No one wanted a child more than Ana Adzic. At least she thought so.

When the 37-year-old journalist went online, she realized there were more Serbian women like her on the internet. She also discovered a private hospital in Macedonia that had been helping single women like her to conceive.

After what seemed like endless doctor appointments, medical bills and travels – and the purchase of enough sperm for three in vitro fertilization attempts – Ana Adzic brought a baby girl, Antonia, into the world by Caesarian section at the Acibadem Sistina Clinic, now responsible for some 6,000 births since opening 14 years ago.

Even though the World Health Organization has recognized infertility as an illness, not all countries permit the IVF treatments that culminated in a newborn for Ana Adzic. Ongoing health issues, ethical debates, and inconsistent international regulations can often raise more questions than they answer about IVF treatments, making medical tourism a popular choice for wannabe parents – both single men and women and childless couples including lesbians and homosexuals.

“The availability of donor eggs and sperms is an obvious reason why potential parents seek infertility treatments abroad,” said Renée-Marie Stephano, President of the Medical Tourism Association®. “Studies also show that shorter wait times, the cost of treatment and the success rates for conception also influence medical tourism decisions, as do the safety and standards of care that a patient should be aware of when investigating any procedure.”

New technologies may have erased some prenatal health fears, but emotion can often supersede science – even in the aftermath of millions of births – as new arguments and concerns continue to surface. Take the case of single women in Serbia — like Ana Adzic – who can travel outside the country to places like Macedonia for IVF treatments; all of which is fine – if they agree to pay for it. Ana Adzic did, and connected with Denmark-based Cyros International, where she was able to add a little bit of Danish heritage to her family in exchange for €5,000, and at no cost to the publicly funded Serbian healthcare system.

Traveling Sperm

Smiling sperm swim on the walls of Cyros International, which ships male reproductive cells to more than 65 countries around the world. Donors — about 40 of the 400 men registered at the clinic visit daily – have been responsible for 23,000 births since 1991. Single women, who make up half of the Cyros cliental, have made IVF medical tourism treatments a popular option to infertility and conceiving naturally.

The secret to Cyros’s success is in the sauce. Potential donors undergo rigorous medical examinations, and physical and psychological tests. Only 10 percent of the donors, between the ages of 18 and 45, qualify.

Medical tourism to enabling countries is another means for single or older women to use IVF treatmetns in combination with embryo selection or genetic enhancement. Little Antonia, the 14-month-old called “Putinche” for her unusual blue eyes that resemble Russian President Vladimir Putin, will never know her biological father, but her mother will tell her that he is Danish, likes football, travels frequently and has fine hand-writing. Those were the traits that Ana Adzic found appealing when selecting her sperm of choice.

The male cells can be ordered directly from the Cyros website in 19 languages. But, the when, where and how insemination is carried out, is another matter.

Deep-Seated Desires

Because medical insurance rarely covers IVF treatments in the United States, Americans have become prime consumers for medical travel overseas where procedures are less expensive and the chance to start a family beckons. In Israel, Joint Commission International-accredited Assuta Hospital in Tel Aviv offers IVF treatments at a cost about 70 percent less than those in the United States. Panama also has a big IVF medical tourism practice, thanks, in part, to the services offered at Hospital Punta Pacifica, a JCI-accredited facility managed by Johns Hopkins.

In Europe, IVF regulations vary. Italy, France, Austria and Portugal allow IVF treatments only for heterosexual couples. On the other hand, Switzerland and Turkey insist that couples be married. Greece, Spain, Great Britain, Denmark, Belgium and Finland allow assisted reproduction for all including single women and lesbians.

The desire to have a baby can be primal, deep-seated and not without opposing views. IVF babies sparked a firestorm earlier this year when Italian fashion icons Domenico Dolce and Stefano Gabbana implied that same-sex couples should not raise kids.

“The only family is the traditional one. No chemical off-springs and rented uterus: life has a natural flow, there are things that should not be changed,” the gay couple, who have since split, told the Italian magazine Panorama.

“You are born to a mother and a father – or that’s how it should be,” said Dolce. “I call children of chemistry synthetic children.”

Those comments triggered a back-and- forth social media tirade including calls for a boycott of the Dolce & Gabbana products from singer Elton John, who has two children with his partner, David Furnish, through IVF treatments.

In an interview later on CNN, Dolce said his views on IVF treatments were private, personal beliefs based on his sense of traditional Sicilian family.

“I believe in the traditional family,” he said. “It is impossible to change my culture for something different. It’s me… I respect all the world, all the culture.”

Mainstream Thinking

Since IVF treatments emerged as a birthing option, every voice in its favor has been equally matched by moral challengers who are determined to see assisted reproduction thwarted. Some arguments fall by the wayside, if, ever so slowly.

In countries like Poland, where the influential Catholic Church is opposed to IVF treatments and the destruction of spare embryos, concern over the falling number of births and an aging society have prompted a compromise of sorts between once-unwilling factions. The two sides appear on the verge of conciliation based on the government’s announced plans to adopt draft legislation that will clarify existing regulations and allow IVF treatments for married and unwed couples who continue to struggle to conceive naturally after at least 12 months.

Because of the costs for travel and accommodations and the time that may be required away from work, Stephano advised IVF patients to be realistic about their chances for artificial insemination in the same way they would for any other health condition before traveling abroad.

But weighing hope against hope can often be enough to sway desperation to act. Lifestyle factors, such as diet, obesity and stress, once overlooked in earlier years, are now at the heart of problems that have increased the demand for infertility treatments overseas.

Policies that restrict the number of fertilized and implanted embryos in European and Asian countries have helped infertility treatments top the lists of medical tourism procedures in Dubai, bucking global trends that have popularized overseas trips for cosmetic, dental, orthopedic and heart surgeries.

And the trend has not gone unnoticed by companies looking to spawn a foothold in the medical tourism marketplace through new expansion strategies similar to UAE-based NMC Health, which announced a deal to purchase a majority stake in Eugin, a Spanish infertility clinic, for US$163 million. Eugin is one the largest fertility clinics in Europe and a leader in cross-border treatments, attracting patients from primarily Western European countries.

Source: Medical Tourism Magazine