General overview

Infertility treatment scenario varies from one country to another. It may differ in terms of quality treatment and general attitude of the social and cultural bodies towards these clinical solutions. The government support also plays a major role in improving the quality of infertility treatment in a country and more importantly making it accessible to all irrespective of ethnic or cultural background. It is observed that:
– Sometimes the high treatment cost might make a huge difference between countries attracting various customer segments making rich couples flock together hoping for a solution no matter how high the treatment cost is.
– It may be prohibitive to those belonging to the lower economic bracket. High priced infertility treatment is a luxury for them.
– Although IVF was first started in the United Kingdom, the cost of this kind of treatment over here is too high forcing many childless Brits seeking this service elsewhere at a far lower price.
– In some countries, the legislative requirements and regulatory issues are so rigid that infertility treatment in those countries would heap loads of hardships on the intending parents. These factors might force them to hunt for legal experts’ opinion to handle the situation at an extra cost.

Countries where fertility tourism is at its best
If we talk about fertility tourism, we need to consider a plethora of services that are intimately connected with infertility treatment. These services are not to be ignored and how well they are organized and available to the customers would determine the success of infertility treatment in a particular country. Let us take some concrete examples:
– In Spain, Britain, Canada and Belgium embryo freezing and preservation don’t have any legal reservations. Neither these countries slap a ban on sperm, egg donation and embryo screening. These facilities are enough for a customer to select these countries as their next infertility treatment destination.
– Surprisingly, some countries which are not considered in mainstream medical tourism do appreciably well in infertility treatment. Normally, these countries offer lowest treatment price keeping the quality satisfactory. Some these countries are Ukraine, Lithuania, Hungary, Turkey, Spain, Greece and Czech Republic.
– However, choosing the right country for infertility treatment extends beyond mere price consideration so far as the treatment is concerned. Travel expenses and accommodation prices also become decisive factors.
– It is a matter of great interest that the size of the country doesn’t always decide the quality of infertility treatment available to intending parents. Even a small country like Barbados provides top grade IVF care to customers flocking in from other countries. It is the attitude which is important. The government and society in Barbados are supportive towards infertility treatment.

Countries that are going to disappoint you in fertility tourism
If you are looking for an egg donation service in Germany and Italy, you may be discontented with the restrictive policies prevailing in those countries because of the following reasons:
– Germany and Italy are too prohibitive about the number of eggs that can be fertilized in one cycle.
– These countries even impose a limitation on the number of embryos that can be used for implantation or cryopreservation.
– Egg donation service is illegal in Austria, and if you are seeking the same with the guidance of an Austrian clinic you might probably be setting your foot in an infertility tourism trap.
– If you are seeking gender selection (a part of ART), then UK would certainly disappoint you. This is because Pre-implantation genetic diagnosis (PGD), which is an extended procedure of IVF used for screening the embryos for sexual preference, is banned here. However, if you use the same technique over here for locating genetic diseases your endeavor is welcome.

The social, legal and cultural attitude makes all the difference
How the society and the local culture are going to accept infertility treatment philosophy is what really matters. Depending upon the social demand for otherwise the government is going to frame legal views which would either support infertility treatment or go against it. Where the attitude of the government is positive, the infertility tourism to that country would flourish. Where the attitude is negative it will perish.


Fertility tourism covers a range of services, which are highly sophisticated demanding a very high level of medical precision. The objective is to have a successful pregnancy through a surrogate mother leading to the birth of a healthy baby. All these services are custom designed and case sensitive. An infertility service required by a particular couple may not be required by another pair. It all depends upon the type of infertility issue suffered by the couple. The couples may be incapable of producing healthy eggs and/or sperms in which case they would require the service of a high potential egg and/or sperm donor. A couple may be capable of producing healthy eggs and/or sperms but the female partner in incapable of conceiving.  At times, the process of fertilization could only be achieved in a highly controlled laboratory environment if the mother’s womb fails to provide the right ambiance.

The core infertility treatment services in fertility tourism include Assisted Reproductive Services (ART), which again encompasses In-vitro fertilization technology (IVF) and ICSI. Again, we have the highly advanced PGD (Pre-implantation genetic diagnosis service) to locate genetic disorders and the donor services which include the egg and sperm donor hiring. Last but not the least and, in fact, the final stage of infertility treatment process is the service available from the surrogate mother who would carry the pregnancy leading to the birth of a healthy baby. Apart from the medical services, the non medical wing has a very significant role to play. The legal and administrative professionals on the staff roll of an infertility treatment clinic handle all the legal and social issues connected with an infertility solution and surrogacy birth.

