The Implications of Reproductive Tourism in the United States

Following the pivotal Supreme Court ruling on birthright citizenship, conversations around banning foreign nationals from utilizing American surrogates captured widespread attention. Yet, it is evident that lawmakers should broaden their scope to restrict all forms of reproductive tourism, not merely birth tourism.

Surrogacy represents a segment within the expansive reproductive industry. The majority of reproductive tourists in the United States pursue in vitro fertilization (IVF). Prior to legislative actions that address specific aspects such as surrogacy, a broader evaluation is necessary. What is fundamentally being offered in this market?

Reproductive tourism encompasses the creation and selection of human embryos, the exchange of human eggs and sperm, and, due to birthright citizenship, possibly an American passport.

Examining the industry data helps clarify this. A comprehensive analysis of the national IVF registry revealed that from 2014 to 2022, non-U.S. residents accounted for 59,246 reproductive technology cycles, originating from 182 countries. Notably, China contributed 19,718 cycles, thrice that of the second-ranked country.

The services sought by international visitors differ from those typically engaged by U.S. residents. Foreign patients have a notably higher tendency to utilize pre-implantation genetic testing and donor eggs compared to American patients. Data from the CDC highlighted similar trends with the share of tourist cycles doubling between 2006 and 2013.

Reproductive tourism thrives on aspects that many other countries restrict or prohibit, such as advanced IVF technologies and genetic screening, accompanied by the purchase of gametes from American donors. Countries like Britain, Canada, France, and Australia have outlawed non-medical sex selection with Italy and Turkey limiting their citizens from procuring third-party services.

Despite prohibitions in other developed nations, the U.S. remains a significant exception for surrogacy and associated practices. Minimal federal or state regulations govern these practices beyond FDA guidelines on infectious disease screening, leaving clinics to operate based on their preferences.

Components of the Reproductive Tourism Market

Embryo Creation: The creation of human embryos on a large scale is an aspect sold to international clients. Standard IVF protocols produce surplus embryos enhancing success rates, leading to an estimated 1.5 million frozen embryos in U.S. storage facilities.

Selection: ISell’s genetic selection is another vital component. International patients often seek clinics for family balancing or embryo selection based on genetic traits, adapting practices banned in their home countries.

Origins: The sale of genetic material involves catalogs of donor profiles, which include specifications such as height, race, academic scores, and degrees, an approach considered inappropriate in other settings.

Citizenship Sale

The Supreme Court assures birthright citizenship to children born on American soil, posing a significant question. Foreign nationals, thus, acquire U.S. citizenship when completing surrogacies within the country.

Clinic marketing strategies openly discuss these aspects. Institutions like the California Center for Reproductive Health and the Western Fertility Institute offer comprehensive packages, including reproductive and customer services, aimed at foreign clientele.

Ultimately, the implications of permitting an open-market approach towards reproductive technologies pose questions about the values upheld by the nation. It is crucial for the U.S. to decide whether it advocates for helping its citizens overcome infertility challenges or maintains a global market in designing and exchanging genetic material paired with citizenship.

Emma Waters, serving as a Policy Analyst at The Heritage Foundation’s Center, emphasizes reassessment of these policies.