Restrictive IVF access prompts thousands to travel abroad for treatment

The results of a new study into cross-border fertility treatment in Europe has indicate that every year thousands of women from Britain are travelling abroad to access treatment which is unavailable to them at home.

The study, presented at the European Society for Human Reproduction and Embryology (ESHRE)'s 25th annual conference in Amsterdam last week, is said to be the 'first hard evidence of fertility patient migration within Europe' by study co-ordinator Dr Francoise Shenfield.

Data was collected from 44 clinics across Europe and was collected by asking overseas patients their country of origin, age, reasons for travelling abroad for treatment, type of treatment they received and whether they were given information in their own language. Six European countries participated: Belgium, the Czech Republic, Denmark, Slovenia, Spain and Switzerland.

Over the one month period, 1230 forms were completed, leading to estimates of 20,000 to 25,000 cross-border treatment cycles per year. In total, patients came from 49 different countries, with the largest numbers coming from Italy (31.8 per cent), Germany (14.4 per cent), the Netherlands (12.1 per cent) and France (8.7 per cent). Britain was sixth in the list, with 53 respondents, accounting for nearly five per cent of patients surveyed.

The main reason given for seeking fertility treatment abroad was to avoid legal restrictions at home, which explains the high numbers of Italian cross-border patients; 2004 legislation rendered many fertility treatments illegal in Italy.

Thirty-four per cent of the British patients asked cited access issues as their reason for travelling abroad, more than any other nationality. Although the UK has some of the most liberal fertility laws in Europe, there are 'all kinds of barriers' to free NHS treatment including waiting lists and age, said Dr Shenfield of University College Hospital, London. Currently 75 per cent of UK IVF procedures are still carried out privately.

Age was another big factor for women travelling abroad. More than 60 per cent of the British women surveyed were over 40, at which age women cannot access IVF on the NHS. In addition to which, private cycles of IVF can cost up to twice the amount charged in countries in Southern and Eastern Europe.

A shortage of egg donors in the UK prompts many women to travel abroad, particularly to countries such as Spain and Slovakia where egg donors are paid and donation is more plentiful. Payment for egg donation is currently banned in the UK with donors able to receive a maximum of £250 for expenses incurred; a 2005 law removing donor anonymity also deters women from donating.

Standards and regulation of treatment abroad is a concern as more women choose to travel abroad for fertility assistance. Clare Lewis-Jones of Infertility Network UK recommends that: 'it is absolutely vital that anyone considering travelling abroad should do some thorough research beforehand as the rules and regulations abroad can be totally different from that in the UK.' Her thoughts are echoed by Basil Tarlatzis, president of the International Federation of Fertility Societies who said that 'we need to make sure that standards are maintained, and that the results of these visits are available for evaluation'.

Dr Shenfield hopes that the results of the study will be of 'considerable value to patients, doctors and policymakers'.