Sun and egg tourism: Spain becomes the mecca of oocyte vitrification | Health & Wellness

There are those who receive gifts for their wedding. Kaia Nathalie Klaumann decided to get one because of her divorce. At 38 years old and her life collapsing, she thought it was time to freeze her eggs and plan her life. But buying time costs money. Doing it in Texas, where she lives, costs exactly 20,000 dollars (about 18,600 euros). So after a Google search and a call to a friend, she decided that her gift would be double: egg freezing and a vacation in Spain, where she paid about 4,000 euros for the same process.

Kaia asked for two weeks off from work and caught a plane. “It’s something quite common,” she explains in a telephone conversation. “Many American women travel to Spain to freeze their eggs.” And there are more and more. According to the market research company Grand View Search, the global fertility tourism market is expected to grow at a rate of 30% in the next seven years, reaching 5.8 billion euros in 2030. And on the world map of this buoyant business, Spain is marked in red.

“First of all, it is because of the price,” says Klaumann, who in recent years has cut his teeth on dozens of forums. “It is also true that I am eight hours by car from Mexico. But of course, Spain has a good reputation, it is one of the countries where there is the most research on the subject,” he acknowledges. Furthermore, Klaumann had lived in Alicante for several years, so he knew the country. She did not need to resort to the numerous intermediary companies that organize these trips for American women.

One of these companies is Milvia. “Spain is a wonderful tourist destination,” explains its director, Abhi Ghavalkar, by email. “The warm climate, the option of being next to the beach and the possibility of exploring a new destination (sometimes while on vacation) are attractive to American women,” she points out, while also emphasizing that the country “has some of the best fertility providers in the world” and that “treatments are offered at a very competitive price.” Spending a couple of weeks full of hormones seems less unpleasant if you spice up the plan with a walk along Las Ramblas, a visit to the Prado Museum or a day languishing in the sun on a Mediterranean beach.

According to the latest data from the Ministry of Health, of the 127,420 cycles carried out in Spain during 2020, 12,171 were for foreign patients. This is something confirmed by Erin Moore, who worked as a translator for seven years in a clinic in Alicante. “Many women came from England, Holland, Italy and the United States,” she explains on the phone. The treatments last several weeks, so patients have to stay in the city for a while. “And there I was,” Moore interjects. “I helped them find good hotels or restaurants to enhance their vacation.” The average health tourism traveler spends 1,082 euros per week, according to a 2022 INE analysis. In the case of vitrification, the expense can be even higher, as it is a relatively simple and not particularly painful intervention. It’s easier to integrate into a vacation.

The warm climate, the option of being beachside, and the chance to explore a new destination are attractive to American women. Additionally, treatments are offered at a very competitive price.

Abhi Ghavalkar, director of Milvia company

Oocyte vitrification is “an ultra-rapid freezing of eggs in their earliest phase,” explains Sara Lopez, gynecologist and author of I want to get pregnant. Keys to understanding assisted reproduction. The process begins when the patient injects hormones that give the order to the ovaries to release all possible eggs. “So, instead of one growing, the 13 or 15 of the menstrual cycle grow,” she points out. Next, there is a small surgical procedure to remove the eggs and put them in liquid nitrogen to preserve them for future use. The process went from experimental to daily in 2012. Since then, it has not stopped growing, not so much for medical reasons as for environmental ones.

In the last decade, the number of women who freeze their eggs has increased by 142% in Spain, going from an anecdotal 129 cases in 2010 to 5,480 in 2020, according to the most recent data from the Spanish Fertility Society ( SEF). The number is now believed to be much higher, but there is some delay in data collection. “Having so much volume of treatments allows you to carry out more studies and advance,” says Lopez. “That is why in Spain we are leaders in Europe, and I would dare say that also worldwide, in matters of assisted fertilization.”

Spain was placed on the international map thanks to egg donation. “It continues to be the most important sector within this market,” explains Anna Molas, postdoctoral researcher in Health Anthropology at the Autonomous University of Barcelona. Many women go to the clinic when it is too late to freeze their own eggs and this is the only alternative. The expert points out that there is an age and class bias in this practice, which she sees as problematic.

Another factor that has helped put Spain on the map also stands out: its legislation, which is more lax and permissive than that of its surrounding countries. “Here in the private sector there is no age limitation like there is in other countries. Nor do they put obstacles in place for being a single woman, or a woman married to another woman. And because of the anonymity (in the case of egg donation) which is no longer the case in most countries.”

