Europe. Sweden borders with Norway and Finland and is connected to Denmark by a bridge-tunnel across the Öresund....
, have a shortage of sperm donors. Sweden now has a 18 month long waiting list for donor sperm.
As a consequence, British women travelled to Belgium and Spain in the late 1990s and in the early years of the 21st century for donor insemination, until those two countries changed their laws and imposed a maximum number of children one donor may produce. Prior to the change in the law, the limit in the number of children born to each donor depended upon practitioners at fertility clinics, and Belgian and Spanish clinics were purchasing donor sperm from abroad to satisfy demand for treatments. Anonymous donation was permitted in Belgium and is a legal requirment in Spain. Ironically, at the time, many Belgian and Spanish clinics were buying sperm from British clinics donated by British donors whose local limit of ten families in the UK had not been reached, and they were able to use that sperm according to local laws and limits. British fertility tourists must therefore now travel to other countries particularly those that do not include children born to foreigners in their national totals of children produced by each donor. Britain also imports donor sperm from Scandinavia but can only limit the use of that donor's sperm to ten families in the UK itself, so that more children may be produced elsewhere from the same donor.
At least 250 Swedish sperm recipients travel to Denmark annually for insemination. Some of this is also due to that Denmark also allows single women to be inseminated.
It is illegal to pay donors for eggs or sperm in Canada. Women can still import commercial U.S. sperm, but that's not true for eggs, resulting in many Canadian women leaving the country for such procedures.
Surrogacy destinations
IndiaIndia
India , officially the Republic of India , is a country in South Asia. It is the seventh-largest country by geographical area, the second-most populous country with over 1.2 billion people, and the most populous democracy in the world...
is a main destination for surrogacy
Surrogacy
Surrogacy is an arrangement in which a woman carries and delivers a child for another couple or person. This woman may be the child's genetic mother , or she may carry the pregnancy to delivery after having an embryo, to which she has no genetic relationship whatsoever, transferred to her uterus...
. Indian surrogates have been increasingly popular with fertile couples in industrialized nations because of the relatively low cost. Indian clinics are at the same time becoming more competitive, not just in the pricing, but in the hiring and retention of Indian females as surrogates. Clinics charge patients between $10,000 and $28,000 for the complete package, including fertilization, the surrogate's fee, and delivery of the baby at a hospital. Including the costs of flight tickets, medical procedures and hotels, it comes to roughly a third of the price compared with going through the procedure in the UK.
Surrogacy in India is of low cost and the laws are flexible. In 2008, the Supreme Court of India in the Manji's case (Japanese Baby) has held that commercial surrogacy is permitted in India. That has again increased the international confidence in going in for surrogacy in India.
There is an upcoming Assisted Reproductive Technology Bill, aiming to regulate the surrogacy business. However, it is expected to increase the confidence in clinics by sorting out dubious practitioners, and in this way stimulate the practice.
Russian Federation.
Liberal legislation makes Russia attractive for “reproductive tourists” looking for techniques not available in their countries. Intended parents come there for oocyte donation, because of advanced age or marital status (single women and single men) and when surrogacy is considered. Gestational surrogacy, even commercial is absolutely legal in Russia, being available for practically all adults willing to be parents http://jurconsult.ru/publications/reproductiveBioMed.pdf. Foreigners have the same rights as for assisted reproduction as Russian citizens. Within 3 days after the birth the commissioning parents obtain a Russian birth certificate with both their names on it. Genetic relation to the child (in case of donation) just doesn’t matter http://humrep.oxfordjournals.org/content/25/suppl_1/i235.full.pdf+html.
On 4 August 2010, a Moscow court ruled that a single man who applied for gestational surrogacy (using donor eggs) could be registered as the only parent of his son, becoming the first man in Russia to defend his right to become a father through a court procedure http://www.surrogacy.ru/eng/news/news4.php. The surrogate mother’s name was not listed on the birth certificate, the father was listed as the only parent. After that a few more identical decisions concerning single men who became fathers through surrogacy were adopted by different courts in Russia listing men as the only parents of their “surrogate” children and confirming that all prospective parents, regardless of their marital status, sex, sexual orientation or nationality, can exercise their right to parenthood through surrogacy in Russia.