We may explore the nature of each of the infertility treatment services in sequential order:

  1. A) Assisted reproductive technology (ART):
    This is an umbrella term used for a number of infertility treatment services offered to the intending parents which include IVF (In-vitro fertilization technology), ICSI (Intra-cytoplasmic sperm injection), fertility medication, artificial insemination, surrogacy and cryopreservation. ART also includes the application of PGD (Pre implantation genetic diagnosis) for locating and eliminating genetic disorders and communicable diseases that the embryo may inherit from the fusion of male and female gametes carrying these irregularities. Basically, in ART the process of natural sexual intercourse is substituted by artificial insemination or fertilization of eggs by sperms outside the female’s body in a laboratory environment.

 

  1. B) In-vitro fertilization technology (IVF):
    This highly specialized medical procedure involves fertilization of eggs by sperms in a laboratory. The fertilized eggs are now cultivated in an ambient medium for further growth for 2 to 6 days and then implanted in the surrogate mother’s uterus for pregnancy. IVF is not available in many countries by local regulations. This necessitates intending parents moving out of their own country seeking this service elsewhere giving rise to fertility tourism.
  2. C) Egg and sperm donors:
    When the female partner fails to produce enough healthy ova capable of getting fertilized, the service of an egg donor is needed. Similarly, if the male partner fails to produce enough sperms of the required potential to fertilize eggs, the service of a sperm donor is called for. Infertility treatment clinics have a direct access to these donors from an extensive and comprehensive database they maintain. In order to qualify for entry into the database, the egg and sperm donors are screened through a series of demanding medical, physical and psychological tests. Records of their family and medical history, habits, level of education, addictions if any are preserved for reference.
  3. D) Intra-cytoplasmic sperm injection:
    This is a service where a single sperm is injected into an egg to overcome male infertility issue when the sperms are not capable enough to penetrate the eggs by them. The process involves a glass needle that pierces the oocyte, and the sperm with its tail snapped and immobilized is released into the oocyte for fertilization.

 

  1. E) PGD (Pre-implantation genetic diagnosis):
    This service helps locating genetic disorders or diseases in embryos created through IVF and done before the embryos are implanted in the surrogate mother’s uterus. The idea is to prevent these disorders to pass into the baby.

 

F) Surrogacy:
The service of a surrogate mother is sought when the biological mother is incapable of pregnancy. Surrogate mother substitutes for the biological mother who carries the baby in her womb and gives birth to the child. Infertility clinics have a rapport with young and healthy surrogate mothers through their database and help the intending parents to avail this service.


Fertility tourism can rob you of your bank balance if not planned properly. The cost of fertility treatments and medications are important factors of concern. They are often so unimaginably high that leaves many couples plagued with infertility worrisome. Even the insurance coverage plans for fertility treatment are very confusing. What is promised by the policy agents look much like a marketing hype. What the insurer actually gets and what was originally promised in the plan turn out way different. There are a lot of expenses associated with fertility tourism. It is prudent to realize all the interconnected costs and give a proper deliberation on them so that you can budget your fertility treatment trip on appropriate lines.

The average cost for In-vitro fertilization technology (IVF) in the US would be around 14000 USD. This is, however, a specialized fertility treatment requiring service of experts and laboratory costs. Common infertility treatments such as ovarian stimulation and intrauterine insemination are less expensive comparatively. Consequently, the results are not as great in these treatments as in IVF. Owing to a cut throat competition among clinics for providing infertility treatment services in a limited area, the costs naturally vary from one clinic to other.

Let us have a look at the nature of fertility treatment services and the average cost associated with them:
– The first visit to a fertility specialist – 200USD to 400 USD.
-Pelvic ultrasound – 150 USD to 500 USD.
-Fertility related blood test – 200USD to 400USD.
-Semen analysis – 50 USD to 300 USD.
-HSG dye test – 800 USD to 3000 USD.
-IUI – 300 USD to 1000 USD.
– Monitored injectable FSH cycle – 1500 USD to 6000 USD.
-IVF + ICSI – Over 14000 USD

Third party service Cost

Expenses related to hiring third part for surrogacy or egg and sperm donation should be calculated accurately going through the contract details thoroughly to avoid future dispute while settling the payment with the party.

