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Infertility

Travelling abroad for fertility treatment

Some people chose to travel abroad to have treatment, mostly when using donor eggs or sperm. This is often known as cross border reproductive care.

Naomi and Martin had had treatment unsuccessfully in England and had been told that they would need to consider using donor eggs. When they started to research the availability of donor eggs, they were excited by the availability in Spain, where the waiting lists appeared to be much shorter than in the UK.

 

Martin was excited to discover that the success rate at the Spanish clinic was 65% for dual donor...

Martin was excited to discover that the success rate at the Spanish clinic was 65% for dual donor...

Age at interview: 41
Sex: Male
Age at diagnosis: 35
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So we were ready to start again and we started looking into abroad because of the availability of donors and also the success rates, and it became really quite exciting when we started to read that with dual donor in Spain was 65% of success. We could actually have lots in our favour for once and there could be more chance of it working than not working. It was fantastic, an unbelievable scenario. It’s scary and people talk about overseas as if it’s one place, you know, it’s bad overseas it’s not regulated but where precisely are we talking because it’s not one place. And that a point that I would immediately keep making, because ‘overseas’ isn’t this deregulated nightmare that people sometimes paint the picture of.

Martin and his wife decided to try Spain because they knew a few people online who had had treatment there and recommended it.

 

Naomi describes how they were very impressed with the professionalism and facilities at the...

Naomi describes how they were very impressed with the professionalism and facilities at the...

Age at interview: 35
Sex: Female
Age at diagnosis: 30
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The [city] experience was fantastic. We went out there for an initial visit and we tied it in with a summer (break) which was great. We had five days in [city], went to the clinic for a couple of hours. We went for two or three trips to the clinic in the end. But we had never been to [city] before. Lovely city. Fantastic city. City break and a beach. It was just great. 
 
But the clinic was amazing. It was, the moment we decided that we’d sign up, or the moment that we enquired about treatment there we were assigned coordinator who spoke completely fluent English, was very efficient about getting back to us about things. No communication issues at all. Probably easier communication than we had with our clinic in the UK actually.
 
The doctor that we met, she spoke fluent, she was fluent in English, but had she not been our coordinator would have been able to interpret anyway. But the clinical facilities there are amazing, absolutely amazing. They are just, it was just for embryo transfer. I mean I have no idea about egg collections because obviously they weren’t my eggs. I didn’t do egg collection. But just for embryo transfer it was, you know, my husband was in full scrubs. You get your own room for you know, waiting in, and you wheeled back there afterwards for recovery. And it was just so, it seemed so far advanced in relation to what most clinics are like over here. I mean the clinic we went to is a very good clinic. But it is not a patch on how they did things over there. 
 
And you do have to wonder if the way that they do things over there contributes to the fact that actually have very, very good success rates.
 
 

Like many people, Martin felt he was naive about treatment abroad. He wants to use his very positive experience to help others make decisions about going abroad for treatment.

Like many people, Martin felt he was naive about treatment abroad. He wants to use his very positive experience to help others make decisions about going abroad for treatment.

Age at interview: 41
Sex: Male
Age at diagnosis: 35
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But there are a lot of people that very naïve about overseas treatment. They think it’s going to be a dingy back room down some side street, and somewhere that doesn’t speak any English. That’s fair I think our expectation wasn’t far off that when we started. But you, talking to people, and we went and viewed in our case, but it’s learning about it. Once you are not naïve and ignorant, you have learnt about it, you can make a judgement. And, you know, I would like to help as many people as possible, who might be considering it, but have shut that door because of their preconception of what it is and actually show them that it isn’t like that. But every country is different. You know, we have got people who have gone to Russia, the Ukraine, their experiences are very different. Not necessarily negative, just very different to, but they had reasons to go to those countries. Sometimes it’s to do with the ethnicity of their background is Eastern European origin then you might be more inclined to go to an Eastern European country. If you’re an India person then probably India’s a good place to go. And it’s important that you speak to people who have been, and do your research and understand, and if you can get there in advance and check the place out, that is not always possible, the further afield it is, but certainly learn as much as you can, because you, if you don’t talk to people about it, then you really make pre, pre, you know, judgements. And I think you’ll be surprised by what is out there. You’ll come home and be shocked by what we do here when you see how it’s done in other countries. 

Martin and Naomi went to the clinic is Spain expecting to use donor eggs with Martin’s sperm. But when they got there they were advised to use donor sperm as well. They decided very quickly to go for dual donor. Martin describes the next steps.

 

Despite a setback, Martin explains that everything was handled well and contrasted favourably...

Despite a setback, Martin explains that everything was handled well and contrasted favourably...

Age at interview: 41
Sex: Male
Age at diagnosis: 35
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So when we came back, we signed the forms, we’d made the decision, press the button, five weeks later the phones rings, we have a donor. So… massively excited. 
 
This time it is different because we have taken all our bits out of the equation that obviously are causing a problem someone along the line. Here we have healthy people, that are screened, for actually everything. We know they going to be fairly young, everything will be perfect for them. So the odds are that the embryos will be great quality, there is a 65% chance of success. Odds are in our favour. And pretty well everybody we know on the bulletin boards that’s going there, it was positive. It worked. So were so excited by that.
 
So we were aware we had been matched, they started the drug protocol on the donor, we now have a rough time line for when to prepare to go out to Spain. And at the eleventh hour we were waiting for the phone call to say, “Get on the plane.” And we get the phone call to say that “We’ve taken her off the drug protocol and the treatment was aborted. 
 
