It’s a Big, Fertile World
Other locales worldwide are also promising for “fertility tourists.” Buenos Aires, Argentina, for example, is the medical-specialty training capital for physicians from countries throughout South America, including for infertility treatments. The highly sophisticated city, dubbed the “Paris of South America,” was where Darla Huaman, a schoolteacher from Waconia, Minnesota, and her husband chose to go when Darla was unable to become pregnant a second time. Thanks to that trip, Darla is now expecting another child in May.
After her 6-year-old daughter Katherine was born (the couple also have an adopted 21-year-old daughter), Darla, then 38, had two miscarriages. “My gynecologist just told us to keep trying. So we did for six years. I wish he’d suggested fertility treatment, but he didn’t.”
Darla, now 44, realized that as time went by, her eggs were aging, too. She went online in the spring of 2009 and spent hours researching fertility clinics around the world. She chose Demián Glujovsky, M.D., who had practiced at the Center for Women’s Reproductive Care at Columbia University in New York City. A reproductive endocrinologist and ob/gyn, he started the first fertility clinic in Argentina 27 years ago: the Centro de Estudios en Ginecología y Reproducción, or Center of Studies in Gynecology and Reproduction.
The Huamans contacted Dr. Glujovsky in June 2009, and by the middle of August the couple were in Argentina. “He always responded efficiently,” says Darla of Dr. Glujovsky. “His English is excellent, and we both speak Spanish. He sent a prescription for the fertility drugs to our doctor here, and he talked to our doctor on the phone. He was very encouraging to us. Plus, he put us in touch with two American couples who had been treated there as references. Our insurance, HealthPartners, covered most of the testing before we left.”
The couple used frequent-flyer miles, instead of paying $800 each for round-trip tickets to Buenos Aires, and spent $75 a night for a “lovely” two-bedroom apartment near the clinic. “The clinic was the same quality as an American one, the medical staff all spoke English, our appointments were on time,” says Darla.
For egg-donor IVF, their son-to-be cost $4,600. “My husband is currently in business school, so there is no way we could have afforded the cost in the States. We would have had to give up,” says Darla. “We were at our Minnesota state fair in September when we got the phone call that we were pregnant. I was in the midway bawling my head off, I was so thrilled.”
Insurance Companies Getting on Board
The most popular destinations for Americans traveling abroad for fertility treatments in state-of-the-art facilities include: Argentina, Australia, Barbados, Colombia, Cyprus, Czech Republic, France, Germany, India, Israel, Mexico, Panama, Singapore, South Africa, Turkey, and Thailand. Malaysia, Dubai, and Cuba are also beginning to offer such services. For Western couples wanting Caucasian children it has become popular to use egg donors from the previous Soviet state of Georgia who are willing to travel to India where surrogates then carry the fertilized egg. And then there is medical tourism “light” in Puerto Rico, an American territory close to home, no passport needed, where U.S. dollars are used, and American medical malpractice laws are in force. There, fertility treatments at two hospitals represented by HIMAHEALTH (himahealth.com) cost 50 to 70 percent less than in continental America, with bilingual, U.S.-trained and board-certified physicians.
HIMAHEALTH and Patients Without Borders are just two of a growing number of medical travel facilitators that organize packages from airfare to medical services, providing interpreters where needed, reserving accommodations and chauffeured vehicles—even providing cell phones with doctors’ numbers programmed in, and loaner laptops so homesick parents-to-be can stay in touch with friends and family back home.
Companion Global Healthcare is one such company, operating in 26 hospitals in 13 countries; it is also a wholly owned subsidiary of BlueCross BlueShield of South Carolina. “The majority of large employers in the U.S., those with over 250 employees, are self-insured. In those cases, the health plan is basically providing only administrative services and will cover IVF if the employer wishes it covered,” says David Boucher, CGH’s president. “Some 10 percent of employers do cover it, but usually set a limit on the annual expense, such as $10,000 per annum. I don’t see this cap necessarily being increased because IVF is now increasingly being made available abroad.” Boucher says that health insurers are now beginning to recognize they can save dollars by sending clients abroad for first-class health care. “We are at the very, very early stage of this insurance trend,” he points out. “Employers are only just now starting to catch on.”
UnitedHealthcare says it is “actively exploring the development of a medical tourism product, based on customer interest.”
And Aetna points out that many Americans are not aware that if their health plan provides coverage for out-of-network medical services, they can access those services from any out-of-network provider, assuming the plan covers fertility treatments. “It doesn’t matter whether that provider is located in the U.S. or in another country, unless the plan has an out-of-country exclusion,” points out Christine Erb, Aetna’s spokesperson. “With Aetna, the member must still obtain precertification where necessary, in order to have a procedure covered. And benefits are only available for services covered under the plan. Out-of-pocket costs may apply.”
As more Americans have shown interest in traveling abroad for treatment, the American Medical Association now has guidelines for medical tourism, and the American Fertility Association newly states: “We support a person’s right to determine where they obtain fertility treatment, whether in the U.S. or abroad, as long as they educate themselves thoroughly on the risks that may be involved legally, medically, and politically in their country of choice. They should also discuss the matter with medical and legal professionals here before they embark on their journey.”
Fertility in Paradise
Some 70 percent of Americans—213 million people—do not have passports, and the idea of not only traveling overseas, but of traveling overseas for medical treatment, may be frightening. But couples who’ve done it, and brought back a baby or come home pregnant, say overcoming the apprehension is more than worth it.
Heather DuPree and her husband, David, of Spokane, Washington, visited the Barbados Fertility Clinic on the beautiful Caribbean island for a “holiday with a purpose,” after 12 years of trying and two excruciating ectopic pregnancies. The couple now has an adorable 10-month old daughter, Violet, as a souvenir of the trip. “From the moment we arrived, we felt like we were in loving, highly experienced hands,” says Heather, 37. Medical personnel there are either European- or Canadian-trained, and their senior embryologist is a former scientific inspector for the Human Fertilisation and Embryology Authority of the British government. “The first thing they told us to do when we arrived was take a walk along the beach to relax,” she recalls. “[They said that] when stress goes down, pregnancy rates go up. For us, they were right.”
Being prescribed a stroll with your husband on a white sandy beach, under palm trees, at the edge of a turquoise ocean, doesn’t seem like hard fertility medicine to swallow!