When a woman considers her life project, just as she thinks about where she is going to live, and what she is going to work on, she should consider her reproductive project. This is not a guarantee, it is an opportunity

Antonio Urries, biologist dedicated to assisted reproduction

Freezing eggs means winding up the biological clock, putting the standby the decision to mother until you have sufficient economic, work or sentimental stability. That’s what happened to Klaumann, who couldn’t find a stable partner or a job that he liked. “Also, my desire to be a mother did not awaken until she was at least 35 years old. “She was too busy living and enjoying my freedom,” she admits. His was an individual decision, but it is, like all decisions, conditioned by a social context.

A woman’s eggs begin to lose quality at age 35, explains Antonio Urries, a biologist dedicated to assisted reproduction and president of the ASEBIR association. Initially, patients’ eggs were frozen before undergoing radiotherapy, chemotherapy or removal of the uterus. “But its use has changed, it has advanced. In recent years there has been a very significant increase due to age.” In this sense, the expert emphasizes the importance of pedagogy. “When a woman considers her life project, just as she thinks about where she is going to live, and what she is going to work for, she should consider her reproductive project,” he points out. He does so by remembering that this technique “is not a guarantee, it is an opportunity”, as it is not 100% effective. “It is very variable and we cannot talk about a specific percentage. In 2020 there was one pregnancy for every 12 or 13 vitrified eggs, but it depends a lot on each case.” Klaumann’s, for example, does not fit into this statistic.

A medical response to a social problem

In 2014, major Silicon Valley companies began offering their workers the possibility of financing egg freezing for their employees. Some voices then criticized that this work incentive hid a clear message to women: prioritize your professional career, postpone motherhood. However, the model spread; today 20% of large American companies offer it as a benefit to their employees. In Spain it is less common, but some companies have agreements to co-finance the treatment. This direct relationship between the productive and the reproductive is not coincidental.

“The delay in motherhood hides a productivist impulse,” says Sara Lafuente Funes, an anthropologist specialized in oocyte vitrification. “It is the result of a society that places capitalist productivity at the center of the social and leaves care and reproduction on the margins.” In this context, the anthropologist denounces, egg freezing becomes a medical patch on a social problem, an individual solution to a collective situation. “In addition, it does so by building another consumer product, turning reproduction into a market,” she denounces.

Currently, Lafuente investigates the social impact of this practice in the Cryosociety project, at the University of Frankfurt. He defends the existence of these techniques, but with nuances. “It is not a question of going against these treatments. They are progress, I know. But we should question that they are not solving the problem, and that they are also generating inequalities, since not everyone can access them.”

The delay in motherhood hides a productivist impulse. It is the result of a society that places capitalist productivity at the center of the social and leaves care and reproduction on the margins.

Sara Lafuente Funes, anthropologist

In Spain, Social Security offers treatment to women who have lost their fertile capacity due to illness. In addition, it requires compliance with a series of requirements (being under 40 years old, not having other children…) which means that many women end up going to a private clinic. They are the ones who can afford it. Many other reproductive projects end up on the public waiting list or finding that the expense cannot be assumed in the private sector. Others don’t even make it to this point.

In 2020, Kaia Nathalie Klaumann remarried and decided to start a family. It was time to thaw her eggs. The limitations on international travel due to the Covid crisis made her reject the idea of ​​coming to Spain to be inseminated, so she asked for them to be sent to Texas. It was not a good idea.

The shipment was paralyzed for a year due to bureaucratic and legal obstacles, and when she managed to have her eggs shipped, the logistics company to which they subcontracted lost them. “I used a code to control where the package was, I saw it until I stopped seeing it. Suddenly he disappeared,” Klaumann recalls with anguish. “I called and they didn’t know how to tell me, they even hung up on me.” After several days of searching, the package appeared, but when thawed, none of the 10 eggs it contained were viable. “No one can tell me the reason for sure, it’s something I can only suspect,” he laments.

Despite this unpleasant episode, Klaumann’s story has a happy ending. His name is Calvin and he is two years old. In parallel, she had started an in vitro fertilization process in a clinic in Texas and it did come to fruition. Despite the incidents, she is a staunch advocate of egg freezing. She also to do it abroad. She only regrets that covid, incompetence and a series of misfortunes frustrated her plan. And she repeats in a somber tone what the experts say: this is not a guarantee, it is an opportunity.

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