The European Society of Human Reproduction and Embryology and the International Federation of Fertility Societies are concerned that the safety of patients crossing borders is not assured due to lack of uniform clinical standards between countries.

"The IFFS's 'Surveillance 2010' report, compiled by Professor Ian Cooke and published on 14 September 2010, illustrates this for over 100 countries. The survey highlights how widely assisted reproductive technologies (ART) are being used and how different cultures are regulating services in different ways. In most countries there is no state or insurance support, so these services are costly and frequently beyond the reach of many families. In some countries access to donor gametes is denied or supply is limited.

To address the safety of patients that seek treatment abroad, the European Society of Human Reproduction and Embryology (ESHRE), in co-operation with national and statutory organisations, is currently developing a 'Code of Practice on Cross Border Reproductive Care'. It will lay out a set of rules that protects and reassures patients, donors, surrogates and future children.

"Although in principle the care of foreign and local patients should essentially be the same and fit the best possible standards, there is evidence that it is not always so," says Françoise Shenfield, co-ordinator of ESHRE's Cross Border Task Force and author of the first study of European patients crossing borders to obtain fertility treatments. The ESHRE Taskforce plans to finalise an approved Code of Practice and steps for implementation, before the end of the year.

Both international organisations support the rights of patients to travel to receive the best treatment. Ideally this should take place in their home country, but if patients need to travel to receive the best treatment, both societies support this decision.

At the same time, ESHRE and IFFS call for the harmonisation of national standards to increase the safety of patients crossing borders to obtain fertility treatments in the hope that uniform standards of practice can ensure equitable treatment for all citizens.

Cross-border reproductive care is a growing phenomenon. Reasons for patients to seek fertility treatment abroad are either legal restrictions and/or unavailable treatments. The International Federation of Fertility Societies has surveyed global infertility services and has drawn attention to the disparity in international regulatory frameworks.

Speaking on behalf of the IFFS, its Director of Education, Ian Cooke acknowledged "the variation in international laws relating to infertility treatment is one of the reasons that cause couples to seek cross-border treatment. Whilst this is unavoidable we call for international standards to ensure these patients receive consistent advice and safe treatment". "Although a country's law or professional society guideline for treatment may reflect the overall cultural view in that jurisdiction, it does not necessarily mean that all that country's residents have the same view. They may then seek access to the proscribed treatment abroad."