Department of Environmental and Preventive Medicine, Graduate School of Medical Science, Kanazawa University, Kakumamachi, Kanazawa, 920-1192, Japan,
Environ Health Prev Med. 2013 Nov;18(6):477-84. doi: 10.1007/s12199-013-0345-7. Epub 2013 Jun 9.
The attitudes towards cross-border reproductive care (CBRC) held by infertile Japanese patients have not been explored. The objective of the present study was to examine interest levels, preferred destinations, motivations, and sources of information related to CBRC. Our findings provide a general outline of CBRC and the future of reproduction and assisted reproductive technology (ART) in Japan.
The study used a cross-sectional design. Data were collected from 2,007 infertile Japanese patients from 65 accredited ART clinics in Japan (response rate, 27.4 %) via anonymous questionnaires.
Most of the infertile Japanese patients who responded denied using CBRC. However, by group, 171 (8.5 %) patients in non-donor in vitro fertilization, 150 (7.5 %) in egg donation, 145 (7.2 %) in pre-implantation genetic diagnosis, and 129 (6.4 %) in surrogacy said that, depending on the situation, they might travel abroad in the future. Older respondents were more likely to express an intention to travel overseas for egg donation in the future. The most popular destination for CBRC was the United States. Popular reasons for interest in CBRC among those considering or planning using this approach to third-party reproduction were that egg donation or surrogacy was unavailable or that obtaining ethical approval takes too long in Japan, whereas these processes are legal and affordable overseas. However, high cost was the most common reason for hesitancy regarding CBRC. Among the participants who were considering or planning to travel abroad for this purpose, TV, medical agencies, print media, and message boards on websites were popular sources of information, whereas doctors, friends, and patient self-help groups were not.
Although CBRC among infertile Japanese patients is not at present common, the demand for and use of this approach may increase in the future in the context of the increasingly aging population. Lack of regulation and unavailability of third-party reproduction is a major cause of CBRC among Japanese patients. Health care provider faces an urgent need for giving useful information for patients regarding CBRC.
不孕日本患者对跨境生殖保健（CBRC）的态度尚未得到探索。本研究的目的是调查与 CBRC 相关的兴趣水平、首选目的地、动机和信息来源。我们的研究结果为日本的跨境生殖保健以及未来的生殖和辅助生殖技术（ART）提供了总体概述。
本研究采用横断面设计。通过匿名问卷，从日本 65 家获得认可的 ART 诊所的 2007 名不孕日本患者（回应率 27.4%）中收集数据。
大多数回应的不孕日本患者否认使用 CBRC。然而，按组来看，171 名（8.5%）未进行供体体外受精的患者、150 名（7.5%）进行卵母细胞捐赠的患者、145 名（7.2%）进行植入前遗传学诊断的患者和 129 名（6.4%）进行代孕的患者表示，视情况而定，他们将来可能会出国旅行。年龄较大的受访者更有可能表示将来有出国进行卵子捐赠的意向。CBRC 最受欢迎的目的地是美国。考虑或计划使用这种第三方生殖方式的人对 CBRC 感兴趣的主要原因是在日本无法获得卵子捐赠或代孕，或者获得伦理批准的过程过长，而这些程序在海外是合法且负担得起的。但是，高昂的费用是对 CBRC 犹豫不决的最常见原因。在考虑或计划为此目的出国的参与者中，电视、医疗代理、印刷媒体和网站的留言板是受欢迎的信息来源，而医生、朋友和患者自助团体则不是。
尽管目前不孕日本患者的 CBRC 并不常见，但在人口老龄化的背景下，未来对这种方法的需求和使用可能会增加。缺乏监管和无法获得第三方生殖是日本患者进行 CBRC 的主要原因。医疗保健提供者迫切需要为患者提供有关 CBRC 的有用信息。
