Fertility and Assisted Reproduction IREMA

The average cost of IVF with your own eggs at IREMA is 4,150 Euros. IVF stands for In Vitro Fertilisation and is a procedure that is performed by retrieving eggs from the patient and then fertilising them. Once the eggs are fertilised they will be allowed to develop in the laboratory until they have reached the correct stage of development as an embryo. Once this stage has been achieved they will be transferred into the uterus in the hopes that they will successfully implant.

With the price including all the stages of the treatment there should be no additional costs, however if there are any the doctor will inform you before you begin treatment. IVF treatment is as follows:

• Consultation. Your initial consultation with your doctor will be to determine what treatment you require.
• Preparation. You will undergo ovarian stimulation in order for your body to produce the eggs that will be required, and during this you will produce more eggs than through your normal ovulation cycle, to increase your chances.
• Retrieval and Fertilisation. Once your follicles are the right size you will undergo egg retrieval in the operating room, but anaesthesia will be administered so that the process is painless. Once the eggs are ready they will undergo fertilisation with the sperm that is to be used, thus creating embryos.
• Embryo Culture. The embryos will be allowed to develop in the lab, this is so that they can reach the necessary stage of development in order for them to be ready for transfer. Once they have reached this stage the best embryos will be selected, in order to give you a better chance of success.
• Embryo Transfer. Once the embryos are ready the embryos will be transferred to your uterus via your uterine cavity using a small thin tube.
• Pregnancy Test. After a certain period has passed you will undergo a pregnancy test to determine whether or not the procedure was successful.

Once the treatment has finished you will hopefully be waiting for your little one to arrive and grow your family.

The cost of popular IVF add-ons with IREMA will depend on which add-ons you choose to have performed during your treatment, as there are different costs for each one.
Some of these add-ons are:

• Mandatory serologies and complementary pre-tests. These include general analytics, hormone tests to determine hormone levels (the exact test depends on if it is performed on a man or woman), sperm analysis to determine the quality of the man’s sperm and see if it is viable for fertilisation or not. Other tests include ultrasounds, cervix bacteriology, a smear test, mammogram and ECG, which is for women over the age of 40. The cost of these tests is 800 Euros.
• HERES test. This will cost 600 Euros per person and is used to detect genetic disorders that you may have that could pass down to your child. This is a popular test as there are a lot of genetic disorders and diseases that can pass down through your DNA, and ensuring that that you minimize chances to pass to your child is essential in order for your child to be healthy.
• Donor sperm for 330 Euros. There are many reasons that you may need donor sperm during your treatment, such as the male factor playing a big part in your infertility problems, or being a single woman trying to have a child. Should you require this it is available with the clinic at the cost above.
• PICSI, MACS and ZYMOT for 450 Euros each. PICSI is a method that is performed in order to select the best sperm for use in your treatment by looking at individual sperm cells. MACS is Magnetic Activated Cell Sorting and is also used for sperm selection but is less invasive. ZYMOT is a chip that tests the motility of sperm to help select it for ICSI.

These are some of the more popular add-ons at the clinic, if you wish to have them added to your treatment or wish to know more you can speak to your doctor at your consultation.

The average cost of the egg donation cycle with IREMA is 7,290 Euros, and this price is for the OVODON programme. They also have a Blastocyst Guarantee Programme which will cost between 7,900 Euros and 10,600 Euros, although the final cost will depend on the number of blastocyst embryos that are achieved, as long as the sperm parameters are good.

