Saving Money with In Vitro Fertilization Tourism

I've been writing a lot about medical tourism lately (see Why Go Abroad for Medical Care Reason #1: Cost Savings and Why Medical Tourism is Going to Be a HUGE Issue in the Future for details), but I was approaching the issue from a medical necessity viewpoint. In other words, I was only thinking that people were traveling abroad to get medical treatment because they HAD to have treatment of some kind (heart surgery, major dental work, and the like.) But it appears that people are also traveling for elective procedures including in vitro fertilization (IVF).

The size of this new trend is not yet known according to MSNBC:

While there are no overall statistics collected on overseas IVF, the Cape Fertility Clinic, where Anderson underwent her IVF, reports 10 to 15 patients from the U.S. per month so far in 2007, roughly double the numbers it saw in 2006. And last month’s media reports on the 60-year-old New Jersey woman who gave birth to twins, produced after a visit to a South African fertility clinic specializing in older patients, will likely serve to increase those numbers — especially among women who seek to have children later in life.

The main reason women go overseas for this sort of procedure is the same reason people travel for other medical issues -- it saves a ton of money. Consider this:

By traveling abroad for fertility procedures, women can pay thousands of dollars less than what they’d spend at home.

The average cost of IVF in the U.S. is currently about $12,000 per cycle, according to Pamela Madsen, executive director and founder of the American Fertility Association, a patient education and advocacy group. The cost of [Anderson's] three-week IVF vacation? About $6,400, including airfare and hotel stay. Anderson’s IVF — including drugs, procedures, and lab and hospital fees — accounted for just $3,600 of that total.

Fran and her husband were faced with paying for the treatment out of pocket, as their insurance wouldn’t cover it due to Fran’s age. Doubting that she’d have success with her own, Fran and her husband decided to use donor eggs, but after researching the local options, she says they learned they could expect to pay about $30,000. In April, Fran and her husband traveled to the Czech Republic. Two weeks and about $12,500 later — including the cost of donor eggs, drugs and procedures, as well as airfare, transportation, food and accommodation for two — she’d been implanted with three embryos. (According to ivfvacation.com, couples using donor eggs can usually expect to pay about $7,300, excluding airfare; women using their own eggs typically pay $5,700.)

But, like with medical tourism of any kind, there are safety issues to be considered:

But some experts caution women to look carefully at the standards, practices and success rates of foreign clinics, especially those that are located in poorer countries and offer donor eggs. By going overseas, women may be paying for a procedure that has a lower chance of success than in the U.S. And there’s been at least one reported case of a Romanian clinic recruiting illiterate donors and failing to take appropriate measures to make sure that those donors were giving fully informed consent.

In the end, you need to do your research to select a good overseas clinic:

He advises women to do their homework when considering a clinic abroad. “Look at the credentials of the hospital,” he says. 

I wonder what else people will start traveling for now. Facelifts? Liposuction? Breast enhancements? Seems like the list is growing.

Comments

[plonkee]

Actually its quite common for people to travel abroad, mostly to Italy for IVF from the UK as they have less strict rules on who is eligible and how many cycles that you can have.

[serenity]

Actually, in order for my husband and I to have children, IVF *is* medically neccessary.

Infertility is a medical condition. Putting IVF in the same basket as breast implants, facelifts, and liposuction is irresponsible.

[IVFer]

It is quite obvious after reading your article that you have never experienced the heart-wrenching emotions of infertility, therefore, you should not be commenting on something with which you have no first-hand experience. No credible doctor would do IVF simply because someone "wanted" it, as they would with breast implants, liposuction or rhinoplasty. IVF is done because it is medically necessary in order to produce a child for some couples, not because anyone necessarily "wants" to have it done.

[FMF]

"It is quite obvious after reading your article that you have never experienced the heart-wrenching emotions of infertility."

This is not a true statement. I know far more about it than I ever wanted to. I'm not going to go into details, but I'll just say you are extremely mistaken in your opinion.

To clarify my words:

No one HAS to have a child. They may WANT one, but IVF is not a medically necessary procedure for survival. People live all the time without children (many by choice, some not) or they take alternative methods like adoption. So when I refer to IVF not being necessary, I mean it from the standpoint that it's not a procedure people have to fix a life-threatening problem. It's an elective process -- a choice -- that people make when they want a child but can't have one.

In contrast, a heart transplant, appendix surgery, major dental work (if you want to keep eating) and the like are medically necessary. That's the point I was trying to make.

I guess you could argue that breast reduction is medically necessary in some cases (such as when large breasts cause medical/back problems), but this is the exception rather than the rule, hence I wasn't focusing on it.

All this said, I'm not minimizing the pain and emotions that go along with not having a child. I know exactly what people in that circumstance are going through. And while IVF is an option to those people, it is an elective procedure, and thus, not medically necessary.

[squarepeg]

Where do we draw the line of medical necessity? Is it at what you need to NOT die? In that case, no one really needs dental work. Sure you might not have teeth, but you can suck down nutrition through a straw. Would you like hip replacement surgery? Well that's not necessary - it's cosmetic, you can always use a wheel chair.

The reason couples are going overseas for infertilty treatment is because insurance companies here consider infertilty treatment "not medically necessary," as you do, and thus have to pay out of pocket for treatment at the rates the market will bear. If more insurance companies did the research, they would find that the cost of covering infertility treatment is minimal. Sure not everyone would want to pay an extra few dollars a month so that infertile couples can have access to IVF, but then again, I don't much care for subsidizing the C-sections of all of those who can have children. Or for the lung transplants of those who smoke. Or the heart surgeries of those who overeat and don't exercise. It all events out.

