Oocyte donation in Italy: effect on Spanish scenario

Cross-border reproductive care (CBRC) is a reality for Italians who want to undergo specific treatments of assisted reproduction that are not allowed within Italy. The Italian case is especially interesting as the first Italian law concerning medically assisted procreation, known as law 40 and issued in 2004 (Law 40/2004), has radically transformed Italy from what was perceived as an unregulated ‘wild west’ of European assisted reproductive practice to a country with one of the most restrictive laws in Europe (1). In its original version, the law restricted assisted reproductive technology to heterosexual infertile couples, established that three was the highest number of embryos that could be produced during any cycle, imposed that all these embryos immediately be transferred, limited research on embryos and banned cryopreservation of embryos, donation and surrogacy. The promulgation of law 40 provoked an increase in the number of Italians who chose to be treated abroad. Since then, cross border reproductive care (CBRC) is a reality for Italians who want to undergo oocyte donation. The Osservatorio Turismo Procreativo (Observatory of Procreative Tourism), a project started in 2005 by the Italian CECOS, Centre d’Etude et de Conservation des Oeufs et du Sperm (Centre for Study and Preservation of Eggs and Sperm) that aimed to monitor the effects of law 40 in terms of CBRC, reports that the number of couples treated abroad in 2005 was almost four times more than in 2003. Task Force of the European Society of Human Reproduction and Embryology (ESHRE) defines CBRC as “a widespread phenomenon where infertile patients or collaborators (such as egg donors or potential surrogates) cross international borders in order to obtain or provide reproductive treatment outside their home country” (2). CBRC is considered as a worldwide and growing phenomenon (3). In 2010, a study by the European Society of Human Reproduction and Embryology, based on a survey administered to foreign patients in 46 clinics in six European countries, found that 31.8% of returned forms were filled in by patients from Italy and that 70.6% of these Italian patients mentioned legal reasons as the predominant motive for CBRC (4). According to the existing literature, there are several reasons why people may leave their country of residence to undergo reproductive treatments abroad: high cost of treatments, lack or low quality of specific services, mistrust in local medical services and waiting lists are just a few (4). Italian citizens seeking reproductive assistance abroad, however, seem to principally respond to a given legal framework, which is perceived as too strict and not corresponding to Commentary