Session 51: Cross Border Reproductive Care
Session 51: Cross Border Reproductive Care
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会议 51：跨境生殖保健
DOI：
10.1093/humrep/de.25.s1.51
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发表时间：
2010
影响因子：
6.1
通讯作者：
Romera N
中科院分区：
文献类型：
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作者：
Romera N
跨国生殖治疗已经引起了广泛的评论，伦理辩论和媒体的猜测。然而，关于这一现象的严重程度、人们接受跨境治疗的原因及其经历的经验数据很少，对比利时诊所的一项调查报告说，希望逃避本国法律的限制是患者在比利时接受治疗的主要动机。然而，该样本中纳入了少数英国患者。ESHRE工作组对6个欧洲国家进行的一项未发表的研究也表明，大多数患者因本国的“法律的”限制而跨境。然而，鉴于不同的法律的和监管背景以及医疗资助试管婴儿的可用性，跨境护理的驱动力将因国家而异。本文报告了来自ESRC资助的定性研究的初步数据（http：//www. transrep. co.uk/），旨在探讨英国个人出国接受辅助生殖治疗的动机、理解和经验（RES-000-22-3390）。方法和材料本研究包括对从英国出国接受生育治疗的人进行深入的录音访谈，以及对关键知情人的访谈（临床医生、顾问和支助小组代表）。参与者是通过在线支持论坛、英国和海外诊所、支持团体邮件、滚雪球和媒体对该项目的报道招募的。参与者被问及他们在英国治疗的经历，他们出国旅行的动机，他们决定使用哪些诊所，在海外进行的治疗，在英国和国外接受的信息，护理和支持的水平，他们对在国外进行治疗的关注，治疗的披露，媒体陈述，英国和海外治疗的监管，捐助者的匿名性和支付和态度adoption.ResultsThis本文是基于从采访的数据与48名参与者（n= 38名妇女，n= 10名男子）谁曾前往（n= 41）或计划前往英国以外的生育治疗（n= 7）。我们提出了与这些参与者的人口统计特征相关的调查结果，包括年龄、种族、婚姻状况、性取向和职业水平。演讲讨论了出国前在英国接受生育治疗的经验和时间;在国外寻求治疗的复杂和主要原因;访问海外诊所的具体途径;访问过的国家和接受的治疗形式。我们还评论谁访问跨境treatment.ConclusionsGiven的社会和法律的背景下的生育治疗，跨境旅行的程度和动机的患者的满意度有很大的不同，根据原籍国。与比利时诊所的调查相反，我们在英国的数据表明，对治疗形式的法律的限制或对可能获得治疗的人群类别的限制并不是患者寻求海外治疗的主要动力。英国有一个强大的生育治疗监管框架，加上相对自由的自费治疗政策，但NHS护理的可用性有限。卵子捐赠者的短缺，随之而来的治疗等待时间和成本问题是更重要的驱动因素。与媒体报道的“生育旅游者”相反，我们的许多参与者在英国进行了漫长的不孕症之旅后决定出国旅行，这是...
IntroductionCross border reproductive treatment has provoked extensive commentary, ethical debate and media speculation. There is however, little published empirical data on the extent of this phenomenon, the reasons why people undertake cross border treatment and their experience of it. A survey of clinics in Belgium reported that the desire to evade legal restrictions in their home country was the main motivation for patients accessing treatment in Belgium. However, few UK patients were included in this sample. An unpublished study of 6 European countries by an ESHRE taskforce also suggested that most patients cross borders because of'legal'restrictions in their home countries. However, given the differing legal and regulatory contexts and availability of publically funded IVF, the driving forces for cross-border care will vary from country to country. This paper reports preliminary data from an ESRC funded qualitative study (http://www. transrep. co. uk/), which aimed to explore the motivations, understandings and experiences of UK based individuals who travel abroad for assisted reproductive treatment (RES-000-22-3390).Methods and MaterialsThe study includes in-depth, audio-recorded interviews with a purposive sample of people travelling abroad from the UK for fertility treatment, and interviews with key informants (clinicians, counsellors and support group representatives). Participants were recruited via online support forums, British and overseas clinics, support group mailings, snowballing, and through media coverage of the project. The participants were asked about their experiences of treatment in the UK, their motivations for travelling abroad, their decisions about which clinics to use, the treatments undertaken overseas, the level of information, care and support received both in the UK and abroad, their concerns about undertaking treatment abroad, disclosure of treatment, media representations, regulation of treatment in the UK and overseas, donor anonymity and payment and attitudes to adoption.ResultsThis paper is based on data from interviews with 48 participants (n= 38 women, n= 10 men) who had travelled (n= 41) or planned to travel (n= 7) outside the UK for fertility treatment. We present the findings relating to demographic characteristics of these participants, including age, ethnicity, marital status, sexual orientation and occupational level. The presentation discusses the experience and length of fertility treatment in the UK before going abroad; the complex and dominant reasons for seeking treatment abroad; specific routes of accessing overseas clinics; countries visited and forms of treatment received. We also comment on the level of satisfaction of patients who accessed cross border treatment.ConclusionsGiven the highly variable national differences in the social and legal context of fertility treatment, the extent of cross-border travel and the motivations of those undertaking it are likely to vary considerably according to country of origin. In contrast to the survey of Belgian clinics, our UK data suggest that legal restrictions on forms of treatment or restrictions on categories of people who may access treatment are not major motivating forces for patients seeking treatment overseas. The UK has a strong regulatory framework for fertility treatment, coupled with a relatively liberal access policy to self-funded treatment, but limited availability of NHS care. A shortage of egg donors, the consequent perceived waiting times for treatment and issues of cost were more significant drivers. Contrary to media reports of'fertility tourists', many of our participants had decided to travel abroad following a long infertility journey in the UK and this was …