Infertility treatment using egg donation is commonly used when a woman is unable to produce oocytes that can produce healthy embryos as a result of fertilisation. The treatment can be performed either by using a partner’s sperm or by using donor sperm from the sperm bank. All donors are anonymous and are chosen based on specific characteristics that you will talk about with your doctor, who will choose the donor on your behalf. All donors are healthy and fertile and undergo strict testing to ensure they are healthy enough to donate. The treatment looks like this:

• Preparation. Both the donor and recipient will need to be prepared for the donation, so the recipient will undergo hormone replacement in order to ensure that her uterus is able to receive the embryo, at a chosen moment the donor will be undergoing ovarian stimulation in order for her to produce the oocytes required in the treatment. Fresh eggs are always used so this will be coordinated to ensure perfect timing.
• Retrieval and Fertilisation. Once the donor is ready the oocytes will be retrieved and then fertilised, in order to allow them to develop as embryos. As stated above this will be performed using either your partner’s sperm or donor sperm.
• Transfer. Once the embryos have developed enough the best ones will be chosen and transferred to the uterus of the recipient. If all goes well the embryos will soon implant and the treatment will have been successful.

If you are from outside of Spain and are undergoing treatment with the clinic, they will coordinate with your local doctors in order to make your treatment as easy as possible, and so that you don’t have to keep travelling to and from the country. If you wish to know more about this treatment, then you can discuss this with your doctor during your consultation.

At IREMA there are multiple ethnicities available when it comes to egg donors, although they mainly offer donors that are Caucasian. If you are looking to have an egg donor that is a race other than Caucasian there may be a small waiting period depending on the availability at the time.

Egg donation is strictly anonymous so you will be unable to choose them yourself or know who they are. The choosing of the donor will be done by your doctor and the choice will be made based on physical and genetic characteristics, in order for the donor to look, and be, as much like you as possible. This is to ensure a close genetic and physical match with the child that will be produced as a result of the procedure.

Due to how important donation is there are strict rules that must be adhered to in order for a woman to be an egg donor:

• Age. Due to how fertility works in women and the fact that it declines as women progress in age, egg donors are usually between the ages of 18 and 30, in order to ensure that the eggs are healthy and fertile.
• Healthy and Clean. Being drug-free is a must for egg donors as illegal substances can hinder the fertility and health of any eggs produced, so donors are tested for drugs. It is also often a requirement that donors adhere to a healthy lifestyle so that their body is healthy enough to produce healthy eggs. Donors will also be tested for any STIs (Sexually Transmitted Infections) as this can also impact the health and fertility of the donor.
• Genetic Diseases. Donors are tested for genetic diseases to minimise chances of passing down to your child. The tests performed can detect hundreds of genetic diseases.

Different clinics can often have different requirements when it comes to donors but the above requirements are usually at every clinic, to ensure that any donations they receive are healthy, fertile, and can offer you the best chance of success during your treatment. Spanish government recommends (and we must offer by law when using a donor) to perform extra testing for recessive diseases (HERES), which the donor could carry but show no symptoms. These kinds of diseases don’t show on standard tests. The donor’s results are then matched with the future father to establish chances of developing a recessive genetic disease. If there were any concerns, the patient would be provided with a different donor.

The average cost of PGT-A testing at IREMA is between 2,250 Euros and 3,250 Euros, and the final cost will depend on the number of embryos that you wish to have tested. PGT-A testing is a genetic test that is performed on an embryo to determine whether or not there are any genetic defects or chromosomal abnormalities within the embryo that will have a negative impact on the development of both the embryo and the resultant child. There are many genetic diseases that can pass down through the DNA to a child through either parent, as well as those that are single-sex defects that only pass down to one gender. PGT-A testing can be used to ensure that this doesn’t happen.

There are certain situations where PGT-A testing is seen as more beneficial:

• Miscarriages. If you have suffered recurrent miscarriages and this was down to chromosomal abnormalities then testing can be performed on your embryos to help prevent this.
• Inherited disease. The biggest risk with inherited genetic diseases is passing them down to your child, as such a lot of people who have a family history of these will opt not to have children, so as to not risk it passing down. The test can allow someone in this situation to be sure that their genetic disease will not pass down and that their child will not have the same problems as them.
• Age. Due to a woman’s naturally declining fertility, women over certain ages, such as 35, have a higher predisposition towards having children born with chromosomal abnormalities that can affect the quality of life of their child.

