Best practice in cross border IVF… Who cares?

Infertility treatment is amongst the fastest growing niches in medical travel.  However, if there are well researched good practices out there on the management of international patients, why aren’t IVF clinics aware of them… or putting them into practice?

There’s no doubt that one of the fastest growing niches in medical travel is patients who travel abroad for infertility treatment.  But, if there are well researched good practices out there on the management of international patients, why aren’t IVF clinics aware of them… or putting them into practice?

The latest report from LaingBuisson, In Vitro Fertilisation – UK Market Report highlights the reduction in NHS funded provision and the growth of private sector involvement. In the UK, and in many other developed countries, infertile couples are seeking IVF treatment abroad to access lower cost treatment, donor eggs and sperm and healthcare providers who are less restricted by regulation than providers in their own country.

But how these patients are managed and how IVF treatment is delivered varies from country to country. Travelling patients face a challenge in comparing success rates, costs and service levels. What makes a good IVF clinic? Which ones are adopting best practice? And how can a patient compare?

ESHRE guidelines on cross-border reproductive care

When we established Fertility Treatment Abroad, we looked at how we might judge the suitability of clinics in providing IVF treatment for international patients. Our starting point was the European Society of Human Reproduction and Embryology (ESHRE) good practice guide for cross border reproductive care for centres and practitioners. The guide aims to ensure high-quality and safe assisted reproduction treatment, taking into account the patients, their future child and the interests of third-party collaborators such as gametes donors and surrogates. The guide deals with the following aspects of cross border reproductive care:

  • Equity in cross border reproductive care
  • Patient information
  • Donors
  • Surrogacy
  • Embryo transfer

The Good Practice Score

To make it easier for infertile couples to compare clinics on Fertility Treatment Abroad, we created a Good Practice Score (GPS). We identified 20 key factors from the ESHRE guidelines that provide a measure of whether a clinic is compliant with the ESHRE good practice guide. Based on the level of compliance, we are then able to derive a “Good Practice Score” for cross border reproductive care. Thus, a clinic receives a score out of 20 (1 point for each of the criteria that it meets), which is represented as a percentage of applicable answers.

Why isn’t anyone aware of the ESHRE guidelines?

At the IMTJ Medical Travel Summit 2018 in Athens, we dedicated two of the parallel sessions to fertility travel (and at the Fertility Forum 2018 in London, we’ll also be providing a focus on fertility travel).

The session in Athens was well attended with clinics representing many of the major destinations for IVF patients. At the end of the session, I asked a question about compliance with the ESHRE’s good practice guide for cross border reproductive care. Were clinics adopting it? What were their views? To my surprise… no one appeared to know what I was referring to! Only one person in the session –  Claudia Mika, CEO of Temos International GmbH, understood what I was talking about. Temos provides a certification for clinics that offer Cross border Reproductive Care (CBRC) and Assisted Reproductive Technologies (ART).  The ESHRE guidelines are an important part of that certification.


If you’re an IVF clinic delivering cross border IVF, I suggest that you take a look at the ESHRE guidelines and how our Good Practice Score works. Let’s try to ensure that every clinic delivering care to international patients is aware of and delivers good practice.

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As Editor in Chief of International Medical Travel Journal (IMTJ) and a Healthcare Consultant for LaingBuisson, Keith Pollard is one of Europe’s leading experts on private healthcare, medical tourism and cross border healthcare, providing consultancy and research services, and attending and contributing to major conferences across the world on the subject. He has been involved in private healthcare, medical travel and cross border healthcare since the 1990s. His career has embraced the management of private hospitals in the UK, research and feasibility studies for healthcare ventures, the marketing and business development aspects of healthcare and medical travel and publishing, research and consultancy on cross border healthcare.