Cross-border oocyte donation in Europe
Résumé
Introduction. In certain European countries, access to new reproductive techniques is particularly restricted. This is the case in France, where medically assisted procreation is available only to men and women in a stable relationship, of reproductive age, and with medically confirmed infertility. Reproductive age is not defined by law, but the French medical insurance system has fixed the upper limit at 43 years for women. Moreover, use of certain techniques such as oocyte donation is restricted and waiting lists are long. Other European countries, however, have more liberal laws on access and offer of fertility care. For these reasons, some French nationals go abroad for fertility care because they do not fulfil the conditions for medical cover or because they wish to maximise their chances of having a child. We describe here the transnational fertility paths that are in operation in France, taking one example: oocyte donation in Greece. Materials and methods. As part of a current study on cross-border fertility care in Europe, we carried out a one-month survey in 2010 in a Greek clinic which has a high demand for oocyte donation from foreign and in particular French patients. We interviewed all women of French nationality who were attending the clinic, alone or with their partners, and obtained 31 interviews. We also collected 24 self-report questionnaires completed by French patients in the medical centre. Results. Through the interviews, we identified the main social and demographic characteristics of French women seeking oocyte donation in Greece. In our population the proportion of women aged less than 43 years and over 43 years was the same, although most were aged over 40 years. The large majority was in a heterosexual partnership, had an intermediate occupational level and had no children. They had been attempting to have a child for several years and often had a history of medical treatment in France. The interviews also shed light on their personal and medical reasons for seeking oocyte donation abroad. In France, the women had been considered " too old " by the medical staff, the procedure required to obtain oocyte donation was too lengthy, and it was often their physician who had advised them to go abroad directly. Lastly, the interviews identified the reasons why the women chose Greece (quality and rapidity of medical management, only one stay abroad, assistance available from a French-speaking person, etc.) and how the cross-border procedure was organised in France and in Greece. Conclusion. Investigation of cross-border fertility care gives us an outside view of what, in France, fails to meet the new demands related to infertility treatment, or indeed the new expectations related to sociodemographic change. From a legal viewpoint, the French restrictions on oocyte donation are justified by medical arguments, but they are also coloured by a certain conformity to social norms regarding procreation and the family, the norm of maternal age and in particular the norm that considers " genetics is everything ". The women who travel to Greece for oocyte donation depart from these socially constructed norms. They are not aware of the medical risks related to their undertaking, or they declare that they assume them, since it is their own choice. They do not understand the restrictions imposed in France, and consider themselves more as symbols of present demographic change than as unconventional women.
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