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The US fertility industry is a lucrative and ever-expanding business, operating with very little by way of public regulation or oversight. While most of the programmes are concentrated in the private sector, a few are also operated by public universities. The industry has become highly competitive, with estimated yearly revenues of US $ 3-5 billion from more than 400 ART programmes, seeking to attract customers who often have no insurance coverage and pay for fertility treatments out-of-pocket. Some fertility firms are now merging, or opening branches in multiple cities. There is a search for new marketing strategies like money-back guarantees, discounts and special offers – prospective customers being lured to an information session by offering a lottery for free donor eggs, etc. New market niches are also being sought out, including people who are not infertile in any medical sense, but who might be willing to pay for procedures like sperm sorting for sex selection, and egg freezing as a backup plan for women who want to postpone childbearing.

The term ‘reproductive tourism’ generally conjures images of North Americans and...