You need to frame a comprehensive budget for your fertility tourism depending upon a realistic database collected from reliable sources. The advantages of budgeting can be put in a nutshell as hereunder:

A feasible budget will help reduce the pressure of having to pay unnecessary costs associated with unwise planning leading to cancellation of programs that don’t ultimately match up to your schedule.

Most of the fertility tourists are unaware of the hidden costs that add quite a substantial amount to the total expenses for the trip. They focus only on treatment, accommodation and travel expenses. There are lots of medical/non-medical costs that contribute largely to lighten the wallet. The expenses associated with hiring the services of a facilitator, for example, is quite substantial. They make up a big chunk of the total outlay that you have to incur. Some hidden costs can be as follows:

-Does the treatment include medication costs? Or you need to pay separately?

-In many clinics, you need to pay separately in case you need the support of a special medical equipment like pulse oximeter.

– Fertility treatment involves lots of medical tests. Often, one time test may not reveal the true picture. Does the package include one-time medical tests or 2/3 tests are included in it as per the situational demand?

-Do you need to pay extra for post treatment checkups?

-In case of extended stay in the clinic, do you need to pay extra?

-If you opt for embryo/egg/sperm freezing, know the detailed costs involved.

-Airfare while traveling abroad can be budgeted. What about other transportation costs to be incurred while visiting the clinic?

-Unexpected legal issues may crop up and you may need to pay extra apart from the scheduled legal and administrative fees.

– Unexpected extension of the duration of your trip abroad would mount your accommodation charges as well.

-Miscellaneous costs related to shopping or short term site seeing can be quite substantial.

The exchange rate is crucial. The possible fluctuations in the currency rates during your stay will certainly have a bearing on your real expenses. You need to factor in this element to draw up a realistic budget.

Take a look at your overall budget from a collective perspective and breakdown each element into smaller bits for giving a close focus on each of these cost elements. Smaller the cost elements, easier would be for you to manage them. One area where you can save your cost is by cutting the requirement for a prolonged stay.

Maintain a clear cut communication and fix up your appointment with the fertility treatment specialist in such a manner that not a single day is wasted. Ensure to meet your specialist as per prescheduled appointment. There shouldn’t be any cancellation due to any miscommunication from your side. A cancellation would mean you are unnecessarily stranded in the hotel shooting the accommodation and food bills.


The plight of a childless couple is often painful, frustrating and socially alienating shattering the self confidence. Fertility tourism, however, brings in a light of optimism and at the end of this trying journey, the fruit of perseverance may wait in the form of a successful pregnancy and delivery of a healthy baby. The picture is however not as rosy as it is portrayed. After a wearing struggle, you may land up in a failed infertility treatment. The road is bumpy and the ordeal too much to bear with before you can have a concrete outcome of these treatments.

Let us take a glimpse of what various intending parents say about their infertility treatment experiences they have faced which can just happen to you as well:

Case 1:
The O’Hara couple belonged to Dublin, Ireland. Frederick O’Hara was 36 years and Nancy his wife was 30 years. They got married seven years ago and were still childless. They had been through IVF s and a host of infertility treatments that bore no result. All on a sudden, a clinic in Mumbai seemed to bloom hope in their lives. The couple once again gathered patience and headed for the new journey. Now we hear the rest of the story from Nancy’s mouth:
“Everything went well and I was admitted to this infertility clinic in Mumbai. The docs and nurses all looked friendly and confident.  Besides I had Fred by my side with a tight and warm reassuring grip on my shoulder that this time it would certainly work.” Whatever be the outcome I just wanted to let the world know how grateful I felt towards the entire arrangement of the clinic. It was spotlessly clean and the cozy atmosphere made me feel I have won half the battle. I was supposed get my baby through IVF where I needed both the egg donor and the surrogate mother. We found two young merry women in their early twenties. The egg donor Martha’s cycle was synchronized with the cycle of Parul, the surrogate mother with due medications. Lots of medical gadgets and monitoring devices were all around us. It was essentially an environment where the electronic devices ruled. The human element and their functional role seemed secondary. The eggs were retrieved carefully. The eggs and the sperms were left to fuse together for achieving fertilization through IVF. But the fertilization never materialized. It was a darn failure that brought fresh pains to my already injured mind. The hope that bloomed had extinguished in a flicker. The eggs retrieved did not meet the quality required for a successful fertilization”

 

