Some interrelated factors motivate patients to travel cross border to obtain their fertility care. The four basic factors are accessibility, cost, regulation, and privacy. Each of these factors is discussed below:
Accessibility of higher quality of care
The patients who prefer to travel cross border for their fertility treatment because they may not satisfied with the available domicile ART services, the quality of care offered by domestic ART service, the available treatment option, and the waiting period to obtain the service.
Survey data reported that patients from Southeast and Middle East Asia and Latin America where ART clinics are not very equipped to have preferred to travel cross-border to obtain the essential treatment. Another reason for cross border traveling is an inadequate supply of donor gametes and gestational services in the departure countries, which unable to meet the requirement. Some countries also have stringent policies on anonymity, compensatory and regulatory means.
The payment restriction to the gamete donors and gestational surrogates in countries reduce the accessibility of the ART service, which influences cross border traveling to the countries where payment method allowed. Countries, where disclosure of donor identity is mandatory also trigger cross border traveling. Countries like the United Kingdom, Sweden, and Norway, anonymous gamete donation is a factor that influences the decision making of the patients for seeking care abroad. Almost 80% of women prefer to travel to Canada to search for anonymous donor eggs for ART.
The expectation of high-quality treatment also promotes cross border reproductive care, as the patient believes clinics abroad have more efficient professionals, modern technology, and more equipped tools and specialized services that provide the least scope for treatment failure. Infertile couples have also experienced less waiting time to cross border reproductive care than national health care support.
Fertility treatment, especially the involvement of ART is an expensive venture. Very few people can effort this. But the global price variation of different treatments including an IVF cycle differs from country to country. The price rate is lowest in India, whereas the most expensive rate is in the USA. Even the price rate of gamete donors and the gestational carrier also differ from country to country. The survey report stated that the huge cost variation in third party reproductive services is significantly impacting decision making to leave the domestic country of infertile couples.
Avoid National stringent ART Law
There is no universal ART regulation followed in the whole world. Different countries have their own rules and regulation of ART. the stringent ART regulation of departure countries influences people to seek to cross borderreproductive care. It has found that the cross-border destination for ART has very liberal or no restricted regulation. The act of seeking fertility care outside of one’s country of residence to avoid the application of prevailing law is sometimes referred to as “circumvention tourism”.
The restriction of ART regulations which motivates cross border fertility treatment has two broad categorizations. One is based on who gets permission to pursue fertility care, another is what fertility care can be accessed. marital status, age of the patient, and sexual orientation are the certain legal barriers that address ‘who’ can avail national fertility care. Usually, departure countries do not allow single parenting, older women and homosexual couples to pursue ART. These categories of people try to obtain the facility by availing cross-border fertility treatment.
A wide range of ‘what’ services can be legally offered in the destination countries also promote cross-border fertility treatment. Jurisdiction agreement on compensated gamete donation, commercial surrogacy, pre-implantation genetic diagnosis (PGD), s#x selection, and embryo cryopreservation prompt international fertility travel. Legal prohibition of these services, or inadequate medical service or social limitation influence people to exist home destination and contribute to continuing circumvention tourism.
To maintain privacy and comfort
Psychological and emotional stress levels along with the physical and financial burden of infertile patients usually minimized by the right selection of destination country for cross-border reproductive care. Patients usually try to maintain their privacy along with a good support system during their treatment period. The easy access to international traveling, cultural comfort and ethnic and racial matched gamete donor or gestational carrier also play important roles in cross-border fertility treatment.