Leaps and bounds in Mexico’s reproductive tourism

In 2011, the first fertility clinic opened on Mexico’s Yucatán peninsula – IREGA clinic, a branch of the Institute of Reproduction and Gynecology in Acapulco. Fertility Center Cancun opened soon afterwards, just across Avenida Tulum in downtown Cancun. These two clinics continue to own the fertility market in Cancun. Their services and treatments include IVF, intracytoplasmic sperm injection (ICSI), assisted hatching, pre-implantation genetic diagnosis (PGD), gender selection, and egg donation. Both clinics also perform IVF for local and international surrogacy agencies. Neither advertises surrogacy services.

“Most of our patients are from abroad,” said Dr. Jose Gaytán, CEO and founder of Fertility Center Cancun. Of the 300 international patients he saw during 2013, he estimates 60 percent to have travelled from Canada, 30 percent from the US, and 10 percent from Europe. “In the beginning our most important patients were local,” said IREGA’s Medical Director. Now they actively recruit from abroad, attracting over 100 international patients in 2013, mostly from Canada and the US.

Low prices and easy access to donor eggs are the main draws for the international client. Prices begin at 4.300 USD for IVF and 7.500 USD for IVF with egg donation – a steal for the North American patient. The clinics also offer services such as gender selection, prohibited by law in Canada, the UK, and other jurisdictions. Gleaming offices, friendly international patient coordinators, English-speaking doctors and nurses, and Skype consultations all present an ethos of personalized, high quality, care. And then there are the sunny beaches, all-inclusive resorts, and Mayan ruins just a taxi ride away. It is a unique package.

…and many agencies …

Medical tourism agencies are central to this growing success. Many service providers operate in Cancun, with differing business models in a fluid and shifting market. Local companies such as My Medical Vacations and Health Ambassadors offer a full concierge service for international travellers, negotiating hotel deals and providing transport to medical appointments, drawing from experience in other markets such as cosmetic surgery. Global agencies such as Orbicare and Visit and Care leverage global experience in medical tourism. Others such as Elite IVF and IVF Vacation Center focus exclusively on reproductive travel, presenting Mexico as a new alternative for North American and European patients who they might otherwise have sent to Cyprus, India, South Africa or Turkey.

… resulting in a surrogacy boom

The year 2013 saw a new focus on the provision of surrogacy services, and the emergence of several new actors. Surrogacy Cancun launched with a focus on gay surrogacy, and the provision of high quality and ethical services. New Life and My Donor Cycle also expanded into Mexico, to supply growing numbers of international patients with both egg donors and surrogates. These agencies recruit Mexican egg donors but also offer “intended parents” access to large international donor databases. Local agencies such as Mexico Surrogacy and La Cigüeña del Bebe (The Stork of the Baby) focus on recruiting Mexican surrogates and cooperate with patient facilitators and fertility clinics to match their surrogates with intended parents.

The Tabasco connection

The surrogacy business in Cancun is highly reliant on Tabasco – the only Mexican state in which surrogacy is legislated. Fertility clinics in Tabasco’s capital city Villahermosa  (e.g. Reprogyn, CEFAM and INSEMER) run their own surrogate programs. Other agencies work simultaneously with clinics in Villahermosa and Cancun. Surrogates must “deliver” their babies in the state of Tabasco to comply with civil law. International intended parents prefer the Cancun sunshine to the humid oil-business town of Villahermosa however. So agencies often bring surrogates to Cancun for their embryo transfer, and some accommodate them in surrogate housing in Cancun until the seventh month of pregnancy.

Reproductive and surrogacy law

“In Mexico there is basically no reproductive law,” said Dr. Gaytán of Fertility Centre Cancun. This lack of clear legal guidelines is challenging for clinician-entrepreneurs such as Gaytán, trying to run responsible egg donation programs and protect the health of donors. “If we have a law, then we can have a registry of donors, we can know where they are donating. That’s very hard to keep track of.”

The legal and ethical status of surrogacy is also contentious, debated within the industry itself. “It leaves a scar,” said Servando Acuña, President of the Quintana Roo Medical Tourism Association and CEO of Health Ambassadors. He listed concerns about human rights and privacy, the potential for trafficking of babies, and the weakness of Tabasco’s civil law, as reasons not to get involved. One agency that has now ceased operations in Mexico – Planet Hospital – is currently under federal investigation in the United States, for allegedly defrauding more than 40 intended parents.Other agencies focus on developing surrogacy as a reputable and well-paid job – offering the equivalent of five year’s minimum wage for one pregnancy, and providing high quality accommodation and medical care. Tabasco and close-by Chiapas offer fruitful recruitment terrains. High levels of poverty and scarce employment opportunities make surrogacy an attractive option for local women. Still, demand exceeds supply.

Many stakeholders envisage a carefully regulated surrogacy industry – offering surrogates educational opportunities alongside financial compensation – as a significant economic opportunity for Mexico. The likelihood of this remains unclear. Optimists are confident that surrogacy will soon be legal in Cancun. Others work on the draft of a new law to significantly restrict international and gay surrogacy in Tabasco, or cite the dominance of Catholicism as a challenge to the passing of a Federal law.

What’s next for the Reproductive Riviera?

Cancun will soon be home to Mexico’s first integrated medical city. This “city of knowledge” – named Wisdom Gardens – will incorporate hospitals, retirement communities, and research centers, according to Acuña. He and his partners have purchased land, drawn up blueprints, and obtained 80 percent of the permits needed for this city. Now they are working on a sustainability plan. They are confident that international medical tourism will rival Cancun’s hotel industry within 10 years. Assisted reproduction will be one of the top five offerings.

Fertility will be, “one of the best ones,” agreed Gaytán. Fertility Centre Cancun treated around 300 international couples in 2013, and plans for 500 cycles during 2014. IREGA clinic is also in a growth phase. New egg donation and surrogacy agencies appear by the day, some with ambitions to set up their own clinics. Business is booming, and the industry is growing – on this, all of the stakeholders in reproductive tourism in Cancun can agree.