The role of professional facilitators in cross-border assisted reproduction

Abstract

The operations of those who facilitate travel across international borders for access to assisted reproduction are little understood. Within the broader field of research into medical travel facilitators, most empirical studies have addressed websites and promotional materials, with few qualitative investigations of individuals who are service providers. The research presented here centres on interviews with 23 professionals facilitating cross-border assisted reproduction. This study sought to understand how facilitators and service providers operate within a professional framework, examining their understanding of the ethical limits on their roles within a largely unregulated and rapidly evolving international ‘marketplace’. Broadly, participants trusted in the market to ‘find its own level’, such that unscrupulous players would not succeed because others would not refer to, or work with, them. In instances where a clear risk to the health of reproductive contributors or to the well-being of future children was perceived, participants understood their own ethical duty to be limited to service denial or withdrawal of participation. Among the eight facilitators who were not legal or medical professionals, there was a striking commonality, in that all had personal experience of assisted reproduction, both as patients and as reproductive contributors. Within this group, and particularly among the six women who directly ‘matchmade’ arrangements between intended parents, egg donors and surrogates, was a strong sense of ‘embodied’ expertise and claims to ethical practice based upon that expertise.

Commercial Surrogacy: An Overview

“…Interestingly, most of the staff of these agencies have also undergone a similar process or is quite familiar with other transnational reproductive treatments by personal experience. 121 They usually provide legal assistance, included in all their plans. Regardless of the countries and their legal context, it is not uncommon for these agencies to advertise that there are no legal risks and there will be no litigation.…”

Reframing egg donation in Europe: new regulatory challenges for a shifting landscape

“…Because agencies and brokers do not directly manage human tissue, they tend to operate outside of the regulatory contexts in which European clinics (and most egg banks) would find themselves meaning there is limited oversight and monitoring (33). Whilst some brokers and agencies work directly for clinics, others offer their services directly to recipients, in some cases charging a fee for mediation or support (33). In a context of growing demand, we may continue to see the emergence of a range of intermediaries carrying out a diverse range of recruitment activity within Europe.…”

Emerging “repronubs” and “repropreneurs”: Transnational surrogacy in Ghana, Kazakhstan, and Laos

“…However, they show how niche locations cater to specific parts of the market and the crucial roles paid by “repropreneurs,” “the mobile reproductive client/consumer/assistant/worker of a global economy in reproductive services” (Kroløkke and Pant, 2012: 233) who are facilitating the development of the local reproductive services industries and building the international linkages necessary for them to develop into regional and international industries. Charlotte Kroløkke and Saumya Pant (2012) coined the term repropreneurs to describe the work of women who work as gestational surrogates; here, we extend it to refer to agents and agencies (see Gan and Frederick, 2011; Gerrits and Hörbst 2016; Millbank, 2018), facilitators or brokers (Speier, 2011) who facilitate international surrogacy arrangements.…”