Next month Debbie Braden, 42, will fly to Spain to try to have a baby. As a result of an infection, her eggs are of poor quality and she needs an egg donor and in vitro fertilisation (IVF). It will be her tenth attempt, each one involving several thousand pounds and a gruelling round of hormone injections and preparation. Yet this trip, like two earlier ones, will be dubbed “fertility tourism”, conjuring images of fun foreign travel. “It’s not a holiday,” she says. “That idea takes no account of the rollercoaster of huge hopes and bitter disappointment if it fails.”

This form of “tourism” has increased dramatically in the past year or so. The reason is simple. There is a serious shortage of egg and sperm donors in this country. As a result, waiting lists at fertility clinics have soared — some have even closed their doors to new patients. A two-year wait is not uncommon and there are reports of eight. “Clinics report increasing difficulty in obtaining enough donor sperm and eggs,” says fertility expert Dr Allan Pacey, senior lecturer in andrology at the University of Sheffield.

A major factor in this sudden decline was the decision last year to remove donor anonymity; from the age of 18 any child born from donated sperm or eggs has a legal right to know who their biological mother and father was. The intention was admirable — allowing people to know their cultural and genetic heritage — but the effect has been to trigger a profound shift in the way infertile couples set about getting help.

“We couldn’t have done it without the internet,” says Braden. “I found there was no problem finding donors in Spain from a fertility website.” She settled on the best-known of the Spanish clinics, Instituto Marqués clinic, in Barcelona. In the past year, the number of couples coming to the clinic from the UK has nearly doubled to more than 100. Ads in the local press call for “tall fair-skinned or fair-haired European donors”.

According to the Infertility Network, a charity supporting people with infertility problems, the majority of women travelling abroad for treatment go for egg donation. This is not a problem in Spain, India, Russia or in a number of Eastern European countries because the donor’s anonymity is guaranteed and the women who donate eggs are paid a compensation fee for their time. Amounts vary, but for each cycle it is around £800 in Spain, and £150 to £400 in Russia and Eastern European countries. In Russia people can live on £700 to £800 a year.

The UK Human Fertilisation and Embryology Authority (HFEA) has called the use of foreign egg donors a “profoundly exploitative and unethical trade”. Critics respond that the HFEA’s decision to limit donor payments to £15 plus expenses contributed to the current UK crisis — it’s estimated another 1,500 egg donors are needed a year.

The other concern of the HFEA is that UK residents going abroad will not be treated in clinics run to the agency’s high standards, and may even be offered dangerous treatments, such as implanting five embryos, which significantly raises the risk of multiple pregnancies. But Braden says that the HFEA is being alarmist: “Of course people should do research first. With the internet that is easy. If a clinic is doing something dangerous there will soon be reports on it. I’ve been to three clinics in the UK, one in America and two in Spain and the non-UK ones were very professional.”

And the popular image of people flying off to a foreign clinic to have treatment unsupported is not accurate, she says: “You have to involve a UK clinic before going because you need a scan before implantation to make sure your womb lining is developing properly or it will be wasted. My clinic in the UK has swapped notes with the ones in Spain. My GP is in the loop too and I have emotional support from a group here in Wales that I met through the internet. When I return the clinic will help with any problems.”

A Rolls-Royce service is offered by the Bridge Fertility Centre in London. “People don’t want to go abroad for treatment” says Professor Gedis Grudzinkas, the medical director. “But if they can’t get a donor, then we have links with clinics abroad that meet UK quality standards. And one of our doctors goes with them.” The cost is from £8,000; at the other end of the scale there are reports of one IVF cycle in India for £600, rather than £3,000 to £4,000, the UK starting price.

It is possible that the donor situation in the UK will improve. Clare Brown, director of the Infertility Network, believes that a campaign to make people aware of what a wonderful gift altruistic donation is could raise the numbers. But either way it seems that fertility tourism is here to stay, an inevitable result of the freeing-up of medical information on the internet and an increasingly consumerist attitude to health. Done intelligently with expert support, and if you can pay for it, there is no reason why it can’t be beneficial.

HOME OR AWAY?

In the UK, women can have no more than three embryos implanted at a time. In India, up to five embryos can be implanted — increasing the chance of success, but also the chance of a multiple birth.

Few UK fertility clinics will treat women over 45. In Italy, over-60s are treated.

“Womb renting” or surrogacy can be difficult to arrange in the UK, and the surrogate mother can claim back the child within two years. In India, surrogates are plentiful, and have no such rights.

Testing of the genetic quality of embryos (preimplantation genetic screening) is closely regulated in the UK. It is easily available in other European countries.

Explore Health

• Expert Advice

• Health Features

• Mental Health

• Alternative Medicine

• Child Health

• Health Club