Reproductive Tourism: Traveling Abroad for IVF

Author: Jody Cross

When Louise Joy Brown came into the world on July 25, 1978, in Oldham, England, she didn't know it, but the techniques used in her birth would enable millions of childless couples across the globe to have the babies they longed for; her birth forever changed people's lives. Louise was the world's first test tube baby. Today, 30 years after her birth, assisted reproductive technology has helped in the birth of over 3.5 million babies worldwide.

The type of assisted reproductive technology used in baby Brown's birth is called in vitro fertilization (IVF). Here eggs from a woman's ovaries are surgically removed and fertilized with sperm in a lab. When the eggs have grown into embryos doctors choose one or two, and implant them back into the woman's uterus. This procedure has enabled women with blocked fallopian tubes to be able to bear children; an impossibility for them before IVF technology. This is only one of many situations where IVF technology has enabled childless couples to have babies.

It is estimated that 1 in every 100 babies born now are IVF births. Europe leads the way in the number of assistive reproductive procedures, with the United States a close second. In the U.S. alone, the American Society for Reproductive Medicine reports 424,401 babies were born with the help of IVF between 1985 and 2006; and 50,515 babies were born using this technology in 2006, the last year for which the organization has complete records.

The high cost of health care in the United States and in some parts of Europe, coupled with the rising number of fertility specialists practicing outside the United States, and increasing numbers of doctors and nurses in distant places who now speak English, plus state-of-the-art medical facilities in countries like India, Mexico, and El Salvador have all contributed to the growth of what is called reproductive tourism. Reproductive tourism, the practice of traveling to a different locale, even a different country, to undergo in-vitro fertilization, or other assisted reproductive technology treatments, is a rapidly growing industry.

Couples from the United States are traveling to Colombia, South Africa, Argentina, the Ukraine, Mexico, Greece, Spain, Belgium, France, Israel, Italy, Germany, Malaysia, Singapore, Mexico, and India, where in vitro fertilization treatments, and other assistive reproductive treatments cost much less than they do at home. At the same time, higher costs in some Western European countries are driving Western European couples to seek reproductive assistance in Eastern European countries.

In vitro fertilization treatments that would cost perhaps $70,000 in the States can be had in Cape Town, South Africa, for around $14,500; or for around $7,000 in India; far less than they would cost in the United States. Reproductive tourism has made IVF and other assistive reproductive procedures affordable for many couples who would have no chance of receiving the treatments in their own countries.

India has also developed a thriving surrogate business. Commercial surrogacy, banned in some States and also in some European countries, was legalized in India in 2002. The system in India has gone a long way to avoid the legal red tape, and the ill-defined surrogacy laws women face in the United States, and has already grown into a $445-million-a-year business.

Indian women, acting as surrogates, agree to carry a couple's baby until birth. In this way, a woman not physically able to carry her own child through pregnancy can have a baby using her own eggs and her mate's sperm. The cost runs about $25,000, and includes all medical expenses and the surrogate's fee. This is about a third of what the same service would cost in the United States. The Indian surrogates are paid between $5,000 and $7,500. In a country where the average wage is a dollar a day, and the per capita income is around $500, this money can go a long way toward helping the women and their families; it is money they can use to buy a business, or to give their children a better education, or to pay for their own children's medical care, or even their daughters'dowries, an illegal, but still widely practiced custom in India.

There is still much room for improvement in the reproductive tourism business as found in many countries. Best practices are a long way from being uniform across international boundaries, and the mortality rate in some countries runs much higher than in the United States. Multiple births and low birth weight babies seem to be prevalent problems. Couples seeking help through reproductive tourism are cautioned to do their own due diligence before choosing a physician, a facility, or even a country; but doing the research has proven rewarding for millions of couples who now have a baby of their own; a baby they never thought they'd ever be able to afford.