Cross-border reproductive care among French patients: experiences in Greece, Spain and BelgiumReportar como inadecuado

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1 INED - Institut national d-études démographiques 2 CESP - Centre de recherche en épidémiologie et santé des populations

Abstract : Study question: What are the characteristics, motivation and experience of French patients seeking cross-border reproductive care CBRC?Summary answer: French patients seeking CBRC are same-sex couples, single women who are not eligible for assisted reproduction technologies ARTs in France and heterosexual couples seeking oocyte donation due to extremely limited access to this technique in France, while their choice of Greece as a destination is influenced by financial issues.What is known already: CBRC is a new, increasing, complex and poorly understood phenomenon. A few studies have investigated UK, German or Italian CBRC patients, but none have specifically investigated French patients although France is one of the top four countries of origin of CBRC patients in Europe.Study design, size, duration: A cross-sectional study was carried out in 2010–2012 in three ART centres in Greece, Belgium and Spain in order to investigate French patients treated in these centres. Recruitment was prospective in Greece and Belgium and retrospective in Spain. The overall response rate was 68%, with 128 French patients participating.Participants-materials, setting, methods: French patients filled in a questionnaire. Information was collected on their socioeconomic characteristics and their search for ART treatment in France and in other countries.Main results and the role of chance: In the Belgian centre, 89% of French patients used sperm donation whereas oocyte donation was used by 100% of patients in the Greek centre and 74% of patients in the Spanish centre. The majority 94% of French patients using sperm donation in Belgium were not legally eligible for access to ART in France as they were same-sex couples or single women, and the main criterion of choice of centre was its geographical proximity 71%. Most of the French patients using oocyte donation in Greece and Spain fulfilled criteria for fully reimbursed oocyte donation treatment in France as they were heterosexual couples 99% with the woman aged ,43 years 65%. For these couples, CBRC was motivated by the extremely limited access to oocyte donation in France. Half of French CBRC patients using oocyte donation in Spain had a low-intermedi-ate occupational level such as primary school teachers, nurses, administrative officers or sales agents, workers and employees and this proportion was much higher in Greece 82%, P , 0.01.Limitations, reasons for caution: Larger and more wide-ranging studies are needed as this study included only 128 patients who may not be representative of all French CBRC patients, especially because the study was carried out only in three ART centres and these too may not be representative.Wider implications of the findings: CBRC among French patients had been thought to reflect mainly law evasion. This study showed that the reality is much more complex and that CBRC among French patients reflects both law evasion and limited access to oocyte donation in France. It also brings new insight into the characteristics of the patients by suggesting a certain degree of -democratization- in access to such care. However, the choice of centre seemed related to socioeconomic characteristics, in that the Greek centre treated a less advantaged population than the Spanish centre.

Keywords : cross-border reproductive care sperm donation - Europe assisted reproduction technologies oocyte donation

Autor: Virginie Rozé E Gomez - Elise De La Rochebrochard -



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