Regional reproductive quests: Cross-border reproductive travel among infertile Indonesian couples

Infertility is a significant reproductive health problem effecting at least 15% of heterosexual Indonesian couples during their reproductive lives. This article explores the preferences and decision-making processes of 15 married infertile Indonesian couples, of high socioeconomic status, regarding intra-regional reproductive travel in Southeast Asia. We consider the reproductive destinations of Singapore, Malaysia and Thailand, revealing their distinct attractions for different couples. We identify a variety of push and pull factors influencing the choice to leave Indonesia to pursue assisted reproduction technologies (ART), as well as the factors shaping the choice of travel destination. One intractable push factor motivating couples to leave Indonesia is the strict regulation of ART, which designates gamete donation and surrogacy as illegal. The paramount concern of our informants was to maximise their chances of reproductive success, and perceptions of higher success rates for conception via ART elsewhere in Asia informed their travel choices. Emotional and psychological concerns were also crucial in determining travel destinations and included a strong desire for privacy; the desire for emotional support whilst attempting conception via ART; the desire for emotional intimacy with one's partner; and the wish for religious compatibility with fertility providers and treatment protocols.