Case 2:

Our next couple savoring bitter taste of infertility treatment mishap is Conrad and Esmeralda Suarez from Cancun, Mexico. Let’s hear what Esmeralda has to say about their frustrating experience in a clinic right in Cancun. We have been married since ten years and the grace of god is yet to shower on us in the shape of a child which we desired so much. Both of us were diagnosed fit so long as our oocyte and sperm quality was concerned. The problem was with my inability to conceive due to medical reasons. There was a block in the womb that prevented a pregnancy from materializing. A middle-aged and healthy surrogate mother named Paola was called in. IVF fertilization was carried out collecting sperms from Conrad and eggs were retrieved from me. But the implantation never successfully completed inside Paola. She suffered from embryo implantation dysfunction which went practically undiagnosed. Her endometrial lining was abnormally thin putting off a possibility to conceive. It’s been a share of bad luck for us and negligence on the part of the clinic.” Esmeralda broke into a muffled sob.

 

Case 3:

Frank and Martha were from Dublin and were childless. Their eight years of marriage life started to turn stale when all of a sudden rays of hope started to usher in their barren life. It all started in a fertility clinic in Delhi, India where the couples started seeking help of infertility specialists. Let us now hear the rest of the blissful saga from Martha’s mouth.
“We almost broke down. Though Frank was still positive about life the world started crumbling down around me. It’s not so much a social alienation or a community stigma that bothered me. It was the painful void that I could not withstand. The information about this Delhi fertility treatment clinic came just like a voice from heaven. The attitude of the entire team was too good to be true. They were all very caring and dedicated. Their expertise must be top grade however being a layman I should not comment on this. But they kept me very happy and comfortable. It was just a second home. In fact it was more than a home. A healthy baby was born to us and we named her after the name of the clinic that changed our lives altogether in a big positive way”.


There are a number of fertility clinics scattered across the globe that help customers from different parts of the world to conceive and have a baby through egg donation schemes.
In fact, there are hundreds of customers living next door who have travelled abroad to avail egg donation services and have successfully become pregnant. All their efforts and patience have ultimately borne fruit of their perseverance and today they are happy parents. There are countless egg donors who belong to different race and religion eager to bring smile on the faces of intending parents. These egg donors are willing to fly abroad to donate their eggs as per the demand of the intending parents or the concerned clinic strictly abiding by the law of the land.

Coordination between the clinics and donors

International egg donors have been connected with global fertility clinics in a close network. The coordinators of these clinics are well aware of their day to day moves and have their biological and genetic details at the back of their hands. These clinics have a vast and comprehensive database of international egg donors maintaining a close contact with them.

Egg donation through egg banks

Many reputed global egg banks have a huge inventory of frozen eggs collected from selected donors. Availing donor eggs through these banks are less expensive. Egg banks are mostly tied up with reputed fertility clinics for supplying frozen eggs even through overseas shipment if required. Of course, the entire proceeding is done amidst the existing legal framework. A customer should seek full clarification and authenticity of the donor and her background while availing frozen eggs from these banks.

Legal implications

However, egg donation at the international level is keenly sensitive to legal standings. Clients come from different countries and each of these countries has different sets of laws having different implications for egg donation programs. Moreover, the laws governing international egg donation programs are highly fluctuating in nature. What is supportive towards egg donation today might go against it tomorrow as the legal framework keeps on changing.

Ethics involved in egg donation

International egg donation is governed by certain medical ethics that ensures security of the recipients as well as it benefits the donors. Most of the clinics that supervise the procedure of egg donation need to be registered. Prior to registration, they need to qualify with respect to the standard of medical facilities available like the experience, qualification and international exposure of their key fertility specialists and rest of the human capital working under them.
The clinics supervising international egg donation need to employ legal and administrative experts who would successfully deal with legal and social issues connected with egg donation.

Selection of the egg donor

A donor should qualify into the donor pool only after a thorough medical screening, which is rigorous and encompasses psychological, physical and genetic evaluation. The candidates should be young within the age group of 20 years to 30 years when the fertility potential is at the peak. Appraisal of the egg donor is not only limited to evaluation of medical history but to the genetic makeup as well. A number of clinical tests are conducted to ensure whether she is carrying any disease like HIV which could harm the baby or the mother.

