O-079 Cross-border reproductive care from France: an original digital survey to measure this phenomenon
Authors: Rozée V , Shenfield F , Massart P , Bondon M , De La Rochebrochard E 
Published: June 2022

Abstract

Study question
Can we accurately estimate CBRC from France and provide new insight on CBRC patients’ experiences and motivations? We present preliminary results of a digital survey.

Summary answer
Estimating CBRC is an important methodological challenge that requires extensive dissemination and collaboration among ART medical centres to avoid technique and destination bias.

What is known already
CBRC is a worldwide, growing and multifaceted phenomenon, involving many different countries, medical centres and associations, and concerning people with diverse sociodemographic characteristics and reasons for crossing borders.
France is one of the top four European countries whose residents seek CBRC. However, the national scale of CRBC cannot be estimated from existing studies because of important methodological limitations.
Quantifying CBRC is an important challenge to be taken up, in order to assess the extent of the phenomenon, which shows a mismatch between the national demands/needs of the population and the ART possibilities in a country.

Study design, size, duration
All French residents concerned by MAR are invited to fill in an online questionnaire between October 1st, 2021 and September 30th, 2022. These participants can also volunteer for post-survey interviews. Macro data are extracted from massive administrative data (registers). The survey has been approved by the French Ethics Commission (CNIL).
The analysis will use cutting-edge statistical methodologies (Benchmark Multiplier) from “Hard-to-reach” population research to get annual estimates of CBRC patients from France.

Participants/materials, setting, methods
The inclusion criteria are being a French resident aged 18 and over who used in the past or are currently using ART in France or abroad, or considering it in the future. Mid-term survey results will be presented (October 2021 to March 2022). By the end of January 2022, 367 persons having used CBRC participated to the online survey.

Main results and the role of chance
The 367 first participants declared to have done 666 different CBRC (one CBRC is defined as using one technique in one center of one countries during a same year). The average number of CBRC by participant was thus 1.8.
The majority of the first 367 respondents were in a union (62%), particularly in a same-sex couple (62% of those in a union). They were mainly between 30 and 40 years old (52%). They were informed about the survey mainly through social networks (68%) and associations (28%). Surprisingly, very few of them were informed by medical centres (1%).
CBRC mainly concerns sperm donation (48%). Surprisingly, egg donation represents only 11% of CBRC. Regarding countries, Spain (50%) and Belgium (21%) appear as the main destinations followed by Portugal (9%) and Denmark (7%). Surprisingly, Greece is absent and some other countries represent a low proportion of CBRC from France, like those from Eastern Europe (6%).

Limitations, reasons for caution
Compared with the literature and with our previous study in 2010-2012, we consider that some techniques and destinations are underrepresented. It is therefore essential to better broadcast the survey, especially through more European medical centers for better coverage of the CBRC population.

Wider implications of the findings
This project is a first step to develop a larger European survey to estimate the size of CBRC.

Trial registration number
ANR-21-CE36-0006-01