These are some of the situations where the PGT-A test will be most beneficial. When discussing your treatment with your doctor they will be able to tell you more about the test and whether or not it will be beneficial in your situation, as often when there is no history of genetic disease the test can be seen as not needed.

The cost of donor sperm from the sperm bank with IREMA is 330 Euros. Donor sperm is most often needed when there is a problem with the fertility of the male, such as low motility or a low sperm count. To determine whether or not donor sperm is needed in your treatment the sperm of the male will undergo testing such as DNA fragmentation, which tests the sperm to see if there are any anomalies present that have caused infertility problems.

If an issue has been detected within the sperm of the male a donor may be required and this donor will be chosen by your doctor, who will match the donor to you according to physical and genetic characteristics to ensure as close a match as possible. Due to donation being anonymous, you will be unable to know the identity of the donor or see who they are. You will have nothing to be concerned about as all donors are healthy and must meet strict requirements in order to become a donor. These requirements are:

• Age. Unlike with egg donation, sperm donors can be older so the age can usually range from between 18 and 50, depending on the clinic. The reason is that men remain fertile for longer. However, younger sperm is often better as it will be healthier and more fertile. Irema informs you about the age of the donor so you can make an informed decision, anyways the vast majority of the donors are on the younger side.
• Health. Donors will undergo health testing to ensure they suffer from no STIs (Sexually Transmitted Infections) as this can hinder the health and fertility of the sperm. They also undergo genetic testing to test for any genetic diseases that can pass down through their DNA to the child.
• Lifestyle. Donors must be drug-free so that the sperm is not compromised in any way, and some clinics also require the donors to live a healthy lifestyle with no unhealthy habits.

With these requirements, you can be sure that the sperm you receive from the donor will be healthy, and fertile, and offer you the highest chances of success with your treatment.

The average cost of ROPA with IREMA is 4,750 Euros. ROPA is IVF for same-sex couples and offers lesbian couples the chance of having a child of their own. ROPA stands for Reception of Oocytes from Partner and is usually referred to as Reciprocal IVF. The way this procedure is performed is that one of the women will donate their eggs and the other woman in the relationship will carry the child to term, this way both of the women will feel like they are a part of the process and feel like the child is truly each of theirs.

The way this treatment works is:

• Stimulation. The woman donating her egg will undergo ovarian stimulation in order to produce oocytes. The woman who will carry the child will also undergo hormone replacement in order to prepare her uterus for the embryo.
• Retrieval. Once the eggs have been produced they will be retrieved under anaesthesia.
• Fertilisation. Donor sperm will be required for this step of the process, and it will be used to fertilise the eggs.
• Cultivation. Once the eggs have been fertilised they will become embryos and be allowed to develop in a laboratory until they have reached the right stage of development.
• Transfer. The transfer of the embryos will be performed using a small tube by placing them into the uterus of the recipient via the uterine cavity.

Your consultation for this will be free, and the price of the treatment will include all of the above, as well as all medical controls, ultrasounds, anaesthesia, theatre fees and a pregnancy test once a certain period of time has passed.

The average cost of embryo donation with IREMA is 2,675 Euros, this price applies when a single embryo is adopted. Embryo donation is where a woman who has frozen embryos stored with the clinic donates them so that they can be used by others who wish to have children and might be unable to produce eggs of their own that can be fertilised to become embryos.
Included in this cost is:

• Consultation. Your initial consultation with the specialist where you will talk about your potential treatment and decide on embryo donation.
• Stimulation. You will undergo hormone replacement in order to prepare your uterus so that it can receive the embryos.
• Ultrasound scans. These will be performed in order to determine if everything is ok and see when you are ready for the treatment to begin.
• Embryo thawing. The frozen embryos will need to undergo the thawing process in order to be used in your treatment.
• Transfer. Once the embryo has been thawed and you are ready it will be transferred into your uterus by using a small thin tube that places it in the uterus via the uterine cavity.
• Pregnancy test. Once the treatment is complete there will be a short waiting period in order for the treatment to work. Once this period is over you will undergo a pregnancy test with the clinic to see if you have fallen pregnant.