According to international egg donation guidelines set up by globally recognized authoritative bodies on embryological science, the egg donor is often personally interviewed by the clinic specialists. It is conducted to ensure that the donor doesn’t smoke or drink too much. General habits, interests and the IQ level of the donor are disclosed by these series of interviews which reveal a lot about the eligibility of being an egg donor.

Signing agreement between the donor and the recipient

The agreement between the donor, the intending parents and the third party that is the clinic, is an important piece of document on which the entire program rests in international egg donation schemes. A legal expert will be present who will interpret the finer points before all the parties sign it.

Egg donation procedure

The procedural steps of international egg donation would involve injecting medicines into the donor to enhance egg production by triggering the follicle stimulating in synchronization with the menstrual cycle with that of the recipient.  The eggs retrieved can be implanted in the recipient immediately through a clinical procedure or may be cryopreserved for later use as dictated by the need of the situation.


Fertility tourism has a chequered history. This is an ancient medical breakthrough when the concept of test tube baby had taken the world of medical science like a storm. Oppositions have come from several quarters including the church that criminalized the ground breaking effort declaring it as against the will of God. It is something that is against natural evolution.

Here we give a date by date chronological account of how infertility science and infertility tourism have evolved over time and had come to a level that we see it today:
– Way back in 1790, the records reveal that birth of a baby was brought about by artificial insemination in which the mother conceived not as an outcome of sexual intercourse but as a result of sperms injected into her artificially.

– In 1884, the case of first sperm donation was recorded in the US where the donated sperms helped couples to have a baby.

-In 1937, the idea of In-vitro fertilization (IVF) was propounded in a medical journal where the fertilization between the male sperms and female oocyte would typically take place outside the body of the female partner. It will usually happen in a watch glass in a highly monitored laboratory environment.

-In 1938, there was a successful attempt at cryopreservation of sperms where they were frozen and kept for use in future.

These facilities including IVF, cryopreservation, artificial insemination and egg and sperm donation were restricted to countries having top class research and development support system in the field of medical and infertility science whereas infertility issues cut across global boundaries. It existed in every country irrespective of its scientific and economic achievements. Childless couples who could not find infertility solutions in the home ground took refuge elsewhere. Thus, the seeds of fertility treatment tourism were sown.

– In the year 1969, an eminent English embryologist Robert G Edwards published a paper on fertilization of eggs artificially. Later on, he succeeded in the test tube baby project.

-The year 1972 sees a successful in-vitro fertilization (IVF) brought about by an American fertility specialist.

– The year 1978 sees a ground breaking feat in the arena of infertility science. Louis Brown, the first test tube baby sees the light of the day in England. This was legendary and a joint effort by Robert G Edwards and Patrick Steptoe after their patient’s 104th endeavor.

– With the arrival of the year 1981, US embryologists have established themselves as the pioneers of IVF aided birth. The first IVF baby Elizabeth Karr was born in the US making IVF an amazing fertility treatment solution leading to a successful pregnancy culminating in a child birth. Childless couples were on a frenzied hunt to locate and travel across the globe in quest of a good IVF clinic to convert their long cherished dreams into reality.

-In the year 1983, another earth shaking event materialized in the field of human reproduction. Gradually, human birth was no longer dictated and controlled by the divine premises as the scientists have started making huge progress in the field delving deep into the enigma of childbirth and coming up with revelations. This year they succeed in bringing a baby to see the light of the day that was born out of frozen human embryo.
-The year 1984 saw more progress in human reproduction technology. In Australia, the first baby was born from donated eggs. A more simplified method to perform an IVF was worked out this year by Dr Richard Ash working in the University of Texas. This method was known as the gamete intra fallopian transfer. This very year the technique of zygote intra fallopian transfer was also developed.

With the passage of time, infertility treatment broke into new arena. New methods were developed bringing smiles to childless couples. However, these treatment facilities were not available globally in all countries which necessitated migration of fertility tourist to better pastures. Legal requirements were important factors that did not support artificially aided birth in quite a number of countries.  This was also a prime cause inspiring fertility tourism.


So far no country in the world has an established governing body that ensures collection of reliable data about the success rates of fertility clinics. Most clinics are rather beating the drum of success as a part of their marketing exercise. It is thus advocated that you ask for positive pregnancy test rates and the clinical pregnancy rates as well where the fetus responds with a clinched heart beat.

