When I came to Greece, a lot o couples went in England in order to do in vitro insemination, while now it's vice versa. Back then the centers were very few. I had the opportunity to work in a big English hospital where a lot of Greek doctors were being trained. In the beginning of 1992 I was still a young embryologist," says Dr. Gill Palmer, and embryologist in the Athenian private clinic "Mother."

It is a common practice right now for a lot of couples from England to come look for help and in vitro insemination in Eastern European countries. They often go to Slovenian and Hungary because of the affordable price- £1600, significantly less than the price in England- £4000. These countries are also attractive because of the success ratio of the procedures there, compared to England.

Greece has become one of the most popular destinations lately. At least two clinics in England organize trips to Spain, Greece and Romania and hundreds of couples go every year in order to fulfill their dreams and have a baby.

The most strict in vitro insemination law is considered to be the one in Italy. The services of the doctors can be used only by heterosexual couples, living together, who must be in reproductive age and clinically proven to be unable to conceive naturally.

Besides England and Italy, the number of couples from different European countries that travel in order to receive in vitro insemination has risen significantly during the last years. The reason is not only in the well known habit of frequent travelling of the Europeans but also because they are better informed on active laws in each country and would like to take advantage of supplementary services such as hotel services, vacations, interpreters and the use of Visa cards.

"The main factors responsible for this kind of tourism are the prohibition of some therapy methods in particular countries due to ethical reasons, the fact that methods which are allowed may turn inappropriate for certain patients and the huge waiting lists," says the in vitro insemination website www.kosmogonia.gr. 

Of highest importance before the beginning of the procedures is for the patients to inform on everything concerning the insemination and the safety of the mother and the embryos.

A representative from the English Service for human insemination and embryology advises those who go abroad "to check the regulations and services offered by each country." They should also answer the following questions for themselves:

What are we going to undertake if something goes wrong in the therapy abroad?

Do donors remain anonymous?

Do donors have legal responsibility for the child?

Is information about patients confidential?

 "We have heard of clinics where the therapies applied are dangerous for the patients and are forbidden in England. For example, in some places the embryos transferred reach five, increasing the possibilities for pregnancy but creating risk for the mother and the babies" continues the representative.

"The questions that Greeks ask are different from those couples from abroad ask. Foreigners are more interested in methods and techniques that are forbidden in their own countries. Another reason that they chose Greece or the procedure, besides the lower price and success rate, is that the law is quite liberal. In a lot of European countries rules are pretty limiting. To add to that, waiting time in here is also shorter" says Dr. Palmer, adding that "when they e-mail me, Greeks ask more general things- for health insurances, for arranging an appointment or the success ratio. Foreigners, however, are far more informed and ask specific questions about problems they face in their own countries."

In a survey conducted by Dr. Palmer and colleague embryologists about patients visiting the clinic website and topics that interest them, it becomes clear that from 297 patients, 75% have access to internet and 69% use it to inform themselves on health issues. 37% of the sample are of age between 31 and 35 and 81% between 24 and 40. The use of internet makes easier gathering information about prices and types of services, making expensive consultations unnecessary.

In regard to the particularities of laws in different countries compared to Greece, Dr. Palmer says that: "In Greece in vitro insemination is done to women up to 50 years old. Currently, in Italy a vey strict law exists. Embryos cannot be frozen, nor exceeding specific number. The number allowed there is three, while here 10 ova can be retrieved from one woman and all of them are fertilized so we can chose the best embryos to transfer into the woman. In Italy, on the other hand, only three ova can be fertilized which has led to an overall decrease in successful conceives."

If a woman does not get pregnant with the embryos implanted, some of the other seven left may be unfrozen and used, which saves money and the woman avoids unnecessary manipulations. In Denmark, the frozen ova can be kept for two years, in Greece-for 5, while in Finland for indefinite period of time.

"We conduct medical examinations of both the man and the woman, in case a hereditary disease is present and in addition we can make pre-implantation tests of the embryos for genetic diagnoses, so we can choose the best. This is also not a practice in Italy" clarifies the embryologist. In some countries, like Great Britain, France, Australia, Germany and Greece, the allowed number of embryos to be transferred into a woman's uterus is defined by law.

Every country has its own history. In the USA and Australia each state has its own legislation. In England, on the other hand, the law was changed and sperm donors must announce their names; consequently, shortage of donors occurred, resulting in raised interest towards Greece.

Marina Nikolova