Cosmopolitan Conceptions: IVF Sojourns in Global Dubai by Marcia C. Inhorn (review)

Marcia Inhorn presents a rich and compelling account of infertile couples’ quests to conceive a child in her ethnography, Cosmopolitan Conceptions: IVF Sojourns in Global Dubai. Inhorn details the experiences of couples who have traveled to Dubai for in vitro fertilization (IVF), the process that “essentially bypasses the fallopian tubes by hormonally stimulating the ovaries to produce excess eggs, removing those eggs directly from the ovaries, mixing them with spermatozoa in a petri dish, and then transferring the fertilized embryos into a woman’s uterus” (p. 4).

This book is based on meticulous ethnographic research in a clinic called Conceive, which is the largest private IVF clinic in the United Arab Emirates. Inhorn conducted in-depth interviews with 219 men and women from 50 countries over a six-month period in 2007, with follow-up trips to the clinic over the next few years and interviews with clinic staff in 2012 and 2013. The “reprotravelers” (p. 19) hailed from “an equal number of Middle Eastern (fifteen) and European nations (fifteen), followed by an equal number of Asian (nine) and African (eight) countries” (p. 55). Infertile couples from South Asia were the main patient population at Conceive and were also the largest group included in the study. Many of those she interviewed were living in the UAE, but originally from other countries, or they traveled to Dubai to seek IVF at Conceive, while others were from the UAE but had traveled across borders for privacy reasons.

Inhorn’s decision to locate this study in Dubai was inspired by her previous work on infertility and reproductive technologies in countries like Egypt and Lebanon. She recalls, “Dubai, in particular, was evoked by Lebanese men as a kind of dream space” (p. 18-19). She was captured by these types of descriptions and with some encouragement from an IVF colleague in Lebanon who was in the process of opening clinics in Abu Dhabi and Dubai, Inhorn designed a study that focused on the “intersection of reproductive travel and the process of globalization” (p. 19). The pace of economic growth and development in Dubai is nearly unrivaled with rapid expansion occurring across many different domains, such as banking, technology, real estate, and tourism. A well-known scholar of infertility in the Middle East, Inhorn discusses how this study is set apart from her previous research given its location in such a global and cosmopolitan place. She writes, “Having worked exclusively in Arab-serving clinics in Arab countries, I had never before grasped the meaning of ‘infertility around the globe’ … At Conceive I truly witnessed the global scope of infertility as a reproductive health problems” (p. 55). Even the clinic’s founding physician hailed from India originally.

Through a presentation of what she terms “reprotravel stories” (p. 28), Inhorn levels a theoretical critique at “reproductive tourism,” a term coined in the early twenty-first century “to describe the movement of IVF-seeking couples across international borders” (p. 5) particularly due to countries’ laws and regulations that restrict the use of IVF. The word “tourist” is not the correct term to use in describing the majority of infertile couples included in her study because they did not want to travel outside of their home countries for IVF, but were forced to because safe, quality, and affordable services were not available. Many of the “reprot-ravelers” had also experienced difficult journeys across regional and international borders. Some of her interviewees suggested that tourism was an “insensitive term, making a mockery of infertile people’s heartbreak and suffering” (p. 7). Patients experienced financial hardships in seeking IVF at Conceive, as well as frustration and sadness when the procedure did not work. Bringing these stories to light makes it clear that traveling for IVF is not a leisurely tourist activity, but rather it is one that is wrought with legal complexities, personal anguish, along with moral and ethical questions.

One of the many strengths of the book is that...