Clinics working on foreign patients often fail to verify the live birth rates in spite of all their good intentions simply because these patients never report back how things panned out for them. This is the primary reason for clinics not being able to report live birth rates. Now in this fast and competitive world where information is the key driver to organizational success who would wait for live births to be reported back by customers? The easiest way out is to report the clinical pregnancy rates which is instant and always more than actual live birth rates helping the clinic ride on a comfortable growth ladder.

Verified statistics are tough to find in most countries but one should do a fair judgment without getting impressed by tall claims. Clinics posting a realistic success rate can be relied upon as it reveals their ethical practice to some extent. A medical consultant or a fertility tourism facilitator generally can provide better clarity in facts and figures.

While deciding upon the country and clinic to explore for studying birth rate success, it is imperative to have a glimpse of country’s legislative framework that governs its operations.
It is quite obvious that legal confinements vary not only from one country to other but even from clinic to clinic for that matter.

These legal mandates based upon a particular country’s social, political and economic structure have their impact upon the operating procedures of a fertility clinic. Now the million dollar question is how the clinics elucidate these laws and execute them in running their day to day operations is a matter to ponder over. You can get enough information regarding the legal mandates from the government regulated websites.

The most common restrictions are as follows:
– Does the country’s legal framework approve egg donation services?

-Does the country have restrictions for traditional and gestational surrogacy?
– Do the donors involved in the egg donation process have a valid identity and registration or are they anonymous who could never be traced in the future?
– What type of clients would the clinic treat -singles, unmarried, straight and gay? Or do they have reservations for a specific class of clients?
– Do both the partners need to come for treatment?
– Is there any age bar for patients undergoing treatment?
– Are there restrictions imposed upon the number of embryos that can be transferred?
– Do they allow frozen sperms belonging to the biological father or a donor to be transferred overseas to a laboratory for fertilization of eggs?
– What would be the fate of the excess embryos leftover?
-Do the embryos belonging to you can be used later? Can they be further donated to someone known to you?
-Can they be donated to another family hiding your identity so that the family could reap the benefit?
-Can they be shipped back to your domestic country?
-Can they be donated for research and development in human embryology and reproduction science?
-Under what conditions can they be destroyed?
-What would be the fate of forsaken embryos?
– Do they have options for setting the family equilibrium (like PGD for sex selection)
– Can you go for legal gestational surrogacy? Can you get an approval for it as a medical requirement?

Experienced and qualified facilitators play a crucial role in finding out the right IVF clinic but you can put forward the following queries or do self research or seek your home country’s fertility specialist who maintain the updates of global fertility treatment issues.

Some common queries that instantly pop up in your mind are the expertise about the fertility specialists and staff of a particular clinic. Many clinics highlight a lot of physical and psychological screening tests to win the customers’ confidence but whether these are carried out in reality need to be verified. Testimonials or experience of customers can throw light on this matter. You can consult them prior to setting out for abroad fertility treatment. But keep in mind that your requirement may differ from theirs and one’s success does not ensure yours. No doubt, success in fertility treatment is dicey, but checking the basic parameters of an abroad clinic before selection is always recommended.


Fertility tourism, an offshoot of medical tourism has its own share of challenges especially while seeking cross border assisted reproductive care. Cultural scenario, medical ethics and above all legal implications of the destination country play a significant role in enabling the intending foreign couples access the required fertility services abroad.

What are the legal challenges?

The legal challenges blocking the growth of fertility tourism vary from one country to another. How much impact would the local legislative framework have on the development of fertility tourism would be the essence of discussion over here. Again the legal framework of a country is not fixed but keeps on changing.

There are two schools of thoughts regarding legal governance of fertility tourism which are as follows:
– Those countries with laws and statutes covering the legal issues of fertility treatment  include UK , Germany, Finland, France and Canada.
– Countries where legal issues having a bearing on fertility tourism are controlled by official guidelines. They include Australia, Cyprus, India, Poland, Mexico and USA.
– It is not at all surprising to find that some procedures and practices in fertility tourism which are legally permitted in one country may not be allowed in its neighboring countries.  Even the banned fertility procedures could put you behind the bars or attract heavy penal actions in terms of fines if still carried out defying the country’s legal system.
– Fundamentally, the legal restrictions in the home country compel a childless couple to seek infertility treatment elsewhere where the legal bindings won’t interfere with having a gratifying infertility solution.
– The legal eye would interfere with every step you take while progressing through an infertility treatment program.
– Whether you would be allowed to preserve frozen embryos for future use is another million dollar question.
– In countries like China, Indonesia and Turkey, legally speaking, IVF treatment is open to married couples only. New Zealand goes a step ahead. It allows IVF only to stable nuclear families.
– Countries like Sweden, USA and Spain seems legally more flexible allowing extension of IVF services to homosexual couples and singles as of today.
There may be other legal issues in a country that an infertility clinic operating within its border should abide by. These are as follows:

