Patients travel for lower prices, donor treatment and services they can’t get at home.
About one in five babies born following fertility treatments carried out in Spain in 2023 was delivered in another country. The Spanish Fertility Society published the finding in December 2025.
Fertility tourism means traveling abroad for reproductive care, including in vitro fertilization (IVF) and treatment with donated eggs or sperm. The clinical term is cross-border reproductive care.
Patients travel to reduce costs, obtain treatment unavailable at home or find care that suits their needs. Clinics build international businesses around those differences. Patients must also work out which doctors and regulators will remain responsible once they return home.
There is no agreed global market figure
Two commercial forecasts give sharply different estimates of the fertility tourism market:
|
Research publisher |
2026 estimate, US dollars |
|
Grand View Research |
$2.6 billion |
|
The Business Research Company |
$1.24 billion |
These are commercial estimates, not a global tally of recorded spending. The public summaries don’t provide enough detail about their assumptions and coverage to reconcile the figures.
The American Society for Reproductive Medicine, or ASRM, has identified a basic obstacle: the lack of a reliable international system for reporting this activity. One patient can account for several treatment cycles, sometimes at different clinics.
Spain’s registry recorded 168,372 IVF cycles in 2023. That total includes domestic treatment. It cannot be presented as a count of fertility tourists, and births abroad cannot capture every international patient because not every attempt results in a birth.
Revenue, treatment cycles and patient numbers answer different questions. A clinic can earn more because it raises prices or sells additional services, without treating more people from overseas.
Lower treatment prices do not remove every barrier
The World Health Organization estimates that one in six people of reproductive age experiences infertility during their lifetime. In some settings, a single round of IVF costs twice the average annual household income.
“Infertility is one of the most overlooked public health challenges of our time and a major equity issue globally,” WHO Director-General Dr. Tedros Adhanom Ghebreyesus said when the agency released its first global infertility guideline in November 2025.
Even where overseas fees are lower, patients still need enough money and time away from work to travel. The WHO’s one-in-six figure measures medical need, not the number of people who can afford care abroad.
Public funding also shapes patients’ choices. In the UK, the share of IVF cycles funded by the National Health Service fell from 35% in 2019 to 28% in 2024, according to figures published in June 2026 by the Human Fertilisation and Embryology Authority, or HFEA.
Cost is only one reason to leave. ASRM also identifies legal restrictions, the range of available treatments, privacy and cultural comfort among the reasons patients seek care abroad.
Treatment laws determine who can go where
Germany prohibits donor egg treatment. Spain permits egg donation and allows adult women to receive assisted reproduction regardless of marital status or sexual orientation, subject to consent and clinical requirements.
A patient who needs donated eggs consequently faces a different set of choices from a couple using their own eggs and sperm. A country’s reputation for medical tourism does not establish whether it offers the treatment that patient needs, or whether the patient is eligible.
The United States attracts patients seeking particular services, too. ASRM’s 2022 ethics review describes international patients traveling there for egg donation, surrogacy and embryo genetic testing.
Clinics should establish legal eligibility before accepting a deposit. Patients need a written explanation of the applicable rules, with independent legal advice where necessary.
Clinics recruit patients before they travel
Foreign patients generated 70% of revenue at Alpha IVF Group’s Malaysian operations in its 2025 financial year. The group opened sales offices in Shanghai and Guangzhou and a satellite clinic in Jakarta.
Its Jakarta clinic offers hormonal assessments and follow-up care. The Chinese offices support patient referrals to Malaysia. This gives the group a presence in patients’ home markets before they commit to treatment abroad.
For the year ended May 31, 2026, Alpha reported a 9.1% increase in foreign patient revenue at its Malaysian operations, to 120.1 million ringgit. Local patient revenue reached 58.6 million ringgit. Across the group, profit attributable to shareholders fell 6.8%, with expansion expenses weighing on earnings.
