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Assisted Reproduction

Cross-Border Reproduction Poses Risks

The European Society of Human Reproduction and Embryology (ESHRE) and the International Federation of Fertility Societies (IFFS) have published results of a survey that indicates that patients who travel abroad for fertility treatment may face legal or medical problems upon returning home:

“Although in principle the care of foreign and local patients should essentially be the same and fit the best possible standards, there is evidence that it is not always so,” ESHRE’s Francoise Shenfield told reporters at a briefing. A survey of 105 countries by the IFFS found that cultural, religious and social differences in attitudes to fertility treatments such as using donated eggs, sperm or embryos mean there are wide variations in the number of clinics that offer treatment, and the services they provide….

The IFFS survey found there are over 500 fertility clinics in India and about 615 in Japan, but only 66 in Britain, 120 in Germany, 200 in Spain and around 360 in Italy. IFFS education director Ian Cooke said discrepancies in access prompted patients to travel abroad for treatment, but could leave them in medical, financial or legal difficulties. One major problem is the rules on the maximum number of embryos that can be transferred to a woman’s womb after IVF. In Britain and Scandinavia only one or two are allowed, but other countries have higher limits or none at all — a factor that can increase the number of multiple pregnancies that can pose risks for both mothers and babies.

Freezing embryos is banned in Germany, Italy and Croatia, but freezing eggs before they are fertilized is allowed. In Britain the removal of donors’ anonymity has led to a severe shortage in donated sperm. Sperm and egg donation is banned completely in many Islamic countries, and in France lesbians are not allowed access to donated sperm. Turkey has recently banned anyone going abroad to receive donated sperm or eggs — a law which the experts said was almost completely unenforceable.

“If a woman goes on holiday and comes back pregnant, who is to tell exactly how or when she got pregnant?” said Shenfield. Both IFFS and ESHRE support the rights of patients to travel to receive fertility treatment, but said in a joint statement that “ideally, this should take place in their home country.” They urged national health authorities to try to harmonize standards to increase the safety of patients and offer equal treatment for all those who want it. “The variation in international laws relating to infertility treatment is one of the reasons that cause couples to seek cross-border treatment,” said Cooke. “Whilst this is unavoidable we call for international standards to ensure these patients receive consistent advice and safe treatment.”

Hat tip to Stehanie Caballero for bringing this to my attention.


5 comments for “Cross-Border Reproduction Poses Risks”

  • Jon

    Most of these governments, if not all, have no issue with wealthy Euros going to the US to have surrogate babies – a practice that has been going for decades – but when middle class Euros go to India or elsewhere outside the Euro zone, it suddenly becomes an issue of national urgency. Without a doubt, this contradiction in policy points to racial and class motives, and perhaps a meddlesome finger or two in the pot by the Vatican.

    • Interesting comment, Jon. While I share some of your concern, I also wonder if part of the motivation is less cynical and more of a worry about the medical standards and safeguards in some of these countries. While the United States is not perfect, at least most doctors adhere to the ASRM guidelines which eliminates many of the risks which Intended Parents and Surrogates face. In countries like the Ukraine and India, the medical practices are largely unregulated exposing the child, Surrogate and Intended Parents to increased risks that might not be present in countries like the U.S.

      • Jon

        The American Medical Association does not share any such concerns, nor does the FDA. I trust our medical oversight agencies would have alerted US citizens to the dangers of medical tourism to India, for example, if they felt there were huge risks involved. I have yet to see any warnings like that. Europe is a different ballgame. I may sound cynical but racism and religious intolerance are endemic in Europe. Just look at what they are doing to the Roma populations in the past few weeks in supposedly progressive countries like France or the laws France recently passed which regulate the wardrobe that Muslim women can wear, banning headscarves and burqas, even if they choose of their own free will to wear them. These are just a couple of examples of the fabric of intolerance which permeates the Continent. On the surface the Euros are very liberal and socially progressive, but to a degree and only when national homogeneity is not at risk. The comments about surrogacy and threats it poses, while disguised as credent medical due diligence, is just another smokescreen attempt by these govts to stop the surrogacy trade by their nationals to Third World countries.

  • “In Britain the removal of donors’ anonymity has led to a severe shortage in donated sperm.”

    This is not true, and I don’t know why people keep repeating it. According to HFEA figures (see the link), the numbers of sperm donors have gone *up* four years in a row since the ending of anonymity, thus reversing a three year decline. The 384 donors in 2008 was the highest figure since 1996, and 160 more than in 2004 just before anonymity ended.

  • Remarkable blog, where did you found this data in this article? I am glad I found it. i will be checking back soon to discover what other posts you have.

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