  1. a) In Greece, for example, the anonymity of the egg donor is guaranteed by legislation.
    b) In many countries, paying for surrogacy service or commercial surrogacy is banned although it is allowed in some Asian countries.
    c) In South Africa, surrogacy services are legally banned for foreigners although for locals there is no legislative obstacle.
  2. d) Genetic screening is disallowed by law in many countries but allowed in a few countries if stringent regulations are observed. PGD procedure which encourages sex determination in an embryo is banned in UK and many other countries.

 What are the ethical and cultural challenges?

– Surrogacy and pregnancy with the aid of artificial reproductive technology is looked down upon in many countries as an unethical choice.
– Paying a surrogate mother and an egg donor for their services is simply equated with exploitation putting them in health hazards and taking advantage of their financial needs.

How these challenges can be surmounted?

The legal challenges can be met by following ways:
– In this respect, the choice of the clinic would play a vital role in handling the legal issues of the locality where you are seeking the service. Make sure that the clinic has an adequately staffed legal wing who will guide you against legal distress arising from infertility treatment in a country having a set of alien code of legal bindings.
– Before launching on a fertility tourism program, the intending parents should get themselves aware of the law of the land. It is recommended to seek professional guidance in this respect. Is surrogacy approved? Can an egg or sperm donor be hired? Is it possible to preserve your eggs and sperms in a frozen state in the clinical laboratory in an alien country for use in the future?
– Socially and culturally as well as legally in many countries, determining the sex of the embryo and opting to have a baby of a specific sex is a taboo. Get the names of such countries from an authentic source and avoid those destinations if you desire to have a baby of a particular sex through artificial reproductive technology.


When infertility is the issue, prehistoric therapeutic techniques applied by early human civilization were no less effective as the modern medical treatments. Early human beings explored the human body in every detail. Their knowledge of human physiology was profound based upon which the symptoms and diagnosis of a disease were possible and so was its remedial solution. Infertility was no exception. The causes were analyzed and solutions offered which were very different from the modern-day IVF and IUI treatments in procedural techniques but in spirit they weren’t much way apart.

Acupuncture and TCM

The art of acupuncture is ancient and was perfected by the ancient Chinese doctors.
It is a smooth and pleasant way of getting treated if you have infertility issue. This ancient infertility treatment is gaining fast popularity. Who could imagine your body nerve endings have huge potential? A gentle prick by a needle over these millions of nerve endings with precision and skill could certainly unlock this huge potential. This ancient treatment helps your body to peak at its optimum capacity and helps you to perform better.
It is largely a different procedure altogether and a wide departure from the approved modern day infertility treatment. It is an interesting fact that acupuncture is a physical therapy. It doesn’t even call for penetration through the skin and still induces the much needed chemical reactions responsible for boosting up your metabolism.

Acupuncture has a history of curing patients suffering from fertility disorders. Acupuncture together with ancient Chinese medicines has been in use since past 5000 years serving humanity and helping females suffering from infertility issues, achieve pregnancy.

Basis of Acupuncture

Acupuncture visualizes the infertility issue from an interesting perspective. The acutherapists study the menstrual cycle first. Since the cycle involves the spilling of Qi from the body with the monthly discard of the uterine lining, the bigger picture comes to the forefront.  It is the flow of the blood, the moisture of the Yin and the temperature of the Yang taken together determine the profile of the female’s hormonal balance or imbalance.

 The female menstrual cycle and the role of Yin and Yang 

According to the ancient Chinese philosophy, the forces of Yin and Yang act in the opposite direction and try to stay in equilibrium with each other. Yin is cool, submissive and retreating. Whereas Yang is hot, dominant and ever expanding.

Yin offers the canvas, the moist material to work on. Yang provides the required potential to work on the canvas. If life is compared with a cascade, Yin is the water and Yang is the current that provides the potential energy.

The first half of the menstrual cycle, which is the follicular phase according to the modern medical concept is when Yin rules. It is the growth stage of the ovum and the levels of Estrogen and Progesterone are low at the start of the cycle. It leads to the shedding of uterine lining.  Next, the quality of the blood Qi that flows out is very important to appraise Yin. Equally significant is the role that Qi plays over here manifesting in cramps and mood swings as a reaction to menstrual flow.

