Growing Fertility Tourism
July 25, 2008
The 30th birthday of Louise Brown on Friday, July 25, may provide hope to millions of childless couples signing up for vastly improved assisted reproduction techniques around the world, but in Europe, the occasion also highlights a growing uneasiness among experts as more and more people shop around the continent for the best fertility treatment.
Wide disparities in fertility treatments within Europe, open borders and cheap flights have fuelled a boom in so-called fertility tourism in the European Union.
Differing laws, costs fuel fertility shopping
Experts say childless couples increasingly circumvent national laws banning or restricting fertility therapies in one European country by simply going to another one where more liberal legal frameworks exist.
Many assisted reproduction techniques that are considered to be best practice in some EU member states are heavily restricted or outlawed in others, and safety measures introduced in parts of Europe are routinely violated elsewhere.
Germany and Italy, for example, ban embryo-freezing, egg donation and embryo-screening for inherited diseases, driving couples who need these services to pay for treatment in countries that permit them, such as Britain, Spain and Belgium.
Cost too plays a big role with many couples from Germany, for example, increasingly heading to Eastern Europe for fertility treatment. In 2004, the German government changed laws, forcing childless couples to shoulder 50 percent of fertility treatment costs. In addition, health insurance providers are required to pay their half of the treatment expenses for only three attempts.
For many in Western Europe and elsewhere, places like the Czech Republic have now become one of Europe's top destinations for foreigners seeking artificial insemination treatments.
"We get Americans, more and more Russians, Scandinavians, Germans, Austrians, and even groups of Israelis accompanied by a rabbi," Ladislav Pilka, head doctor at a fertility clinic in the city of Zlin near Prague told news agency AFP earlier this year.
Some travel companies even offer "in vitro fertilization" holidays, according to the type of treatment, with optional visits to regional tourist sites and spa therapy.
With one of the most liberal legal frameworks in Europe, nearly all types of treatment can be offered in the Czech Republic: egg donation, sperm donation, embryo donation, in vitro fertilization (IVF), micro injection (ICSI), embryo cultivation, pre-implantation genetic diagnosis (PGD).
Experts warn of health risks
But experts warn that the lack of universal regulations governing fertility treatment severely compromises safety with many couples ending up taking huge risks at clinics that may not have adequate standards.
Much of the concern centers on in vitro fertilization or IVF which is hugely popular. Since Brown's birth on July 25, 1978, around 3.5 million babies have been born worldwide using assisted reproductive technology and at least 200,000 more join them each year.
The procedure involves surgically removing eggs from a woman's ovaries, combining them with sperm in a lab and then implanting the best fertilized embryo in the woman's uterus.
But one of the biggest hazards of IVF treatments is the maximum number of embryos that can transferred to a woman's womb. That number varies in different countries. While Scandinavia and Britain only allow one or two, others don't have a limit. That, experts says, raises the chance of multiple pregnancies and thus health risks for both the mother and babies.
"Patients sadly often come back with a high rate of multiples from some places of the world where the standards are not as high," Francoise Shenfield, a fertility expert at University College of London and a member of the European Society of Human Reproduction and Embryology (ESHRE) told news agency Reuters.
Ethics groups and fertility experts are lobbying the European Commission and European Parliament to harmonize rules on fertility treatment across the 27-member bloc.
“The human right to reproduction and access to assisted reproductive technology for infertile couples should be preserved in similar legislation throughout Europe as part of a unified strategy to address human infertility,” Professor Paul Devroey, chairman of the ESHRE told The Times last year.