Sometimes the journey to pregnancy takes a woman far from home and, increasingly, to other countries.
Several years ago, a woman I knew told me she was thinking about going to Brazil for a facelift, where the cost was significantly lower than in the U.S. “That’s crazy!” my boyfriend at the time—her son—and I cried. We desperately tried to talk her out of it. “Why would you do something so risky?”
Recently, Mara Yacobi, who lives in Edgewater, New Jersey, added to the many stories I’d been hearing about women going out of the country not for cosmetic surgery, but for fertility treatments. She’d just spent five weeks in Tel Aviv where she underwent in vitro fertilization (IVF)—at less than half the cost of most American clinics. “Hmm,” I thought to myself, “that’s not such a bad idea.”
Have times changed so dramatically that what once sounded outlandish and scary now sounds rational and perhaps even logical? Or is just that extreme measures are easier to rationalize when it involves having a baby? Is it in fact a good idea to go out of the country for IVF?
As you’d expect, the American medical community can give fertility-challenged women a lot of reasons—and a lot of valid reasons—for staying stateside. But many women who need fertility treatments are finding that there can also be valid reasons for getting on a plane.
Bargain Travel for Fertility Treatment
Nobody knows how many people are leaving the country for assisted reproduction, though the numbers don’t appear to be big enough to have taken a bite out of IVF commerce here. According to the American Society for Reproductive Medicine (ASRM), its members aren’t reporting any drop-off in business. Still, there are signs that fertility (or reproductive) tourism (as it’s often called) is on the rise, with destinations as diverse as India, Israel, South Africa, Canada, Mexico, and Central Europe. “It’s almost impossible to calculate exact numbers, but everyone I have spoken to says it’s growing—in both directions,” says Debora Spar, Ph.D., professor and senior associate dean at Harvard Business School, who researched the topic for her book, The Baby Business (Harvard Business School Press, 2006). “One big donated egg brokerage in California told me that a third of their business is from foreigners.”
When people from other countries come to the United States for assisted reproduction, it’s usually because clinics here offer procedures that are outlawed in their own countries. Chile, Romania, and Norway, for example, don’t allow oocyte preservation, the process of freezing unfertilized eggs for later use. Some countries don’t allow egg or sperm donation use in IVF; others have outlawed surrogacy. Some foreigners also come to the U.S. because they don’t qualify for treatment in their own countries. Many Middle Eastern and Asian countries, for instance, require that patients receiving assisted reproduction be married. Other countries—Germany and France, included—require proof of a stable relationship.
Americans, on the other hand, almost always travel for financial reasons: For those whose health insurance won’t cover the cost (that is, most Americans), the procedure can be one-half to one-third the price outside the U.S. That, notes Spar, opens it up to people who otherwise probably wouldn’t be able to afford IVF.
That fact wasn’t lost on Jodi Simon, who recently made plans to travel to Toronto for IVF. Simon, 32, a cattle rancher in rural Montana, is the mother of three children from a previous marriage. Yet she and her second husband haven’t been so lucky: Simon had two ectopic pregnancies, which resulted in the removal of both fallopian tubes. So while her ovaries are still producing eggs, there’s no way for the eggs to be fertilized naturally. IVF is the couple’s only hope. Nonetheless, their insurance company declined any financial help, so Simon started doing some research on the Internet. “I came across a clinic in Toronto and couldn’t believe how low the price was,” she recalls. “Then I saw that all the Canadian clinics were priced that way.”