EU enlargement could lead to fertility tourism from West to East
Berlin, Germany: Fertility tourists could be heading for eastern European countries in the wake of EU enlargement as data revealed today show that parts of the East match the West in terms of the availability and efficacy of assisted reproduction techniques, but cost less.
Dr. Anders Nyboe Andersen, Head of the Fertility Clinic at the Rigshospitalet at Copenhagen University Hospital, Denmark, told fertility experts that countries such as Slovenia and Hungary are achieving success rates after in vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI) that are as good as the best in the West.
Presenting preliminary data on ART in Europe*, Dr Nyboe Andersen told the 20th annual conference of the European Society of Human Reproduction and Embryology that while the availability of ART continued to be highest in Denmark with 1,923 cycles per million of the population in 2001 (the most recent year for which information was available), Slovenia ranked fifth with 1,122 cycles per million and Hungary carried out 578 cycles. In comparison, The Netherlands carried out 963 cycles and the UK 593 cycles per million.
Dr. Nyboe Andersen said: "We need to treat the pregnancy results with some caution because these are preliminary figures and some of the smaller countries are dealing with fewer patients and have different ways of recording data. But Slovenia and Hungary both have a good system of collecting data and they show that in 2001, Slovenia had a pregnancy rate per embryo transfer of 36.2% after IVF, and 30.2% after ICSI. In Hungary the pregnancy rate per embryo transfer was 31.9% after IVF and 25.4% after ICSI. This compares with Germany (28.6% after IVF and 28.1% after ICSI) and the UK (28.4% after IVF and 27.4% after ICSI)."
In Germany new funding regulations introduced in January 2004 have meant that infertile couples now have to pay half the cost of three cycles of infertility treatment and the whole cost after that. One cycle can cost between 1,500 to 3,500 euros (depending on whether or not the treatment is paid for privately). In the UK, the average cost of private IVF treatment is between £2,000 and £4,000 (3,000 to 6,000 euros) and there is limited availability on the NHS. But in Hungary and Slovenia the cost of drugs can be cheaper, which brings the price down.
Co-author of the ESHRE European IVF Monitoring report, Professor Karl Nygren, said: "With EU enlargement and the increasing freedom of movement that this brings, it has become even more important that countries collect accurate and complete data on the assisted reproduction technology carried out in their clinics. Discrepancies in prices between countries, particularly between the East and West, means that it is vital that potential patients can compare not only prices, but also the quality and efficacy of the treatments on offer."
Prof. Nygren, Associate Professor of Obstetrics and Gynaecology at Sofiahemmet Hospital in Stockholm, Sweden, added: "Our experience in collecting data for this report is that countries such as Hungary and Slovenia appreciate the opportunity to co-operate with the rest of Europe, share information and experiences and foster good relations."
The report also reveals that intra-uterine insemination (IUI), which may be used in about half or more of all ART treatments, cause multiple pregnancies but the results show that the rate is much lower than after IVF and ICSI. Until now it was commonly believed that IUI was responsible for a greater number of multiple pregnancies than IVF and ICSI.
Dr. Nyboe Andersen said: "The number of twin pregnancies after IUI is between 9.6% and 10.6%, but about 24.5% after IVF and ICSI. The triplet rates after IUI are 1.3% to 1.8%, which compares well with rates of 1.6% after IVF and ICSI."
He continued: "This is the fifth report of the EIM committee and the data collection has been running long enough to be able to show trends. Figures on multiple births are encouraging and show that over the five years quadruplet births have been almost eliminated, the number of triplets born has more than halved, but that there has been no improvement in twin birth rates. This is good news, but it would be even better if countries could concentrate on improving the rates of elective single embryo transfer."
Presented at 12.30 hrs CET, Wednesday 30 June, in Hall 3.
Notes * Preliminary data from the ESHRE European IVF Monitoring (EIM) programme for 2001.
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