ESHRE Task Force on Ethics and Law 15: Cross-border reproductive care

Abstract

This paper analyses the ethical aspects of cross-border reproductive care. Ethical questions are raised by some of the main reasons of cross-border travelling, i.e. law evasion and unequal access to treatment. The phenomenon also generates possible conflicts linked to the responsibility of the professionals. Three points are discussed: the moral obligation of the physician to refer the patient, his/her duty to provide information and counselling and the acceptability of fee-splitting. The recommendations focus on measures to reduce or limit the number of patients that have to travel abroad and on steps to guarantee the safety and quality of the treatment wherever it is provided.

Impact of egg donation deliveries from domestic and overseas sources on maternal care: a questionnaire survey of Japanese perinatal physicians

“…Consequently, increasing numbers of Japanese women have traveled overseas. This phenomenon has been referred to as ''reproductive tourism'' [7] and ''cross-border reproductive care'' [8,9]. Japanese patients unable to access to donor eggs have usually traveled to the United States, but increasing numbers of Japanese women also travel to Asian countries, such as India, Thailand, Malaysia, and South Korea.…”

Cross Border Reproductive Care (CBRC): A Global Perspective

“…That is why some international organizations have been recently concerned to set general guidelines for the global CBRC/fertility tourism industry. Examples of such international organizations are the European Society of Human Reproduction and Embryology (ESHRE), the American Society for Reproductive Medicine (ASRM), and the International Committee Monitoring Assisted Reproductive Technologies (ICMART) [14][15][16].…”

“…Practically, a host country could be considered ready for CBRC/fertility tourism and its all implications if it has high quality medical and reproductive care, less-restrictive legislations, affordable prices, and liberal social, ethical and religious views. The major global markets or hubs for CBRC/ fertility tourism industry are: Belgium for IVF, Denmark for sperm donation, Spain and Czech Republic for egg and embryo donation, India, Russia and USA for commercial surrogacy, USA for PGD and sex selection, Denmark, Belgium, and USA for fertility preservation and freezing of sperms, eggs, embryos, ovarian and testicular tissues [13][14][15][16].…”

“…In India, there are less-adequate medical and reproductive care, less-specific legislations, affordable prices, and quite liberal social, ethical and religious views. In the Middle East, there are less-adequate medical and reproductive care, non-specific legislations, affordable prices, and very strict and conservative social, ethical and religious views [13][14][15][16].…”

Gestational Surrogacy and the Feminist Perspective

“…45 Calls are also growing from professional organizations in industrialized countries, such as the European Society of Human Reproduction and Embryology, for a reduction in cross-border reproductive care referrals and more aggressive measures to ensure safety and quality when patients do seek treatment abroad. 46 And in what may be an effort to position itself as consumer friendly and to control the tenor and content of proposed regulations, the fertility tourism industry itself has launched online forums with the stated goal…”