Foreign Fertility Patients Boost U.S. Business


AMSTERDAM — A bright light in the floundering U.S. economy may be an influx of foreign fertility patients, several experts suggested.

Last year, up to 5,000 patients seeking fertility treatment—8% of the national U.S. annual volume—came to the U.S. from abroad, with European and Latin American populations comprising the bulk of those patients, according to study findings from a survey of American and Canadian fertility clinics conducted in October 2008 that were presented at the annual meeting of the European Society of Human Reproduction and Embryology.

“There is significant transatlantic traffic of patients to the U.S,” said the study's lead author, Dr. Edward Hughes from McMaster University in Hamilton, Ontario, Canada. These patients are seeking conventional in vitro fertilization (IVF), as well as anonymous egg donation and gestational carriers.

The influx is thanks to a glut of European patients, attracted by the faltering U.S. dollar as well as by less restrictive access to certain treatments, particularly third-party reproduction, according Dr. Brian Kaplan, a reproductive endocrinologist with Fertility Centers of Illinois in the Chicago area.

“There are favorable laws in the U.S. compared with many European countries, which have banned certain treatments. Combine this with the excellent pregnancy rates at our center, and most of the centers in the U.S., and the fact that U.S. fees are more attractive because of the recession, and that's why they're coming,” Dr. Kaplan said in an interview.

Although U.S. fees have traditionally been, and remain considerably higher than those in many European countries, they are offset by better success rates and access, he emphasized.

Indeed, the U.S. has always been an attractive choice for many foreign infertile couples hampered by restrictions they face at home, says Dr. David Adamson, immediate past president of the American Society for Reproductive Medicine.

“Patients with infertility will do almost anything they can to have a family. If a country has a situation where a large number of citizens are deciding to go elsewhere for care, then it's very important for that country to look at the reasons and to decide if their regulations are appropriate or not,” he said in an interview.

A good example is the recent influx of Canadian patients across the U.S. border. According to the survey, the U.S. received 7% of Canada's national volume of in vitro fertilization patients last year. A full 80% of those patients were seeking egg donation, which has become virtually unavailable in their own country since a ban on payment to donors, said Dr. Hughes.

“If a patient in Canada has an altruistic donor she can certainly have care, but in the absence of that, donor egg patients have been traveling to the States in increasing numbers,” he said.

The economy may also be providing additional incentives in this context, as more U.S. women are considering egg donation as a means to supplement their income.

“Clinics are reporting a surge in egg donors as a result of the economic climate,” reported Wendy Kramer from the Donor Sibling Registry. She cited a Wall Street Journal headline from last December, which read “Women Line Up to Donate Eggs—for Money.”

Regardless of the economy, cross-border fertility “tourism” is a growing reality that will continue to flourish as long as countries differ regarding regulation and access, Dr. Adamson said.

“One can expect in the future there will probably be slow harmonization of legislation, guidelines, and oversight, but I don't see that there will be complete unanimity for decades and decades to come—if ever,” he said.

The survey was a joint effort of Assisted Human Reproduction Canada, and the U.S. Society for Assisted Reproductive Technology.

It involved the polling of 392 U.S. and 34 Canadian fertility providers. A total of 125 (32%) U.S. providers responded, and it was estimated that they were responsible for providing about 42% of national fertility services, said Dr. Hughes. The Canadian response rate was 82%, representing 77% of that country's fertility services.

U.S. clinics reported a total of 1,809 patients entering the country for treatment, 1,400 for IVF. “That's about 4% of the national volume, but in absolute terms these numbers need to at least be doubled,” he said, explaining that the responders provided less than half of the fertility services in the country. “There are probably 5,000 incoming patients, about 3,000 of them for IVF,” he concluded.

Regardless of the economy, cross-border fertility 'tourism' is a growing reality that will continue to flourish.


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