European patients travelling for fertility treatment
A substantial number of European patients travel to other countries for fertility treatment, both because they think that they will receive better quality care abroad and in order to undergo procedures that are banned in their home country, says a study of the European Society of Human Reproduction and Embryology.
Study co-ordinator Dr. Françoise Shenfield, from University College Hospital, London, UK, said that this was the first hard evidence of considerable fertility patient migration within Europe. "Until now we have only had anecdotal evidence of this phenomenon", she said. "We think that our results will be of considerable value to patients, doctors, and policymakers."
During a one-month period, the ESHRE Task Force analysed data from participating clinics in six European countries: Belgium, the Czech Republic, Denmark, Slovenia, Spain and Switzerland. Clinics were asked to provide questionnaires to patients coming from abroad for treatment. Although the sample size was relatively small, the results implied that there were at least 20,000 to 25,000 cross-border treatment cycles per year in these countries.
"It is, however, difficult to derive a number of patients from these numbers as patients receive more than one cycle to obtain a pregnancy, the mean number depending on the type of treatment."
Almost two-thirds of the patients surveyed came from four countries, with the largest number coming from Italy (31.8%), followed by Germany (14.4%), the Netherlands (12.1%) and France (8.7%). In total, people from 49 countries crossed borders for fertility treatment.
"It has also enabled us to have concrete proof of the large numbers of Italians who cross borders to obtain treatments which were made illegal under the 2004 legislation, or because by doing so they will receive what they perceive to be better quality treatment. This may mean, for instance, the possibility of embryo freezing," Shenfield said.
The main reason for going abroad for fertility treatment was to avoid legal restrictions at home, with 80.6% of the German patients surveyed citing this as their primary reason compared with 71.6% of Norwegians, 70.6% of Italians and 64.5% of French. Difficulties in accessing treatment were cited more often by patients from the UK (34%) than those from other countries.
"This was a pilot study carried out in a small number of countries, and hence has limitations", said Dr. Shenfield. "However, it confirms information already gathered by patient support groups and reported in the media. For example, Spain and the Czech Republic are popular destinations for ovocyte donation; Swedes travel to Denmark for insemination, and French to Belgium.
In another study, Professor Guido Pennings from the University of Ghent, Ghent, Belgium, looked in more detail at the situation in his own country. 16 out of the 18 Belgian reproductive medicine centres which were licensed to handle oocytes and create embryos were surveyed on the nationality of foreign patients coming for treatment between 2000 and 2007, as well as on the type of treatment for which they came.
The researchers found that, since 2006, the flow of foreign patients into Belgium had stabilised at around 2100 patients per year, although that number may be an underestimate, because 2 qualifying centres had not replied and other centres which provided less technically demanding treatments, such as hormonal stimulation or artificial insemination, had not been included. "Although collection of data on the numbers of patients moving from one country to another is a first and important step, future research should include the experiences of patients, the difficulties they experience, the impact of such movements on the national health care systems, and the effects of, for instance, portability of insurance on the numbers", he said. "We will only be able to evaluate the phenomenon properly when we can see the full picture."
Source: European Society for Human Reproduction and Embryology (news : web)