Fertility Tourism – Definition, Causes, Treatments & Destinations

Fertility tourism or reproductive tourism, also called cross-border reproductive care, is defined as the practice of traveling from one country to another in the pursuit of a fertility treatment to overcome fertility issues. It is a subclass of medical tourism that is becoming increasingly popular internationally, especially amongst patients from countries where regulations are too strict.

The laws that govern the use of fertility treatments to deal with infertility are not equal in all countries. For this reason, many potential patients are forced to travel overseas, to a country where the treatment they need is legal and available for non-citizens. Surrogacy or egg donation are good examples of fertility options that are often banned or too limited in most countries.

Definition

Fertility or reproductive tourism can be defined as a type of medical tourism whereby childless patients can have a baby by undergoing a fertility treatment in a foreign country. This subtype of medical tourism is becoming a popular practice all around the world.

Definition of fertility tourism

Medical tourism offers many benefits for patients who can't access, for a variety of reasons, the treatment they need in their country of origin. In particular, reproductive tourism is an advantageous option for infertile patients who see it as their only option to have a child.

But one should consider both the pros and cons of fertility tourism before making a haste decision:

• Pros: Intended parents who can't conceive naturally and can't do so in their country have the chance to achieve pregnancy overseas. Moreover, more often than not, it is considered a type of tourism because it allows patients to undergo treatment while enjoying the charms of a foreign country.
• Cons: Traveling abroad translates into additional costs that may not be affordable by all families. This is a major disadvantage when cross-border reproductive care is their only chance to have a child. And, depending on the nationality, applying for the necessary travel documents to enter the country may be more or less complicated.

Typically, hopeful intended parents get in touch with an agency or clinic in the destination country in order to be informed about the steps to take. As a matter of fact, a number of patients decide to pursue fertility care abroad because the quality of the clinics and services in the destination country are much better and subsequently allow them to reach higher success rates.

Causes & origins

The need for a particular fertility treatment or procedure that is forbidden or too limited in a particular country is the main reason why childless people turn to the phenomenon of fertility tourism.

Particularly, the following are the causes that make reproductive tourism a reality:

Donor conception

Although most couples seek IVF abroad because they need to use donor eggs, some couples look for known sperm donors in another country as well.

Surrogate motherhood

This is possibly the most sought-after treatment, as only a few countries around the world allow it. Out of them, the regulations are usually so strict or the costs so high that residents prefer to pursue surrogacy overseas.

PGD/PGS

Genetic testing of embryos is not permitted in multiple countries, especially in communities where religion plays a major role, as it implies the manipulation of human embryos.

Gender selection

Choosing the gender of your unborn child for just social reasons (family balancing) is an option that is not allowed in the majority of countries.

New family types

In many countries, gay couples and single people don't have reproductive rights—or they if they do, their options are too limited—to create a family. This is the reason why the most common profiles are same-sex male couples and single parents.

Previous treatment failure

In some countries, reproductive medicine is more advanced than in others. So, if fertility patients didn't achieve a successfull fertility treatment in their country of origin, they consider treatment options abroad.

Age limits

Another important factor is the age of the fertility patients: on average, they are 37 years old.

Treatment costs

Having the highest prices for IVF cylces, many U.S. patients seek fertility treatments in Europe due to its excellent cost-effectiveness.

Reasons for fertility tourism

Medical tourists that travel abroad to start a fertility treatment make the decision after considering the many advantages that it offers to them based on their preferences. A better healthcare system, the anonymity of donors, lower costs, or more flexible age limits are the main motivations.

Most sought-after treatment options

As mentioned earlier, the availability of fertility treatments is dependent on the existing laws in each country. In most cases, such unavailability is associated with religious beliefs, politics, or the culture of a particular country. This is precisely the reason why some clinics are more controversial than others.

To sum up, what follows is a list of the most controversial treatments, which at the same time are the most sought-after ones by fertility tourists. The need for pursuing them abroad is associated with the regulations governing them, but also with the costs, waiting lists, age limits, etc.

Egg and sperm donation

Egg and sperm donation is the solution for those couples who cannot use their own gametes (reproductive cells) because they lack reproductive function or their quality is too low.

Due to the many ethical issues associated with donor conception, also known as donor-assisted reproduction, this fertility option is not accepted in all countries. There exist two big types of donation based on the conditions required by law in each country:

• Altruistic or commercial donations
• Anonymous or known donations

As for the regulations of the identity donor conception, they differ significantly from country to country: Spain, for example, is a major destination country for fertility tourists worldwide. There, donors must remain anonymous by law. On the other hand, in the UK the identity of the donors must be disclosed, whereas in the United States, which is a top country as well, allows intended parents to choose between known and anonymous donor profiles.

