Reproductive Tourism: The Globalization of Artificial Reproductive Technology

By: Heather Ivery

What do you do when you want to have a baby, but it is too expensive or what you want isn’t available where you live? Take it overseas! Reproductive tourism is a phenomenon that has sprung up and expanded over the last two decades. This trend involves citizens of mainly affluent countries traveling to other countries for the use of their artificial reproductive technology industries.

Why travel for it? Cost and availability. Where are elective medical procedures most expensive? The U.S. and Europe. It should come to no surprise then that U.S. and European citizens are choosing to travel outside of their countries for the procedures that will get them the same outcome for much cheaper, or using the laws in other countries to skirt their own.

Some people are using reproductive tourism to bypass laws and restrictions in their native countries. Up to a quarter of multi-fetal pregnancies from artificial reproduction in England originate from outside of the U.K.^[1] People from the U.K. (as well as many other countries) are limited to only implanting up to two embryos, while countries like the US have no legal limit. The more embryos that are implanted, the better the chance that one will attach to the uterine wall. It comes to no surprise that people wish to implant ore embryos per cycle, even at the risk that they will all attach, and a multi-fetal pregnancy will occur.

In Canada and the U.K., egg donors are true donors – they cannot be monetarily compensated.^[2] These types of donors are pretty rare, as the process is not painless and does have potential complications. In the U.S., egg donors can be paid an average of $5,000 per donation cycle and can go beyond $35,000 for well qualified donors.^[3] This causes people from Canada and the U.K. to travel to the U.S. or Spain where there is a much larger supply of eggs.^[4]

In Italy, people are only allowed to use fresh specimens in in vitro fertilization, rather than the much more common frozen means most countries allow.^[5] This lowers the amount of eggs available, as donors are given hormones so they are able to donate multiple eggs at once, which can be frozen and divided among recipients. This also makes implantation more difficult, as the egg donor and the recipient of the egg need to both be in a similar stage of their menstrual cycle for implantation to be successful, which is easily done when an egg can be frozen then later thawed when the recipient is in the optimal stage of their cycle for implantation.

The U.S. is in an interesting place in this whole matter, as people both travel to and from the U.S. depending on what procedure they are after. While the U.S. has lax rules for much of the invitro fertilization procedures and egg and sperm markets, the cost of artificial reproductive technologies is steep. In the U.S., invitro fertilization on average costs $12,000 for a single cycle, while it only costs $2,000 per cycle on average in Russia.^[6] This cost can quickly add up, as many recipients require multiple cycles for an egg to attach.

The biggest cost saver through reproductive tourism comes from surrogacy. People from affluent countries bring their reproductive material to poorer countries to be implanted, then in essence incubated for nine months. Women in the U.S. are compensated over $20,000 for a successful surrogacy, while women in India are compensated between $7,500 and $9,000.^[7] An entire surrogacy in India using an agency can cost $28,000, while a surrogacy can cost over $100,000 to complete in the U.S.^[8] It comes to no surprise that American couples are choosing to take their business to India.

Reproductive tourism will continue to grow as the world becomes more interconnected, and will not likely stop until the money saved from traveling is reduced, or when laws are changed to be a bit more uniform across countries. This is an upside to globalization that many people seeking genetic babies are utilizing to their financial benefit.

^[1] Judith Daar, reproductive technologies and the law 175 (Carolina Academic Press et. al eds., 2d ed. 2013).

^[2] Id.

^[3] David Tuller, Payment Offers to Egg Donors Prompt Scrutiny, n.y. times (May 11, 2010), http://www.nytimes.com/2010/05/11/health/11eggs.html?_r=0.

^[4] Id.

^[5] Judith Daar, supra note 1, at 176.

^[6] Id.

^[7] Douglas Pet, Make Me a Baby as Fast as you Can, Slate, (Jan. 9, 2012), http://www.slate.com/articles/double_x/doublex/2012/01/reproductive_tourism_how_surrogacy_provider_planethospital_speeds_up_pregnancies_and_lowers_costs_.html.

^[8] Id.