Another setback, another massive disappointment really, you know, we expected to be flying out to [city] in 24 hours and here we are back on the shelf again. But it’s not for the reason it was before. This is just a delay, this isn’t a failure, it’s not like the cycle has gone wrong. It was just that our expectations were gone, the excitement was there, and there was a setback.
 
Anyway, we got on with our lives, okay, you know, the phone would ring again shortly and in a couple of weeks it did, and they had a new donor, donors. So, that was great, and this time it went absolutely perfectly and we did get that call to say, “Get on the plane. We’ve got some great embryos.” 
 
And went over to the clinic and did transfer and it was a totally different experience to this country. I went into again when they put the embryos through the transfer, but this wasn’t a room off a corridor, this was a proper operating room. I had to wear scrubs, you know, we had to absolutely decontaminate, there was no playing around here. Whereas in the UK it was a room off a corridor. You know the difference, I can’t really start to explain. And the professionalism that we saw out there.
 
And it was very well done and they put it in, and then there is no sort of rushing you out, time to go. [wife] went into a private room for recovery and she was on the bed and a couple of hours lying down just to make sure we didn’t disturb anything, and then in our own time we leave. We had a couple of nice days in [city] and then back on the plane come home. Two week wait. 
 

Their treatment was successful first time and they conceived twins.

Susan also went for treatment in Spain. She had had many years of treatment for endometriosis and pelvic pain and unsuccessful attempts at egg donation in the UK. For her last treatment she decided to try Spain. Her doctor explained that there was a cultural difference in attitudes to donation in Spain; this meant that there was no shortage of donors.

 

Although her treatment was unsuccessful, Susan was very impressed with the level of care and the...

Although her treatment was unsuccessful, Susan was very impressed with the level of care and the...

Age at interview: 52
Sex: Female
Age at diagnosis: 25
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He was very interested you now to listen to... what I, you know my story. And... also quite sad I think that... and he actually got, went into a great deal of depth, you know, about the way they operate their egg donation programme. It is about the largest egg donation programme in the world and explained also the cultural attitude towards donation, egg donation. Well not just egg donation, organ donation in Spain, they have a very different cultural attitude that is very much more favourable to donating in general and they have no shortage of egg donors. And he, you know, explained some of the reasons for that, which was very interesting and also he got his team to together there to discuss my case and my notes before I went in order to seek their opinion beforehand, because normally they wouldn’t treat someone over 50, but they, because of my history, they said that they would make an exception and when you did, they actually do the examination in the office. So he had all the equipment there and I, when it is the actual person the top person if you like actually doing the investigations as well as you now deciding on the treatment and doing the treatment itself, you have got the continuity there and he knew exactly what he was looking for. You know he was interested. He actually identified adenomyosis in the uterus and I had always been told that they were fibroids and... he then sort of went into great depth about adenomyosis and infertility. So I had already looked at that a bit and now of course I have looked into that side of things in greater depth as well and very involved you know with adenomysis. So and you now he discussed the implications of that. And I was just amazed you know, that he was able to established that on an ultrasound. So, and I just thought well things are obviously considerably more advanced [laugh] in some places, you know where they can assess the state of the uterus and what is happening in the pelvis. You know look at the person’s history and then make a judgement you know, and tell the patient, you know, what the chances are. So... but whether he was more open with me because he knew I knew a lot about it. I mean that, that is a possibility. Whether he would have gone into that much detail with somebody that was not so well informed is hard to say. But I just thought that having that amount of information at their finger tips really from so many centres, because they, actually they combine the results in their programmes from several centres. So it is not just one centre working in isolation. It gives a huge advantage. So… the actual facilities were just absolutely amazing and the cost is a fraction, you know of what it is here. And I was thinking well how can they, how can they provide that. And why can’t we. You know?

Martin was aware from talking to other people that some are worried that care abroad would be “unregulated” or performed in the backstreets. Some of the other people we talked to said they would not have considered seeking treatment abroad because they would be worried about standards and concerned there might be a language barrier. Belinda said, “If you didn’t speak the language then how can you question the treatment they are offering you?”

However, Martin was involved in an infertility support group where he was able to share his experiences of researching treatment abroad. He described how important it was to do your homework about the country you are going to, the clinics on offer there and what their regulations are.

 

Martin described how important it is to do your homework about the country you are considering,...

Martin described how important it is to do your homework about the country you are considering,...

Age at interview: 41
Sex: Male
Age at diagnosis: 35
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You do have to do your homework, you have to fully know and understand where you are going and why you’re going and what you want from that. I read something earlier today that talked about the regulation, it’s not as regulated. Because in Spain for example, the donor was totally anonymous. We have no right to know who they are, which is different to the UK. That doesn’t mean it’s not as regulated, but it is differently regulated. And in some cases, some people might find that an advantage. So… Sorry.
 
That’s it, carry on.
 
So in some cases some people might see that as an advantage. Certainly, the European countries, are more regulated in many cases then they are here. So the regulatory issues really are not an issue, but you have to understand what the regulations are in the country you are going to. And that’s part of doing your homework and making sure. 
 
We decided on [country] because of, for a number of reason, the availability, it’s not far to fly, it’s readily accessible. The clinics are absolutely second to none out there, partly because we could have a nice time going there as well. It’s a nice place to go. 
 


​Last reviewed July 2017.
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