There are not only regulations on the identity of the donors. Also the financial compensation is considered in the legislation of the respective country: altruistic vs. commercial donations. In Spain for example, the process has to be carried out completely altruistic, that means the donor is compensated with costs derived from the egg donation process only. This, on the other hand, leads to a shortage of willing donors, which makes the waiting lists for egg donation treatment almost endless.

Surrogacy

Surrogacy or surrogate motherhood is a third-party assisted reproduction option that involves many actors. For this reason, it is considered one of the most challenging fertility treatment options, both ethically and psychologically. This is the reason why it's now included in the regulations governing ART in the majority of countries.

Top destination countries for surrogate motherhood

Some US states, as well as countries like Canada, Greece, Ukraine, and Russia, are the most common destinations for commissioning parents willing to have a baby via surrogacy. This is due to the number of facilities they have in these destinations when it comes to becoming the rightful parents of the baby.

As for India, used to be the most popular destination amongst intended parents from all around the world until the Indian government updated the law. Read more: Surrogacy Laws in India – Cost, Process & Requirements.

Choosing a destination depends basically on the following factors:

• Costs
• Rights for new family types: gay couples, single men and women...
• Access to donor conception
• Legal requirements to obtain legal parentage

From an international perspective, either because it is permitted or banned, surrogacy is a highly controversial technique, especially from the ethical viewpoint.

Preimplantation Genetic Diagnosis (PGD)

Preimplantation Genetic Diagnosis (PGD) is a technique whereby the genetic material of an embryonic cell is examined to determine if it's normal or has its DNA altered, in which case it may develop a genetic disease.

In order to perform a genetic screening of embryos, a small incision is done to the membrane to remove a cell. By doing this, we are manipulating the embryo, which is ethically and morally debatable. This is the reason why PGD is banned in certain countries or strictly regulated in which the technique can only be applied if there is an existing genetic hereditary disease running in the familiy.

This is the case in Germany for example. Patients who need to seek PGD there, will require a hearing in front of an ethics commission who is responsible for assessing if indications for PGD are given in this situation.

PGD is banned in countries like Italy, mainly due to the influence of the Catholic Church. For them, creating embryos and not using them for whatever reason translated into destroying a human life. Subsequently, many tourists choose Spain or the USA, where PGD is permitted.

Gender selection

Sex selection is a technique that allows you to choose your baby's sex. It is permitted in some countries only for medical reasons, that is, to prevent the transmission of genetic diseased linked to sex, while others allow it for social reasons as well.

This fertility treatment has created an extensive debate from the ethical perspective where we can distinguish too clearly different viewpoints:

• In favor: Those who are in favor of sex selection consider it way of expressing the reproductive rights of the woman and, at the same time, of her partner. Moreover, it improves the decision making of individuals when it comes to starting a family. It also reduces the dropout rate.
• Against: Many medical experts have qualified it as a highly invasive technique, especially when used for non-medical reasons. It contributes to the creation of the so-called gender stereotypes in our society, which could negatively impact the fight against gender-based violence.

The USA is a top destination for those willing to choose the gender of their unborn child. Typically, patients come from the following countries: United Kingdom, Australia, and Canada. All of them have in common the fact that PGD is allowed for medical reasons only.

FAQs from users

How long does an ivf cycle abroad take?

It depends on your home country and the destination chosen. Normally, a typical IVF cycle requires a 17-day protocol, so you might need to stay for this time period. If you, on the other hand, are undergoing donor-egg IVF, the length of stay abroad might be even shorter as you would only need to be there on the day of the embryo transfer and then return after 2 or 3 days.

What are the dangers of fertility tourism?

When traveling abroad to undergo IVF, you should keep close attention to the number of embryos the clinic is going to transfer. Transferring more than one or two embryos can lead to a multiple pregnancy, which carries a number of risks and complications. Also, the standards and safety of clinics should be carefully examined.

What is the most common profile of fertility travelers?

Patients from all family types pursue fertility care abroad, including heterosexual couples, same-sex couples, and single people. A common profile are gay male couples whose home country is too restrictive in relation to reproductive rights for these families.

Recommended for you: Parents through Surrogacy Guide – The Process Step by Step.

Suggested for you

Are you considering traveling abroad to have a baby via surrogacy or egg donation? If so, you should know, as we have explained above, that surrogacy is not permitted in several countries, while others offer many advantages for all kinds of families. Read more: International Surrogacy – Laws & Options for Surrogacy Abroad.

To learn more about international laws on surrogate motherhood, we recommend that you visit this guide: Surrogacy Laws by Country – Where Is It Legal?