‘‘Fertility Tourism’’ is the latest form of medical tourism, or ‘cross border’ medical treatments. As women are leaving starting a family until much later in life, and a woman’s chances of getting pregnant naturally drop significantly after they hit 35, the number of women requiring fertility ‘help’ is constantly increasing. But legal issues and year-long waiting lists are forcing many European women to travel abroad for their treatments.
The fertility treatment which currently prompts the most travel within Europe is Egg Donation. Eggs are retrieved from a donor’s ovaries, fertilized in the laboratory with sperm from the woman´s partner or another donor, and then the healthy embryos are injected into the recipient’s uterus. There are a number of reasons why a couple might have to resort to egg donation; they may have had no success with other less complicated treatments such as IVF, the woman´s age may be an issue (women over 35 are less likely to produce healthy eggs), there may be a risk of infectious diseases, or the woman may be suffering from premature menopause or side effects from previous medical treatments or conditions.
The treatment is complex but does offer couples another chance at starting a family. Women wanting to receive a donor egg must be no older than 50 and be healthy enough to go through the procedures involved and a subsequent pregnancy; ‘‘It has been a great breakthrough in fertility treatments, couples who thought they would never be able to start a family are able to get excited again thanks to egg donation’’ says Dr Marqueta from IbiLab.
Ibilab (Instituto Balear de Infertilidad, Clinica Son Moix) is a private clinic in Palma de Mallorca which covers all aspects of women’s health, from standard gynecology to advanced fertility treatments, including egg and sperm donation. In 2010 50% of the egg donation treatments carried out by Ibilab were administered to European women from outside of Spain. In fact German and British women account for a vast amount of their clients. In Germany, Austria and Italy it is illegal to receive donor eggs, so women resorting to this kind of treatment are forced to seek it out abroad. In the United Kingdom the problems are twofold; there is a huge lack of donor eggs, and donors are no longer permitted to remain anonymous. In 2005, changes to the Human Fertilisation and Embryology Act lifted the anonymity previously granted to donors in the UK meaning that a person born from a donor egg is now free to trace their biological parent later in life. Donors are therefore wary of donating their eggs and being contacted 18 years later by a child who may think they have a claim on them and as a result clinics now have long waiting lists for donor eggs, sometimes of over a year.
In Spain women who donate their eggs remain anonymous (although their details are kept for 30 years by the medical authorities) and they also receive compensation for their time and effort. Spain’s proximity to countries such as Germany and Britain where these treatments are more problematic, if they are even an option, has meant that it has become a major European fertility destination. Clinics such as Ibilab, which boast great results, an excellent reputation and multilingual staff have only made it easier for couples to come to Spain for their treatments.
‘’We are backed up by European standards and regulations. Some women consider having treatments outside of the EU where they may even be cheaper, but they forget that the European Union provides them with safety and security which they will not find anywhere else.’’ Said Dr Marqueta.
Last year Ibilab performed between 700 to 1000 fertility treatments, 200 of which were egg donation treatments. Prospective donors must be between 18 to 35 years old and they have to go through a rigorous testing process including blood tests, psychological testing and several medical tests before they can be approved as donors. Compensation is regulated by the European authorities and ranges between 600 and 900 euros. It is illegal to ‘buy’ eggs anywhere in Europe so women are compensated for their time and the inconveniences involved. Considering they have to visit the clinic an average of 10 times and go through a series of invasive treatments, I doubt very much that their main motive is monetary. Doctor Marqueta tells me that most of their donors are friends and family of women who have had fertility problems, in fact, the majority of their donors come back to donate again.
‘‘Spain has the highest medical donation rate in Europe, so it is not surprising that women here also give their eggs so altruistically.’’ So they just give their eggs in the spirit of helping other women?
‘‘A lot of them do, yes, but I think most women have several combined reasons for donating; they want to help, but they are also interested in the thorough medical examinations they have to go through in order to donate. We run a lot of tests on donors which provide a very detailed analysis of the woman´s health and fertility, and they go away with information that would be very difficult for them to get otherwise, and of course I do think the monetary compensation attracts some women too.’’ The clinic runs ‘informative’ publicity campaigns on the radio and media to attract new donors but finds that most of the women who decide to donate come on a personal recommendation from other donors or women who have used the clinic.
Donor eggs are matched to the receiver according to race, blood group, skin and eye colour, size and weight, but the results are always unpredictable. The clinic also offers an ‘egg freezing’ process whereby young women can choose to freeze their eggs for later use. ‘‘More and more women are leaving starting a family very late – if they freeze their eggs before they are 35, they have a higher chance of having healthy eggs when they do decide to get pregnant.’’ I asked the doctors when a couple trying to start a family should consider visiting a fertility clinic; ‘‘if you have been trying to get pregnant for a year, and been unsuccessful, you should have a first consultation. And if the woman is over 35 you should visit a doctor after 6 months of trying to have a baby. Unfortunately there is a lot of stigma attached to fertility treatments, and a lot of people leave it very late; initial tests are very simple and informative and are nothing to be afraid of.’’
Instituto Balear de Infertilidad
Clínica Son Moix
Interview with Dr Javier Marqueta – Medical Director and Dr Eugenio Sobrino – Director