Procreation, which includes both conception and childbirth, is arguably one of humanity’s most fundamental activities. Both sexes celebrate and take for granted the opportunity to become parents. Even though the vast majority of couples become pregnant when they expect to or even earlier if they are trying to conceive, 9% of all couples of childbearing age experience accidental childlessness [1]. It is considered emotionally taxing by most couples; their stress signs are comparable to those seen in people with cancer and other life-threatening diseases [2]. The World Health Organization classifies infertility as an illness and a serious health issue and social concern. Stigmatization due to infertility is widespread, and similar emotional responses have been recorded in various cultures [3]. Many infertile couples have become biological parents thanks to the proliferation of assisted reproductive technology and the improvement in the efficacy of infertility procedures. Recent advances in infertility therapy, such as hormone medications and in vitro fertilization (IVF), have led to a rise in the demand for infertility services [4,5] and promoted the use of medical techniques to treat infertility. Having a child of one’s own is viewed as a perfectly reasonable desire by many societies around the world [6]. Although not a recent trend, increasingly people are opting to seek medical treatment in other countries, which is known as medical tourism. Numerous websites have been devoted to assisting individuals in their quest for medical facilities overseas interested in carrying out required treatments, such as a facelift or a new child [7]. The knowledge and tools for assisted reproduction are now widely available around the globe, prompting varied responses from governments, religious institutions, and public opinion [8,9]. Traveling to another country for reproductive healthcare has become the focus of a new type of global market reproductive industry, frequently referred to as "reproductive tourism" [10]. Many different factors motivate people to travel internationally in search of IVF treatment and other forms of assisted reproduction. Cost differences between the homeland and the country of destination, ease of access in the home country (e.g., waiting times), and a non-flexible legal system, and religious, governmental, and sociocultural issues facing the availability of specific healthcare, in addition to demographic variations (e.g., longer life expectancy), and personal standards are recognized in the literature. These factors can all affect the delivery of specific health services [11, 12]. On the other hand, using a universal language, the availability of new healthcare technology environments, exceptionally skilled clinical staff, facilities of top standard (in relation to patient services and facilities), certification of the care delivered, and an advantageous and forward-moving funding culture are all components that distinguish locations in their ability to attract larger numbers of medical tourists seeking assisted reproduction care [13]. Despite the growing popularity of medical tourism, particularly for IVF procedures, the majority of studies have taken a broad EU-centric approach, with only a few studies attempting to define the issue in North Cyprus [14, 15].
The high success rates of IVF procedures in North Cyprus, along with the cheaper rates (i.e., 50% of the comparative price in European countries and nearly 25% that of the US), and the relatively liberal legislative basis trying to regulate these procedures in comparison with other countries have attracted numerous international medical tourists [16]. In the most recent research on reproductive travel, these trips have yet to be characterized. While this mode of travel has been considered, current perspectives and data on medical tourism in general have become more complicated. It also brings to light a subcategory of migratory medical tourists who need to be taken into account when conducting research on the subject. Despite the fact that there is substantial scientific literature on reproductive travel around the world, there is no practice that focuses on the mobility of migrants for medical therapy. Despite anecdotal evidence suggesting that migrants may make up a substantial portion of people who travel internationally for medical treatment [17–22].
There has been a scarcity of studies on the perspectives of infertile patients on medical and patient-centered care. The technical competence and readiness of the staff in conducting examinations and administering treatments are examples of what constitutes "medical care." Providing routine psychological support is a type of patient-centered care delivered by all staff members. Couples struggling with infertility should have access to care that is not only safe and reliable but also tailored to the needs of each individual patient [23–24]. Patient perspectives and requirements are increasingly seen as crucial determinants of healthcare quality [25–26]. In fertility treatment, however, functional outcome metrics, such as live birth rates (success) and postoperative complications (safety) continue to dominate the area of care assessment, while patient-centeredness is barely addressed. Amazingly, patient-centered care has been shown to be profitable in the treatment of chronic conditions with high emotional burden, such as infertility [27].
It is necessary to gain insight into the patient’s opinion on the treatment of infertility. The field of reproductive medicine needs to place a greater emphasis not only on "effectiveness" (the percentage of patients who become pregnant), but also on other quality parameters, most notably the degree to which patients are satisfied with the care they receive. By conducting an evaluation of patients’ perspectives, healthcare providers can gain a deeper understanding of their patients’ desires, requirements, and preferences regarding fertility services and amenities [28]. Interviews and questionnaires are commonly used to measure how satisfied patients are with their care [29–32]. This is especially crucial if doctors’ and nurses’ impressions of their patients’ experiences with treatment do not properly represent the real situation [33], because this could hinder their opportunity to make adjustments that are advantageous to their patients [34–35].
An increasing body of research suggests that infertility and its care can bring about significant social and psychological hardship and, as a result, diminish the quality of life (QoL) among people who struggle with infertility [36–39]. Therefore, QoL is an essential indicator of the impact of infertility on individuals’ daily lives. According to studies, infertility issues are one of the most distressing events one may experience [40, 41]. It is possible that the notion of health-related QoL can help shed light on which areas of life people who are contemplating IVF may be experiencing more difficulty in. The beginning of treatment may inspire hope and optimism, leading to an improvement in the QoL. Therefore, it is possible that the treatment has a favorable effect on at least some areas of health-related quality of life as well. The health-related quality of life, as experienced by the patients themselves, is becoming an increasingly popular metric when assessing the consequences of disease and treatment efficacy.
In the past, infertile patients’ quality of life was measured using a variety of general self-reported instruments. Recently, skilled professionals from all around the world have collaborated to create the Fertility Quality of Life (FertiQoL) questionnaire, a disease-specific tool designed to measure QoL in infertile men and women [42]. QoL items unique to infertility issues were included in this questionnaire. The FertiQoL has been employed for infertile patients from a wide range of cultural backgrounds, and it has been converted into 26 languages [43], as well as being shown to have adequate levels of reliability and validity [44, 45]. A small number of studies have utilized FertiQoL to evaluate quality of life and identify factors connected to it in infertile couples from different demographic backgrounds.
The purpose of this study was (1) to determine which factors contribute to patients’ overall satisfaction with IVF clinics in North Cyprus; (2) to identify background differences (age, education level, marital status, income, and region of residence) in the evaluation of patients’ quality of life and satisfaction infertility services received overseas in North Cyprus; and (3) to determine which factors are most likely to affect a patient’s overall experience.