There may be additional fees depending on whether or not there is more that you need during your treatment, but you will discuss this with your doctor during your consultation so that you know the price ahead of time.

The average cost of egg freezing with IREMA is 2,500 Euros. This is a procedure where you will have your eggs frozen in order to preserve their fertility for when you wish to have a child. Once you have had your consultation with the doctor and decided to go ahead with egg freezing you will have a plan put in place. Part of this plan will include ultrasound scans to determine the right time to proceed, followed by ovarian stimulation. Ovarian stimulation is performed in order to help your body produce more eggs than usual, this way you will have more to freeze. The procedure will be performed under anaesthesia in their operating room, so you will not feel anything while the eggs are being retrieved. Once the eggs have been vitrified they will be stored safely for one year. There may be the option available to pay for longer storage but you should discuss this with the doctor.

There are many reasons why women may choose to have their eggs frozen:

• Sickness and Medical Treatment. In certain situations, women who are younger could fall ill or develop a serious medical issue such as cancer. The treatment for some sicknesses can be quite aggressive, especially with cancer where radiation or chemotherapy are used. Such cancer treatment or sickness can affect the fertility of the woman, so having her eggs frozen is a good way to preserve her fertility for the future.
• Waiting. Some women choose to hold off on having a child for purposes such as education, their career, wanting to find the right partner, or hoping for financial freedom. These are all valid reasons and sometimes can take a long time in order to reach the point where they are comfortable having a child. So freezing their eggs in order for the right time is useful and can enable them to have children at a later age.With egg freezing being more advanced it is a more viable solution than ever before, if you wish to know all about this process then speak with your doctor and they will tell you all you need to know.

The average cost of intrauterine insemination and donor sperm insemination at IREMA is between 750 Euros and 1,195 Euros. IUI (Intrauterine Insemination) is a procedure that is performed where semen is pushed into the uterus via the uterine cavity, in order to help facilitate fertilisation. It is a relatively painless procedure and patients undergoing it should only feel a small pinch and some cramping as the device passes through the cervix. It is also known as artificial insemination, and is commonly used when there are issues with the male, who is unable to have his semen reach the uterus in a large enough quantity to fertilise the egg. Donor sperm insemination, also known as AID (Artificial Insemination with Donor) is the same procedure, although it is performed by using donor sperm instead of the partner’s sperm.

The full prices are as follows:

• Intrauterine Insemination (IUI) – 750 Euros.
• IUI pack of three attempts – 1,950 Euros.
• Donor sperm insemination (AID) – 1,195 Euros.
• AID pack of three attempts – 2,940.

You will notice that AID costs more and this is because there is the fee for the donor sperm included in the cost as well. The full treatment is as follows:

• Stimulation. Ovarian stimulation will be performed on the woman who is to receive the sperm, this is so that she produces more eggs. More eggs give the sperm a better chance of fertilisation, which increases your odds of successful treatment.
• Medical controls. All medical controls that need to be performed during the procedure will be included in the cost.
• Ultrasounds. These will be performed in order to determine the right time for the recipient to undergo ovarian stimulation.
• Insemination. Lastly, the insemination itself, which will be performed in the clinic.

If you wish to know more you should speak to your doctor at your consultation.

The medical director of IREMA is Dr. Verónica Serrano De la Cruz Delgado, who graduated from the University of Valencia with a Master’s degree in Assisted Reproduction and Endoscopic Surgery. She is a very friendly doctor and her patients are able to put their trust in her, knowing that she will do everything in her power to help make their dreams come true.

As well as Verónica Serrano De la Cruz Delgado the clinic has numerous staff and doctors, some of whom have over 20 years of experience working with IVF. Along with the experienced doctors the clinic has a team of patient coordinators, whose job is to ensure that all patients have as easy a time as possible during their treatment.