Treatment principle

-It is common for the therapist to ask about the color and texture of the blood. It is a part of the treatment.

– Queries about emotional stress, pain and cramp that accompany the menstrual cycle are asked by the acu-therapist as well.

-During the culmination of the first half of the cycle, the element of Yin (modern day FSH) allows one follicle to grow larger in size than the others. This very follicle is the moist structural development we were talking about earlier on which Yang would work on. The journey of the unfertilized eggs from fallopian tube to the endometrium has begun at this critical juncture when Yin is at its helm. The cycle of nature is at its best. The Yin creates Yang which grows until it reaches its apical coordinates and in turn gives birth to Yin. This mutual transformation sustains life.

-In the second half of the cycle (Luteal phase), Yang rules. The growth of a follicle triggers a deluge of luteinizing hormone that causes the egg to move towards the uterus. Enough energy is released and the egg finds it warm and cozy inside the uterus.

-The therapist keenly studies the cycle, diagnoses the cause, identifies the nerve points and starts his therapeutic treatment.


Fertility tourism is travelling abroad in the quest for availing proper medical treatment for infertility problems. The success of the entire venture rests upon the quality of treatment available and on the medical health of the intending couples and the third parties who are intimately connected to the process. Several medical jargons found in the lexicon of Human reproduction science seem to flood the discussion on fertility tourism. Terms like Assisted Reproduction Technology (ART), In-vitro fertilization technology (IVF), Pre-implantation genetic diagnosis (PGD), Surrogacy and surrogate mothers, Egg and sperm donation, Intra-cytoplasmic sperm injection (ICSI) are some of the very common terms used in texts on fertility tourism.

There are indeed distinctions between these terms which we are going to discuss in some detail in an attempt to clarify the basic ideas of fertility tourism to a layman.

ART and IVF:

ART is a combination of medical procedures used to facilitate fertilization and normal delivery to childless couples. ART includes but is not confined to IVF, GIFT, ZIFT and ICSI.

In contrast to above, IVF is a medical procedure where an egg is removed from the female partner or a professional egg donor and fertilized by a sperm cell outside the body of the female. The fertilized egg is allowed to divide and develop in a closely monitored laboratory environment for about two days and then is inserted back into the uterus of the women who may be a surrogate mother or may be the producer of the egg. The process is also known as test tube fertilization and the baby born known as the test tube baby.

ICSI and PGD:

Intra-cytoplasmic sperm injection, known as ICSI in its abbreviated form is an IVF process where a single sperm is directly pushed through into an egg with the aid of an injection. This method of fertility treatment is mainly done to get over male infertility issues. However, it may also be employed where the sperm fails to penetrate the eggs easily.

On the other hand, Pre implantation genetic diagnosis or commonly known as PGD is a genetic screening procedure where it is employed to ensure the embryo is free from any genetic abnormalities or diseases inherited from the suppliers of male and female gametes and carried down to the offspring. PGD permits closely exploring the DNA strains of the eggs or embryos for that matter and select those healthy ones that qualify for certain traits. This method is very useful when there are any previous chromosomal or genetic disorders down the bloodline and falls within the purview of In-vitro fertilization programs.

 Gestational surrogacy and traditional surrogacy:

In Gestational surrogacy, pregnancy develops from the transfer of an embryo created by In-vitro fertilization in such a way that the child is genetically not related to the surrogate mother.

In traditional surrogacy, the surrogate mother is impregnated naturally or by artificial methods and the child born is related genetically to the surrogate mother. Gestational surrogacy is legally more complex than the traditional surrogacy.

Agglutination, Amenorrhea and Anovulation:

Agglutination is a male infertility reason when the sperms clump together. Whereas a female infertility cause is Anovulation where the female doesn’t or rarely ovulates.
Amenorrhea is a female infertility condition where a woman doesn’t have menstrual periods.

Artificial insemination and Gamete Intra-fallopian transfer:

Artificial insemination is a procedure in which the sperms are inserted directly into the cervix of a female or into her fallopian tubes or uterus.
Gamete Intra-fallopian transfer is an assisted reproductive technique that involves the removal of sperms and eggs, fusing them together and setting them onto the fallopian tubes.

 

More terms need to be included….