Finally, I would like to point out that while yes, one can and does survive without reproducing, the ENTIRE point of us being on the planet as humans is to MAKE MORE HUMANS. It might not be all we CAN do, but it is our biological imperitive. So while not having children might not prevent us from eating and breathing, from a strictly evolutionary standpoint, it might as well.

I'm sorry you apparently suffered from infertility - though for someone who went through it, your sensitivity to others still in the trenches seems, well, lacking.

[Zippy]

While I don't disagree with the notion that IVF is not a medical necessity (defined as a life or death procedure), it is irresponsible and unfeeling to compare it to having a breast augmentation or a nose job. Given your own alleged infertility experience, I would have hoped that you would be more compassionate.

[FMF]

Squarepeg --

Obviously, this is an emotional issue for you. It was for me at one point too.

The main point of the piece is really that people are going overseas for more and more treatments. However, we're now off on a tangent issue. I'll make one more comment here and then let it go.

If you want to go "evolutionary" on the issue (note: I did not bring this up, you did), couldn't IVF be seen as circumnavigating nature (i.e. creating a child where one wouldn't naturally occur) and in opposition to the whole "survival of the fittest" theory? Maybe infertility in some couples is the way nature keeps the human race strong.

Now I don't believe this, but you suggested the concept and it seems like a logical extension of what you were saying.

Another thought: just because some couples can not have children doesn't mean the human race is doomed. There are more than enough children in the world being born. Look at population numbers, the numbers of orphans worldwide, etc.

I'm not trying to be harsh or insensitive (though I understand that written text on a computer screen can be read many ways and is often impersonal). To tell the truth, I don't really care if people have IVF, breast enhancements, heart surgery, dental work, or whatever. In the end, people can spend their money however they want. I'm simply fascinated by the fact that more and more people are getting medical procedures of any kind (and in increasing numbers for increasing numbers of ailments) overseas.

[squarepeg]

FMF - you're absolutely right - perhaps WE (I'm assuming you're included in this) were never meant to have children and this is evolution's way of cutting us out. And maybe people with cancer were meant to die. Could be. That doesn't mean we shouldn't treat these ailments, as they are each real diseases. I'm not advocating we use evolution as our only metric - I mentione it only to point out that it is dangerous to offhandedly declare something as evocative as infertility treatment as "not medically necessary."

I know we're off on a tangent; your post was provocative though, and while you claim to not care, lumping infertility treatment in with something as frivolous as botox is going to ruffle feathers. Don't backpeddle by saying you just find it "fascinating." There was judgement implicit in that comparison - if you're not trying to be insensitive, don't make ludicrous comparisons.

I too will butt out now.

[Trish]

Perhaps a better comparison with infertility would be a torn ACL. Will you die from it? No. Will it cause you pain for the rest of your life- probably. Would anyone suggest that it wasn't "medically necessary" to fix? Doubtful.

Even the evil health insurance companies will pay for a knee surgery.

Just because something won't kill you doesn't mean it's "elective."

[Just my $0.02]

Where do you draw the line at "medically necessary"? It seems to me that your definition is pretty subjective.

Should a fertile couple with a child with cancer not be allowed to have the child treated for said cancer because they could always have another child? Don't give people vaccinations because they cost money? One could argue these points given your definition.

[FMF]

Ok, maybe we say "practically necessary."

For example, an insurance company will pay for knee surgery but not IVF. They'll pay for cancer treatment but not Lasik (at least most won't.) Why is this?

I contend that they should pay for IVF. And am lucky enough to live in a state that agrees with me. (Illinois- mandatory coverage.)

I don't think it compares to Lasik because there is a cheaper, easier, less invasive treatment to poor vision- Glasses. IF glasses couldn't fix it, you could probably fight the insurance company and win.

With IF coverage, I'm required to try the cheaper, easier, less invasive stuff first. That's reasonable. There are rules and I see no problem with that. If I can take Clomid & get pregnant, IVF is a bit of overkill.

That's a bit off the subject of the original article.

I have a question. What exactly were you getting at with the article that started this? Do you think that people shouldn't do IVF? Shouldn't travel to do IVF? I don't really get a sense of your point and I'm interested.

I mean, quite honestly, who cares if someone travels to SA to do IVF? Honestly, (though I think the two are extremely different) who cares if they go to SA to get a facelift. If I want to have some lipo and do some research and find a good clinic in SA that will do it for half or a third of what it would cost in the States, why not?
It's my money.. yes?

[Trish]

Sorry, last post was by me, I didn't realize I wasn't signed in.

I have to admit to being offended by this article. Yes, I think that IVF is an elective medical treatment. No, I don't think that it can be classified as "medically necessary", although, like a previous poster, my husband and I can't produce a child who is biologically ours without IVF. However, I also don't think that it deserves to be classified as the step right before liposuction or a face lift. I like that the author is bringing this up as a "Wow, I never thought of this." situation, but dislike the comparison to what I consider to be far more frivolous medical procedures.

[FMF]

Trish --

To answer your question, I was originally getting at the fact that people are travelling more and more for a wider variety of medical procedures. This seems like a new and growing trend, one I think will continue as health care costs keep rising in the US.

[Trish]

Okay. Just informational. I can live with that.
The tone at the end just came off (the way I read it, anyway) a little bit like "gee, how crazy will people get.." and I think that's where some of the responses are coming from.