For many American couples, getting pregnant and having a baby is hard. Infertility is not being able to become pregnant after a year of trying through unprotected sex. Infertility affects about six percent of couples in the U.S. and increases with age. 
Assisted reproductive technology or in vitro fertilization (IVF) has been a welcome option for many of these couples. Fifty thousand babies are now born in the U.S. every year using IVF. However, IVF comes with a big price tag. 
Paying for IVF in the U.S. can be a major stumbling block. A single IVF cycle can cost up to $15,000. A repeat cycle using frozen embryos can add another $7,000. Fertility medications can add up to $5,000 more. Genetic screening, using a surrogate donor, and special techniques like sperm injection can add even more cost. 
Insurance coverage in the U.S. is just a hot mess. Some states mandate some coverage and some don’t. Insurance may cover some of IVF but not all, and may place a lifetime limit on what is covered. Long-story-short, out-of-pocket costs can be out of reach for many couples. This has led many to consider travelling abroad for IVF, also called fertility tourism. 
What Is Fertility Tourism?
The U.S. is not the only country that offers high quality IVF. About 50 million babies are born around the world using IVF, and many offer treatment at 50 to 60 percent less than in America. This could add up to many thousands of dollars. Counties that offer IVF to Americans include Spain, Barbados, Israel, Greece, Mexico, Panama, and South Africa. [4,5] According to the organization Patients Beyond Borders, Barbados and Israel are among the most popular destinations with proven success rates. 
Of course, finding the best clinic and jumping through all the hoops to get started is complicated. So it is not surprising that agencies have sprung up, some sponsored by foreign countries, to ease the process. But, if you are considering travelling abroad for IVF, you need to do your homework. You can’t go to the CDC website and find out about the success rates of these IVF clinics. [4,5]
You will need to talk to the clinic and find out about their certifications and success rates. One thing to look for is certification from the Joint Commission International (JCI). When asking about success rates, you want to know the live birth rate and the multiple pregnancy rate. You should ask if the success rate is self-reported or verified by a government or international agency. Other questions to consider: [4,5]
- What is the cost and what does it include? Add in the cost of accommodations and travel.
- Does the clinic treat same-sex couples? Many do not.
- Does the clinic treat single women?
- If donor sperm or egg is used, what is the screening process and the rules about anonymity?
- Are you allowed to send frozen sperm or frozen embryos before you arrive?
- How do you prepare before arriving at the clinic?
- What type of contact will you have with the clinic after you return home?
- If you create frozen embryos at the clinic, what happens to those embryos if you do not use them?
What to Expect
One pitch that clinics in beautiful places or interesting destinations may use is that going through the process of IVF in a vacation setting reduces stress and increases success rates. Although there is no evidence to support this claim, it does make sense. You may feel more at ease being away from home in a place where you have privacy and a sense of being on vacation. 
Once you have chosen a destination for IVF, the process may go something like this: 
- Check with your pregnancy care provider at home to make sure he or she will be willing to take care of you before you leave, and pick up your care after you return.
- Expect a waiting period of a few to several months, depending on the waiting list of the clinic. This will give you time to get your passport or visa and to do your pretreatment medications at home.
- Pretreatment medications are needed to synchronize your ovulation cycle before IVF. Your clinic may send you the medications, get you in touch with an overseas pharmacy, or send you prescriptions to get at home.
- If you are having a basic fresh egg retrieval and implantation, expect to spend about 7 to 10 days at your destination. If you are having a repeat cycle with frozen embryo, it may only be two to three days.
- After IVF, you may be asked to wait one or two days before flying.
- Your clinic should give you a complete report and instructions for home care when you leave.
- You should be able to do a pregnancy test at home and pick up your pregnancy care with your home pregnancy provider if your IVF is successful. The clinic will want to know if your treatment was successful and they should give you options for follow-up treatment if the treatment was not successful.
IVF abroad is an option to consider if you can’t afford IVF treatment at home. It requires a lot of effort and research on your part and an OB-GYN doctor at home willing to cooperate. If all goes well, it could be well worth the time and the trip. [2-5]