Making the decision to have your fertility treatment abroad is a big step into the unknown. The more information you have at the hand, the more likely you can make an informed decision on which clinics and countries best suit on your particular needs and expectations. Part of the challenge is knowing which questions to ask. With this in mind, we have put together our five MUST ASK questions when choosing an IVF clinic abroad.
1. Can anyone be treated at your clinic?
Access to fertility treatment varies from one country to the next and unfortunately due to local laws it’s relatively common for same sex couples and single women to be denied treatment. There are also restrictions based on Body Mass Index and other physical factors such as age – some countries are more relaxed than others. In Russia the upper age limit for treatment is 50. In Turkey there is no law restricting the age limit, with 46 being the recommend cut off point. Others offer treatment up until the age of menopause.
The good news is there are over 500 clinics offering treatment in excess of 50 countries, so it is likely whatever your circumstances, there will be a high quality clinic able to offer you the treatment you are looking for.
2. What is the law governing fertility treatment?
The regulatory framework governing fertility treatment varies between countries and clinics. With this in mind, you should always ask the clinic what regulations they adhere to and how this affects the treatments available and service levels.
The first and most important question to ask is what their standards of safety are – we have addressed this in question five below.
The most common areas that vary between clinics from a regulatory standpoint include:
- Treatment availability to same sex couples or single parents;
- The number of embryos that can be transferred per cycle;
- Whether they permit surrogacy or not;
- Upper age limit of woman;
- Sex selection;
- Egg/sperm donation anonymity
You can find out more about laws in different countries here:
3. What are the clinic’s success rates and how are they calculated?
Some people prefer to go abroad because they’ve found a clinic which claims to have very high success rates. You should be cautious in these cases as there are lots of different ways to present success data. For example, they may only be presenting data for women under 35 or their data may relate to pregnancies rather than births.
Success rates can also be affected by the types of patients a clinic treats. If a clinic treats a large number of younger women with mild fertility problems, their success rates will inevitably be higher than clinics treating older women or those with more complex diagnoses.
Also be sure to the clinic for their ‘success rate per embryo transferred’. A good success rate based on multiple embryos transferred is not the same as a good success rate based on one embryo transferred. Putting multiple embryos back can lead to a greater risk of multiple pregnancy. If in any doubt, always seek help from a professional before setting your heart on a clinic that promises the world.
The experience of the clinic is also an important consideration and will affect success rates. How many treatments do they perform a year? Which treatments do they do more of? Clinics tend to specialise in certain areas or perform a certain procedure more regularly than others. For example, PGD/PGS is offered at most places, but usually only a few centres will be considered ‘experts’.
4. How much will it cost me?
Clinics abroad can be up to 50% less expensive than in the UK, but always ask the clinic about the hidden costs. Some clinics seem to offer very low rates for IVF, but these prices may not include fertility drugs or other essential procedures such as blood tests or an initial consultation. Make sure you’re comparing like with like and you get the whole package cost.
You’ll also need to pay for accommodation and living costs, flights, specialist medical insurance and the cost of taking time off work if you need to take unpaid leave. Calculate roughly the total cost for being treated abroad and make sure you have a healthy contingency fund in case anything goes wrong.
Here is a list of costs you can ask your clinic to clarify:
- Cost of the initial consultation with an infertility specialist;
- Cost per cycle of IVF;
- Cost of donor sperm or donor eggs for use in IVF;
- Cost of fertility drugs and hormone treatments required;
- Cost of specialist infertility treatments such as intracytoplasmic sperm injection (ICSI);
- Cost of frozen embryo storage for future frozen embryo transfer cycles.
5. What is the clinic’s record on standards and safety?
Safety standards will vary between clinics, so it is important you do your research by
asking the clinic and seeking external advice.
In the majority of countries, a basic standard of quality is regulated by the ministry or department of health, and all infertility clinics in these countries should be registered. Again, the level of inspection and testing required for registration will vary from country to country, so you should check out the details to see exactly what national registration means and what reassurances it gives you when comparing quality.
There are a number of internationally recognised standards that are used when comparing different infertility clinics on the basis of their quality of service. The most well-known of these is ISO9001. The American-based Joint Commission International also provides accreditation to an internationally accepted standard.
Within their own countries or regions, infertility clinics can also apply for accreditation and registration with federations, associations and societies, such as the European Foundation for Quality Management, or the Quality Council of India. The International Federation of Fertility Societies can help you find the relevant organisation for your chosen country.
It should be noted, however, that the standards that infertility clinics need to achieve to receive accreditation with these bodies vary, from strict quality checks and regular inspections to simply filling in a form and paying a membership.
You should always research in depth organisations claiming to accredit infertility clinics to see which quality accreditations carry genuine credibility and kudos and which are just meaningless certificates.
We hope these question provide a useful benchmark for the kind of information you should be looking for before choosing a clinic. It’s always worth seeking professional advice from your GP or fertility specialist or from reputable fertility support organisation. There are also forums and networks full of couples that have been there before, so always seek peer review and ask others which clinics they would recommend or avoid. Best of luck in your fertility journey!