Availability of reproductive technologies varies worldwide

ASSISTED Reproduction Technologies (ART) such as IVF (In Vitro Fertilisation) and ICSI (Intracytoplasmic sperm injection) are amongst the most heavily regulated forms of medical treatment. However a new survey shows that there are still large country to country variations in the regulation and treatment which is available to prospective parents.

The IFFS (International Federation of Fertility Societies) Surveillance Report is produced every three years.  International clinicians are asked to provide details on the state of ART in their country. The collated results allow international comparisons to be made, as well as showing trends since the last report in 2010. The 2013 Surveillance Report is being presented to the ASRM/IFFS joint meeting in Boston on 17 October.

The new report, which includes 60 countries, compares 20 main topics, such as:

> The number of centres in each country, and how these have changed since 2010

> The legal framework – what is allowed in each country

> Marital status – which countries require marriage, and which will treat single and gay parents

> Which countries allow sex selection and Preimplantation Genetic Diagnosis (PGD)

IVF continues to grow, although this growth seem slower than in previous reports. There has been a consistent trend towards greater quality control, a broader access to services, and more safeguards.

Recent years have seen a growth in people travelling to access fertility treatment outside of their home country (cross-border reproductive care)*. This survey shows that there is wide variation in what is available in each country.

Some highlights of the survey include:

Number of centers There has been a modest growth in the number of IVF centers worldwide.  Some countries, such as Brazil and Russia, have seen significant growth

More laws There is a general trend towards greater legislation. Of countries which responded, 31% used only legislation to regulate ART, 21% used only guidelines to regulate ART, 37% used both legislation and guidelines, and 9% had no regulations or guideline at all.

Who pays? Around half of the countries which responded report IVF funding via a national health system. Often the payment systems are very different, for example Spain pays for IVF under the age of 40, South Korea pays up to the age of 44. In Sweden, 60% of costs are paid by the government, with the patient picking up the remaining 40% of the bill.

Marital status Most of the 62 countries surveyed require marriage before allowing treatment, however 26 countries allow singles and 14 allow lesbians to receive ART. These trends towards single/lesbian treatment are increasing.

Multiple pregnancy Many countries are concerned about the risks associated with multiple pregnancy, and more and more clinics worldwide are restricting the number of transferred embryos to one or a maximum of two.

Egg freezing In 42 countries, egg freezing is alloweb, but there are huge differences in what this means from country to country. Some limit the storage period to 5 years, some to the endΠΑΙΔΙΚΑ ΠΑΠΟΥΤΣΙΑ