Other groups are expanding through partnerships. In February 2026, UNC Fertility announced a partnership with IVI RMA North America while retaining UNC Health’s ownership of the practice. The announcement described IVI RMA Global as operating in 15 countries, with more than 200 locations.
Such partnerships also expand local services. Counting all the revenue of an international clinic group as fertility tourism would include treatment for patients who never left their own country.
What the advertised price leaves out
Medication, scans, anesthesia, embryo freezing and storage are not always included in an advertised IVF package. Patients need an itemized quote showing which costs are included, which are optional and which could become necessary during treatment. [14]
In July 2025, the UK’s Competition and Markets Authority said available price information still did not always allow patients to compare treatment costs effectively. It did not proceed with the voluntary pricing approach it had explored.
Travel adds expenses outside the clinic: flights, accommodation, time off work and return visits. The HFEA advises patients to calculate the full trip cost and keep a contingency fund.
The quote should also explain what happens to fees if treatment stops before egg collection or embryo transfer. A refund offer needs equally clear terms: who qualifies, which attempts are covered and what would make the patient ineligible.
A pregnancy rate is not a birth rate
An advertised pregnancy rate doesn’t tell patients the clinic’s live birth rate. The HFEA warns that success claims can also reflect a younger patient group or people with less complex fertility problems.
Results per embryo transfer exclude attempts that never reached transfer. Donor egg results should not be casually compared with results using patients’ own eggs. Without knowing who and what was counted, patients cannot make a fair comparison.
The HFEA’s preliminary 2024 data show how much age affects outcomes. Birth rates per embryo transferred using patients’ own eggs were 38% for ages 18–34 and 8% for ages 43–44. These are results per embryo transferred, not the odds for everyone starting an IVF cycle. [6]
A clinic’s multiple birth rate belongs beside its success claims. Pregnancies with two or more babies carry greater risks, including premature birth. In the UK, 84% of transfers involved one embryo in 2024, while the IVF multiple birth rate fell to 3.2%.
Treatment extras deserve the same scrutiny. In June 2026, Professor Tim Child, chair of the HFEA’s scientific and clinical advisory committee, said its review of add-ons found that “most offer no proven benefit to patients, and some can even be harmful.” He acknowledged that specific medical circumstances can justify their use.
The clinic should explain why it recommends an extra for that patient, what evidence supports it, what risks it carries and how much it costs.
Donor records must remain traceable
In December 2025, the HFEA confirmed that a small number of UK women had received treatment at Danish clinics using sperm from a donor associated with a rare cancer-causing mutation. It said the Danish clinics had informed the affected women. The UK regulator held information only about treatment carried out in the UK. [17]
Patients need to establish who will notify them if new information about a donor emerges, how their records will be retained and what information their child will be entitled to receive. Those obligations extend well beyond the treatment itself.
ASRM’s ethics guidance also identifies risks to donors, surrogates and children. Patient safety cannot be assessed solely through the experience of the person paying for treatment.
Surrogacy brings a separate set of legal obligations. British government guidance warns that overseas birth certificates and court orders do not, by themselves, settle legal parenthood under UK law. Obtaining travel documents for the child can take months. [18]
Families need independent legal advice in both countries before entering an international surrogacy arrangement. A clinic or agency should explain those requirements before accepting payment, including the possibility of a prolonged stay after the birth. [18]
Tracking treatment across borders
The European Society of Human Reproduction and Embryology is developing its EuMAR registry to link individual treatment cycles and outcomes, including care in different countries. A pilot ran in Estonia, Germany, Portugal and Slovenia in 2024 and was validated in 2025.
The project has entered a second phase to resolve technical and legal requirements and widen participation. Its aim is to track outcomes across treatment attempts, so a patient treated in several clinics does not appear only as a series of disconnected procedures.
Before a patient books a flight, the treatment plan should name the clinician who will review the next blood test and explain where urgent care will be available. The clinic should also say how and when it will send records to the doctor at home.
