Patient and clinician experiences with cross-border reproductive care: A systematic review. Issue 7 (July 2022)

• Record Type: Journal Article
• Authors: McLean, Laura; Ros, Stephanie T.; Hollond, Calder; Stofan, Jordan; Quinn, Gwendolyn P.
• Is Part Of: Patient education and counseling. Volume 105:Issue 7(2022)
• Page Start: 1943
• Page End: 1952
• Publication Date: 2022-07
• Subjects: Cross border reproductive care -- Assisted reproductive technology -- International -- Infertility -- Travel tourism -- Medical tourism; CBRC cross-border reproductive care -- ART assisted reproductive technology; Patient education -- Periodicals; Health counseling -- Periodicals; Health education -- Periodicals; Counseling -- Periodicals; Patient Education -- Periodicals; Éducation des patients -- Périodiques; Counseling -- Périodiques; Éducation sanitaire -- Périodiques; 615.5071
• DOI: 10.1016/j.pec.2022.03.016
• Languages: English
• ISSNs: 0738-3991

Abstract

Abstract: Objectives: This review analyzes the experiences of patients and clinicians with regards to international cross-border reproductive care (CBRC) for the purpose of conception. Methods: Electronic databases PubMed, Embase, Web of Science, and Scopus were searched using 'medical tourism' AND 'assisted reproductive technology' from 1978 to 2020. Results: Predominant patient motivators for CBRC were cost and legality of assisted reproduction technology (ART) in one's home country, followed by cultural factors like shared language, religion, and cultural familiarity. Clinicians suggested global laws for CBRC would reduce the potential for exploitation of vulnerable populations but believed the enactment of international regulations unlikely and, even if enacted, difficult to enforce. Conclusions: While patient and clinician experiences with CBRC varied, patients frequently cited financial and legal reasons for pursuing CBRC, while many providers had concern for the patient's safety. Clinical practice implications: This review recommends clinicians involved in family planning counsel patients seeking treatment abroad by: (i) informing patients of the risks and benefits of treatment abroad, (ii) establishing guidelines and standards for clinicians on resuming patient care post-CBRC, and (iii) creating a directory of reputable CBRC clinicians and experts. Highlights: In addition to cost and legal restrictions, cultural connectedness with destination country is a key factor in decision-making. While attitudes vary, a common theme expressed amongst clinicians included the concern for the patient's safety. CBRC's lack of central regulation highlights the need to differentiate factors influencing decision to travel abroad.