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New phase of cross border reproduction
The aftermath of the COVID-19 pandemic is expected to have major impacts on the nature of cross border reproductive care where infertile couples and individuals in the past travelled extensively abroad to access medically assisted conception.
The 2022 Congress of the Asia Pacific Initiative on Reproduction (ASPIRE) in May heard that as the pandemic unfolded, access to fertility care in other countries was severely curtailed because of border closures, the adverse effects of COVID-19 during pregnancy, and vaccine hesitancy issues.
Queensland-based fertility specialist, Dr Clare Boothroyd, said restrictions on commercial surrogacy emerged as coronavirus and its variants spread throughout the world and there was a sudden shortage of donated sperm, eggs and embryos.
“The early and immediate restrictions of travel across borders resulted in many couples who had commissioned surrogates being unable to undertake parentage of their newborns following gestational carriage,” she explained.
“This created manifest anxiety and reduced bonding while the enforced or voluntary closure of medically assisted reproduction in some centres also resulted in some women with limited fertility windows realising they would never become mothers. This resulted in enormous psychological distress.
“Clinic closures also meant a serious reduction in medically assisted reproduction locally for infertile residents and those planning to donate eggs or sperm, and this exacerbated a global shortage.”
Dr Boothroyd is President-elect of ASPIRE and President of the Australian and New Zealand Society of Reproductive Endocrinology and Infertility (ANZSREI).
COVID-19 restrictions have eased substantially, vaccination rates are increasing around the world and fertility clinics are operating with new risk mitigation strategies in place.
Dr Boothroyd said this would lead to a new surge in cross border reproductive care, but with a major difference.
Frozen embryos, eggs and sperm will do much of the travelling previously undertaken by people
Clare Boothroyd ... telemedicine is changng the face of cross border reproductive care
“One positive outcome of the pandemic was that fertility clinics embraced telemedicine, and this is likely to change the face of cross border reproductive care into the future,” she told the ASPIRE Congress.
She said prospective parents would increasingly engage by telephone or electronically with fertility clinics abroad to access donated gametes that will be transported cryopreserved (frozen) to them in their home countries.
“In the future, cryopreserved eggs, sperm and embryos will do much of the travelling that was previously undertaken by people wanting to access reproductive care in overseas locations,” Dr Boothroyd added.
There is an acute shortage of accurate data on the level of cross border reproductive care, but it has been a growing phenomenon around the world as thousands of infertile individuals and couples travel in the hope of achieving their dream of parenthood.
The Asia Pacific region has been a booming market for procedures such as sperm, egg and embryo donation and surrogacy, but this has recently been constrained by legislation and the pandemic.
Reasons for crossing borders to access reproductive care include prohibition or restriction of certain services in the home country, or treatments being too costly where people live. Unmarried couples experiencing infertility, and same sex couples wanting to have a baby, face even more challenging legal and cultural barriers to treatment in many countries.
ASPIRE is a task force of clinicians, scientists, nurses and counsellors involved in the management of infertility and assisted reproductive technology in the Asia Pacific region.
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