Cross-border reproductive care in times of pandemic and ART legislation changes in European countries: a population based study

Adéla Volejníková , Charles University
Anna Štastná, Charles University
Jirina Kocourková, Charles University

Cross-border reproductive care (CBRC) is shaped by legal frameworks, treatment costs, quality of care, accessibility, and socio-cultural preferences. The COVID-19 pandemic disrupted access to medically assisted reproduction (MAR) and assisted reproductive technology (ART) services through lockdowns, travel bans, and shifting regulations, making CBRC unstable and access uneven across countries. This study examines how the pandemic and related restrictions affected the dynamics of CBRC in Czechia, one of Europe’s key destination countries, during 2020 and 2021. Focusing on ART, it analyses changes in the overall volume of care and in the structure of ART cycles undertaken by foreign patients. The study draws on population-based data of all ART cycles initiated in Czechia between 2016 and 2021, using anonymised individual records from the National Registry of Assisted Reproduction. In total, 261,571 cycles were analysed, including 167,641 (64%) initiated by natives and 93,930 (36%) by foreign patients travelling for infertility treatment. The findings show that CBRC had a significant influence on ART provision in Czechia, with its share rising from 36% in 2016 to 38% in 2019. The pandemic led to a marked reduction in treatment volumes – by 14% overall and by 27% for CBRC. However, the decline was uneven across countries: it was most pronounced among patients from Germany, Ireland, and the UK, whereas numbers from Poland and Hungary increased, and those from Austria and France continued moderate growth. The pandemic thus temporarily reduced CBRC volumes, yet legislative and access-related factors remain the primary long-term drivers shaping CBRC in Czechia.

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 Presented in Session P8. Demographic Trends, History, Data and Methods