title: Motivations and experiences of patients seeking cross-border reproductive care: the Australian and New Zealand context.
abstract: OBJECTIVE
  To explore the motivations, clinical care, counseling, and support experiences of Australian and New Zealand participants considering or having participated in cross-border reproductive care (CBRC).
  
  
  METHODS
  Questionnaire-based study.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  One hundred thirty-seven Australian and New Zealand participants aged 23-53 years.
  
  
  METHODS
  None.
  
  
  METHODS
  Quantitative and qualitative responses to an anonymously completed online questionnaire.
  
  
  RESULTS
  Quantitative responses from participants indicated that motivations for engaging in CBRC included limited availability of gamete donors in their home state, difficulty in meeting treatment eligibility criteria, and treatment being legally prohibited. Experiences of CBRC were generally rated positively in terms of medical needs (91.2%), safety (89.4%), and costs (85.7%), although rated more conservatively to emotional needs being met (57.9%). Less than half the sample (47.5%) had accessed some form of CBRC-related counseling. Themes identified in qualitative analysis reflected gamete supply and demand issues, the importance of donor information and disclosure, the personal impact of legislation, and ongoing support needs after CBRC treatment.
  
  
  CONCLUSIONS
  A greater percentage of participants agreed that their CBRC clinic satisfied their overall medical needs and treatment expectations in comparison with overall emotional needs. Participants indicated access to post-treatment support counseling particularly with regard to their emotional well-being and disclosure issues to donor-conceived children would be useful. The implications of our findings for the provision of best-practice psychosocial counseling support and development of counseling guidelines are highlighted.
authors.affiliation: School of Anatomy, Physiology & Human Biology, The University of Western Australia, Perth, Western Australia, Australia; Concept Fertility Centre, Subiaco, Western Australia, Australia. Electronic address: iolanda@perthivf.com.
authors.forename: Iolanda S
authors.initials: IS
authors.lastname: Rodino
authors.affiliation: Department of Psychology, School of Public Health & Psychosocial Studies, Faculty of Health and Environmental Sciences, AUT University, Auckland, New Zealand.
authors.forename: Sonja
authors.initials: S
authors.lastname: Goedeke
authors.affiliation: Melbourne IVF, East Melbourne, Melbourne, Australia.
authors.forename: Sarah
authors.initials: S
authors.lastname: Nowoweiski
mesh_terms: D000328:Adult; D001315:Australia / Q000453:epidemiology; D005260:Female; D006801:Humans; D007246:Infertility / Q000453:epidemiology / Q000628:therapy*; D008297:Male; D057193:Medical Tourism / Q000706:statistics & numerical data*; D009042:Motivation; D020380:Needs Assessment; D009520:New Zealand / Q000453:epidemiology; D057240:Patient Preference; D027724:Reproductive Techniques, Assisted / Q000706:statistics & numerical data*; D013533:Gestational Carriers / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires
keywords: Cross-border reproductive care; donor conception; infertility counseling; legislation; motivations