The pilot project, unveiled at a European Society of Human Reproduction and Embryology conference, suggests that Italians are particularly likely to visit fertility treatment clinics abroad, a phenomenon ascribed to national legal restrictions on treatments and the perception that better care is available abroad.
The news comes in the wake of the adoption by the European Parliament of the Cross-border Healthcare Directive (EurActiv 1/4/09). The Parliament agreed in March to back a new law which will allow patients to be treated in any European country and be reimbursed up to the full cost of the procedure in their home country. Critics of the proposal have warned that data on health tourism in Europe is currently limited.
Françoise Shenfield, from University College Hospital, London in the UK, said that this was the first hard evidence of considerable fertility patient migration within Europe. "Until now we have only had anecdotal evidence of this phenomenon," she said. "We think that our results will be of considerable value to patients, doctors and policymakers."
Shenfield and colleagues surveyed patients at clinics in Belgium, the Czech Republic, Denmark, Slovenia, Spain and Switzerland over a one-month period. She said the sample size was relatively small but the results implied that there were at least 20,000 to 25,000 cross-border treatment cycles per year in these countries.
"It is, however, difficult to derive a number of patients from these numbers as patients receive more than one cycle to obtain a pregnancy, the mean number depending on the type of treatment."
Almost two-thirds of the patients surveyed came from four countries, with the largest number coming from Italy (31.8%), followed by Germany (14.4%), the Netherlands (12.1%) and France (8.7%). In total, people from 49 countries crossed borders for fertility treatment.
"It has also enabled us to have concrete proof of the large numbers of Italians who cross borders to obtain treatments which were made illegal under the 2004 legislation, or because by doing so they will receive what they perceive to be better quality treatment. This may mean, for instance, the possibility of embryo freezing," Shenfield said.
The main reason for going abroad for fertility treatment was to avoid legal restrictions at home, with 80.6% of the German patients surveyed citing this as their primary reason compared with 71.6% of Norwegians, 70.6% of Italians and 64.5% of French. Difficulties in accessing treatment were cited more often by patients from the UK (34%) than those from other countries.
