Expert / 5 February, 2018 / Ellie Thompson
Over a year and a half ago after many routine tests, we finally earned the label ‘unexplained’ infertility – for better or for worse. I remember it well. We sat down with our NHS Consultant who told us to come back in a year’s time (we had ‘only’ been trying for 18 months) or better still – ‘Go abroad!’ she said, breezily: ‘Treat yourself to a holiday in Spain and get IVF done there!…’
I was incredulous, she made the IVF process sound so easy, when at the time, it was this big ‘thing’ that we had no knowledge of – it was unchartered territory, and scary territory at that. We discarded the idea immediately – we weren’t risk takers, and besides – I’d heard of lots of stories about other medical procedures abroad, (you know, the buttock implants, the boob jobs etc) and the sad and sorry results of them. Since documenting our journey via The Jellie Diary, we’ve come across a few people that have had very positive experiences and success with IVF treatment abroad. I wanted to explore this topic with a reputable expert in the field, so we contacted Dr Caroline Phillips, from Fertility Clinics Abroad to give us the low-down on how to seek treatment in the correct way. The following article contains questions from some of our Jellie Diary followers too.
Last year we teamed up with Fertility Network UK to look at the main drivers behind fertility tourism from the UK. You can find a link to our research here. We have some of the best health care in the world, both privately and through the NHS and yet many couples are turning their backs on the UK when it comes to having IVF.
We asked 250 couples who had undergone or were undergoing treatment to share their experiences. What they said painted a worrying picture of the state of affairs. 76% of respondents were leaving the UK because of the high cost of private fertility treatment, with three quarters saying it was twice as expensive as they were able to pay. People were generaly willing to pay between £1000 and £5000 for IVF using their own eggs, yet this treatment is often in excess of £10k in the UK when additional expenses are taken into account.
We also found many people were disappointed at the standard of care provided by some NHS funded fertility clinics. The majorty felt standards were either passable or substandard, with 44% believing it was average and 25% saying it was poor. Only 3% of respondents felt it was excellent. Most people were aggrieved that access to NHS fertility treatment was a postcode lottery, with 35% saying waiting lists were too long.
What is abundently clear from our research, is fertility tourism is a trend that is on the rise and probably here to stay – for those of you who are considering going abroad for treatment, we’ve put together five top tips as well as answers to some community questions to help you make the right choices before taking the plunge.
1) How does treatment abroad differ from the UK?
Many people from our survey said that clinics abroad offer a more personal service compared to the NHS, which can take a ‘one size fits all’ approach to care. All of the primary fertility treatments as well as add-ons that you find in the UK are available abroad, so there is little difference with regards to the treatments on offer. It is more about the standard of care.
Another major difference between the two comes down to cost. In the UK, IVF can often exceed £10K when additional expenses are taken into account, which is up to 50% more than comparable treatments abroad. According to our survey, the high cost of fertility treatment in the UK is the primary reason people go abroad. Other reasons include; greater supply of donor eggs, shorter waiting times, higher success rates and donor egg anonymity.
2) What are the logistics of the process e.g. are there some appointments that can be held in the UK? How does the transition of medical info from the UK to abroad happen etc?
Each patient will be assigned an International Coordinator who manages appointments, books travel and deals with all the day-to-day practicalities. More detail on this has been summarised in Question 4.
Some tests can be done in the UK such as mammograms and blood tests which will cut down on the time needed abroad. Most of the clinics offer Skype consultations with patients so that any pertinent information can be gathered before travel. The clinics abroad will work with your GP or health professional to ensure medical details are shared.
3) What ‘fail safes’ are there in place to protect woman?
Many clinics have ISO accreditation which regulates standards. One of your first considerations will be to check that the clinic meets these standards. Some clinics electronically tag sperm and egg samples to avoid any mix ups. All donor eggs and sperm are rigorously screened and clinics follow the European Society of Human Reproduction and Embryology guidelines (ESHRE).
4) Prior care / after care – what to expect?
There is usually an International Coordinator assigned to each patient. The IVF coordinators will look after you before, during and after your treatment. They will instruct you on when you should arrive at the clinic and facilitate the smooth running of the entire process.
They have an in-depth knowledge of the treatments and deal with all the practicalities e.g. obtaining prescriptions, booking consultations. They have an important role in directing enquiries to the most appropriate place and understanding the urgency of requests.
Nurses will also be directly involved in your care. The nurses are primarily focused on your treatment, rather than dealing with the practicalities of having treatment abroad.
You will also be assigned a Doctor or Consultant at the clinic, who is responsible for answering any medical questions and giving guidance and support throughout.
You can see a more comprehensive over view of your support team here.
5) Pharmacies in UK prescribing drugs from overseas clinics – how does that work?
This varies. A patient can usually get the drugs they need from the clinic at a cost, or your doctor can write a prescription. There are international pharmacies online.
6) How much do costs differ?
On average, the cost of IVF treatment abroad is up to 50% cheaper than the UK. Unfortunately there is no official research which compares costs between different countries, so much of the research is up to you. However in 2016, we did some of our own research based on four of the most popular destinations that offer fertility treatments:
You can find more information about costs and the main reasons why treatment in Europe is cheaper than the UK here.
7) Is there a body that oversees the clinics like the HFEA / or recommends ones to use?
Each country has their own body which overseas each country, a bit like the HFEA in the UK. For the whole of Europe, many clinics submit their results and follow best practice guidelines from ESHRE.
Dr Phillip’s ‘Top Five Tips’
Like anything in life, careful preparation is key to success and this is especially the case when planning your IVF trip abroad. Always consult with your GP and/or fertility specialist in the first instance and seek out advice from recognised bodies such as Fertility Network UK when you can. Desktop research is also an easy and affordable way of gathering useful information. Check out the forums on Mums.net or Fertility Friends or ask someone you know who has been abroad for IVF. What were their experiences?
The country you choose could be down to something as simple as personal preference or as critical as IVF age legislation. One of the more common considerations is anonymity. In the UK, the identity of egg and sperm donors is not protected by law, which can have far reaching consequences in the future. If this is a concern to you, you should look at countries where egg donations are anonymous, such as Spain, the Czech Republic and Greece.
Other considerations may include the cost of living, expense of travel or accommodation costs. Different countries also have different age limits for IVF treatment, or there may be specific laws on the number of embryos that can be transferred. These could be a deal breakers before you even step on the plane, so make sure you do your research.
Choosing a clinic can be a daunting prospect, so having ‘must have’ check list can be a useful tool. Jot down your must haves and use these to help you make your choice – if the clinic isn’t ticking the right boxes, then you can discount it from your list.
Some useful starting questions include:
Success rates are often the major determining factor for people choosing a clinic, but be warned – you need to be careful when interpreting what success actually means. For example, some clinics base their success rates on transferring more than one embryo into the womb. This can not only result in multiple pregnancies, it presents a higher risk to the patient. Always ask for a clinic’s ‘success rate per embryo transferred’ to give you a more accurate picture. If in any doubt, always seek advice from a professional before setting your heart on a clinic that promises the world.
Treatment costs tend to be fairly transparent but watch out for any “hidden” extras. For example, is the first consultation deductible from the final treatment cost? Is sedation included in the price for egg collection? Is sperm or embryo freezing included? Are there any guarantees e.g. pay for two cycles and get third free. We have developed a useful new calculator tool to help you determine the full cost of your treatment.
Dr Caroline Phillips, Fertility Clinics Abroad