For West European couples unable to conceive children, the Czech Republic has become a destination of hope. The country's 23 centers for assisted reproduction offer not only services remarkably cheaper than in Western Europe, but also high-quality treatment with a high success rate.

Because assisted reproduction can involve the destruction of fertile eggs and embryos, much of Western Europe has strict legislation that prevents doctors from trying all available methods. Czech doctors, however, are not bound by such laws and are thus free to employ techniques considered controversial elsewhere.

"People from abroad don't come just because we are cheaper — their main reason is we have better results," says Hana Višňová, a doctor from the Center for Assisted Reproduction in Plzeň.

Some 70 percent of the clinic's patients are from abroad. Some other centers boast similar percentages of foreign clients, although official nationwide figures won't be out until later next year.

The 37.8 percent success rate for assisted reproduction in the Czech Republic is about the same as in the United States, but it's better than in European countries with legal restrictions. In Germany, for example, it's only 27 percent.

But treatment costs in the Czech Republic are also a big part of the attraction.

IVF attempts are usually conducted in 10-day cycles, and the price for one cycle (including medication) is 50,000-60,000 Kč ($2,400-2,850), while in London it's $7,000 per cycle and in Italy about $8,500. In the United States, one cycle can cost as much as $18,500.

Czech women under 40, meanwhile, have free access to IVF, with the first three cycles covered by insurance.

Expertise is also a factor; the first "test tube" baby was born in the Czech Republic in 1982, four years after the world's first IVF baby, Louise Brown, was born in the United Kingdom. Now, IVF babies account for three percent of all newborns.

"Since 1982, the research and new methods in this field have been progressing like an avalanche," says Igor Crha, a gynecologist and obstetrician from Brno's Teaching Hospital, where the country's first assisted reproduction clinic was established.

Crha doesn't hide his scorn for other countries' ethics rules, calling them "pseudo-humanistic views" by groups that "have not been strong enough here to force restrictions on us."

But, even in the Czech Republic, some voices are calling for limits on the use of embryos. One of them is Josef Kuře, a professor of philosophy at Masaryk University in Brno, who calls for a change of the legislation. "Minimal attention is devoted to the ethical aspects of IVF," says Kuře, who calls Czech assisted-reproduction methods "immoral."

The first Czech regulations on assisted reproduction were issued in June 2006, but these only set age limits. Only women under 40 can have three IVF cycles covered by insurance, and sperm donors cannot be older than 40, while the age limit to donate eggs is 35. Limits don't apply to couples and partners.

Tomáš Cikrt, Health Ministry spokesman, acknowledges the concerns in Western Europe but says, "There has not been any pressure from the EU on the Czech Republic to tighten the rules."

The regulatory environment varies significantly across Europe. Germans, the biggest foreign group seeking assisted reproduction in the Czech Republic, have some of the most rigid limits. For example, a maximum of three embryos can be used for one try and if all of them happen to be fertilized, triplets are transferred into the mother's womb because none of the embryos can be destroyed or frozen for further use.

"With only three eggs, the chance of fertilization is lower, but it can also happen that two or even all three eggs are fertilized, and then with twins or triplets the health risk involved is higher," says Tonko Mardešiç, head of Pronatal Clinic, a private assisted reproduction center in Prague 4.

In Germany, the greater protections for embryos are based as much on 20th-century history — Nazi genetic experiments in particular — as on independent moral concerns. "After the Nazi era, any manipulation of the embryo has been guarded against in Germany," says Matěj Stejskal, director of Gennet, another IVF center in Prague.

In Italy, by contrast, laws concerning embryos are rooted mainly in religious ethics.

And, while in Germany egg donation is not permitted, in Britain women are allowed to donate eggs but may not be paid more than $40, which results in a shortage. For Britons, this has been a key reason for embarking on what some term Czech medical tourism.

"People from abroad usually come here after previous treatment in their country," Višňová says. "They see more can be done, and they don't want to sit and wait while their biological clock ticks away."

Crha agrees, noting that, for both men and women, the ability to reproduce decreases by 40 percent after the age of 35, and, in women over 40, the success rate of IVF is only 10 percent.