The evidence for cross-border reproductive care

We have limited evidence for how many people seek cross-border reproductive care (CBRC), why they go abroad and who they are, according to Dr Shenfield and Professor Culley. Professor Culley is principal investigator on the first empirical study of UK fertility travellers – the Trans-national Reproduction (Transrep) study. Dr Shenfield coordinates the European Society of Human Reproduction and Embryology's (ESHRE's) Cross-Border Reproductive Care Taskforce, which published the first European study into numbers of fertility travellers.

The ESHRE study found thousands of patients were travelling abroad for fertility treatment. Dr Shenfield thought ESHRE would struggle to get 500 responses when they gave questionnaires to patients travelling to European clinics, but they received 1230 questionnaires in one month from clinics in countries including Croatia, Spain and the Czech Republic.

Travellers from the UK had different motivations than people from other European countries. Around 34 percent travelled because of problems accessing fertility treatment and 38 percent because they expected better quality care abroad. Dr Shenfield mentioned the 'disastrous' state of NHS fertility treatment, such as PCTs suspending funding.
Professor Culley also found some fertility travellers from the UK were dissatisfied with the cost and quality of UK treatment and believed success rates were better abroad.

Choosing care abroad was not a spur-of-the moment decision, contrary to media stereotype. People were treated for up to 10 years in the UK before going abroad, Professor Culley said. Long waiting lists for donor gametes was a common problem: 70 percent of participants needed donor eggs. One woman went abroad after being put back on a three-year waiting list after waiting three years for unsuccessful treatment with a donor egg.

An argument erupted over the definition of CBRC. Retired gynaecologist John Parsons thought Dr Shenfield wrong to include transporting vitrified (frozen) eggs from Russia to the UK in CBRC. Dr Shenfield said technological advances in vitrification would allow 'Russian and Ukranian eggs to conquer Europe' and was concerned about exploitation of foreign donors. Checking the treatment of donors in Barcelona is easier than in the Ukraine, she said.

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