title: Crossing borders for fertility treatment: motivations, destinations and outcomes of UK fertility travellers.
abstract: BACKGROUND
  There are few systematic studies of the incidence of cross-border fertility care and even fewer reports of qualitative research with those undertaking treatment outside their country of origin. This paper reports findings from a qualitative study of UK residents with experience of cross-border care: the socio-demographic characteristics of UK travellers; their reasons for seeking treatment abroad; the treatments they sought; the destinations they chose and the outcomes of their treatment.
  
  
  METHODS
  Data regarding cross-border fertility treatment were collected from a purposive sample of 51 people by means of in-depth, semi-structured interviews between May 2009 and June 2010. Data were analysed using a systematic thematic coding method and also subjected to quantitative translation.
  
  
  RESULTS
  Patient motivations for travelling abroad are complex. A desire for timely and affordable treatment with donor gametes was evident in a high number of cases (71%). However, most people gave several reasons, including: the cost of UK treatment; higher success rates abroad; treatment in a less stressful environment and dissatisfaction with UK treatment. People travelled to 13 different countries, the most popular being Spain and the Czech Republic. Most organized their own treatment and travel. The mean age of women seeking treatment was 38.8 years (range 29-46 years) and the multiple pregnancy rate was 19%.
  
  
  CONCLUSIONS
  UK residents have diverse reasons for, and approaches to, seeking overseas treatment and do not conform to media stereotypes. Further research is needed to explore implications of cross-border treatment for donors, offspring and healthcare systems.
authors.affiliation: School of Applied Social Sciences, De Montfort University, Hawthorn Building, The Gateway, Leicester LE1 9BH, UK. lac@dmu.ac.uk
authors.forename: L
authors.initials: L
authors.lastname: Culley
authors.forename: N
authors.initials: N
authors.lastname: Hudson
authors.forename: F
authors.initials: F
authors.lastname: Rapport
authors.forename: E
authors.initials: E
authors.lastname: Blyth
authors.forename: W
authors.initials: W
authors.lastname: Norton
authors.forename: A A
authors.initials: AA
authors.lastname: Pacey
mesh_terms: D000328:Adult; D005260:Female; D005102:Health Expenditures; D006801:Humans; D007246:Infertility / Q000523:psychology / Q000628:therapy*; D057193:Medical Tourism / Q000523:psychology*; D008875:Middle Aged; D009042:Motivation; D011247:Pregnancy; D018873:Pregnancy Rate; D027724:Reproductive Techniques, Assisted / Q000191:economics* / Q000523:psychology; D012959:Socioeconomic Factors; D013315:Stress, Psychological; D016896:Treatment Outcome; D006113:United Kingdom