Connect with us

FERTILITY 360

Keeping A Lid On The Cost of IVF

Published

on

The Cost of IVF

We recently undertook some research with Fertility Network UK to look at why more people from the UK are going abroad for fertility treatment. We found that the high cost of private IVF treatment in the UK was the primary driver, with over 76% of our respondents believing it was too expensive. Nearly 80% felt it is twice as expensive as they were willing or able to pay. According to our survey, people were willing to pay between £1000 and £5000 for IVF. In the UK, IVF can often exceed £10K when additional expenses are taken into account.

The research also revealed some of the shocking ways people were funding their IVF treatment and the impact this was having on them. We found that 62% of couples were forced to dip into their life savings, putting added pressure on their ability to fund pensions, pay for educational fees or support other family members. Some of the respondents had to remortgage their houses, sell personal belongings, ask for help from family and friends or even start crowd funding campaigns to fund treatment.

Facing such financial pressures at home, it is little wonder why more people are seeking a better deal abroad. Treatment in some countries can be up to 50% cheaper than the UK equivalent.

We have put together some useful tips to help individuals and couples reduce their fertility costs, both at home and abroad:

1. Get fertility help early

General medical advice is to get a fertility assessment after trying to conceive for one year without success. However, couples should not fall into this “one year” trap. This advice is for younger couples (less than 30 years of age) who, if given adequate time, will conceive naturally in 80%-90% of cases. The remaining 10% may need some help. When the female partner is older or has any known medical conditions which may impair her fertility, early fertility assessment is imperative. The one-year rule does not apply to this group of women because the longer they wait, the more their fertility declines. They should see a fertility specialist after about six months of trying naturally. For example, a woman with endometriosis may have an ovarian cyst or a blocked tube, which might require laparoscopic (keyhole) surgery. If they wait for a year, the endometriosis may worsen and impair her fertility still further. Starting IVF early in the journey increases chances of success; reducing the number of cycles required and saves thousands of pounds in the process.

2. Understand your costs

Don’t just look at the IVF price as advertised – make sure you make a note of any additional expenses that may be incurred such as flights, accommodation, medical insurance and living expenses. You may also need to take some time off work which will affect your earnings and if the treatment doesn’t work first time, you’ll need money aside for future treatments should you wish to continue.

3. Hidden costs – Don’t get caught out

Treatment costs tend to be fairly transparent but watch out for any “hidden” extras. For example, is the first consultation deductible from the treatment cost? Is sedation included in the price for egg collection? Is sperm or embryo freezing included? Are there any guarantees e.g. can you pay for two cycles and get a third free? Most clinics will expect you to have undergone certain tests such as mammograms, sperm analysis, HIV and so on before your trip –– so make sure you find this out before your visit. Clinics will charge extra to have these tests done on site.

4. Look for savings

It is worth having a look for clinics that offer a ‘shared risk programme’ to mitigate possible failures. For example, some may allow you to pay for two cycles, and if they don’t work, offer a third round for free. At the very least this could save you some money. Egg sharing is another option, which can significantly reduce the cost of IVF. Egg-sharing is an In Vitro Fertilisation (IVF) treatment that brings together women who produce surplus eggs (an egg sharer) with those unable to produce eggs (an egg recipient). Egg-sharing enables these two groups of women to help one another – egg sharers receive free standard IVF treatment, whilst egg recipients receive the eggs they need for IVF.

5. Do you need ‘add-ons?’

Many clinics will try to promote treatment add-ons to enhance success rates, but we advise caution in paying for these as we believe many are unnecessary. Add-ons such as embryo glue, time-lapse monitoring or endometrial scratching are often offered by clinics, but in our experience their impact is minimal and probably not worth the added cost. Better save your money for further rounds than waste it on unnecessary perks. It’s always a good idea to consult with your GP and/or fertility professionals about add-ons offered by your clinic. Some women under certain circumstances may benefit from additional treatments – e.g. women over 40 or those with medical conditions, such as endometriosis or irregular periods – but make sure you get a professional’s opinion before you get the credit card out.

6. Country research

Take the time to investigate different countries across Europe and the world. Some ‘less popular’ countries – Turkey, Greece, and Russia may actually offer what you need in terms of donor selection or the law around anonymity and be cheaper. For example, Finland has different rules on donor anonymity than most of Europe and is up to 15% cheaper than Spain, one of the more popular destinations. The country you choose could be down to something as simple as personal preference or as critical as IVF age legislation. One of the more common factors aside from cost, is anonymity. In the UK, the identity of egg and sperm donors is not protected by law, which can have far reaching consequences in the future. If this is a concern to you, you should look at countries where donations are anonymous, such as Spain, the Czech Republic and Greece. Other considerations may include the cost of living, expense of travel or accommodation costs. Different countries also have different age legislations for IVF treatment, or there may be specific laws on the number of embryos that can be transferred. These could be a deal breakers before you even step on the plane.

7. Choosing the right clinic

Choosing a clinic can be a daunting prospect, so having a ‘must have’ check list can be a useful tool. Jot down your must haves and use these to help you make your choice – if the clinic isn’t ticking the right boxes, then you can discount it from your list. Treatment costs vary from one clinic to the next. Unfortunately there is limited information about international clinics in the UK, so you’ll need to visit the clinic’s website to get an idea of treatment costs. It is also a good idea to pick up the phone and speak to them in person so you can ask any specific questions you may have. Some useful starting questions related to cost include:

  • Do they offer help with translation and travel?
  • Are they accessible?
  • Do they offer complementary therapies?
  • Do they offer guarantees or shared risk plans?
  • Will they pay for travel between the airport, clinic and hotel?

8. Hotel recommendations

Many clinics have deals with local hotels where reduced room rates are offered to patients. Some clinics even have their own hotel e.g. IVF Zlin in the Czech Republic. Always ask the clinic if they have accommodation deals to help reduce your travel and living expenses.

Fertility Clinics Abroad was set up in 2012 by Dr Caroline Phillips, a former clinical embryologist at the London Fertility Centre on Harley Street in London and senior embryologist at the Chelsea and Westminster Hospital’s IVF Unit. fertilityclinicsabroad.com

Continue Reading
Advertisement
Comments

FERTILITY 360

What Is Polycystic Ovary Syndrome (PCOS)?

Published

on

Polycystic Ovary Syndrome

Polycystic Ovary Syndrome or PCOS is a hormonal imbalance that affects 5 to 10 percent of women of reproductive age across the world, and results in irregular or absent periods, acne, excess body hair and weight gain. It is also a major cause of infertility and yet is frequently misdiagnosed and often missed completely.

PCOS gets its name because under an ultrasound scan, the ovaries can look like a bunch of grapes, each one covered in what look like multiple cysts. In fact, these aren’t cysts at all, but are small, undeveloped follicles.

Symptoms

Not every woman with PCOS will get the same symptoms, but common signs to look out for include:

  • Few or no periods
  • Excess hair on the face or breasts or inside of the legs or around the nipples
  • Acne
  • Oily skin
  • Scalp hair thinning or loss (male pattern baldness)
  • Skin tags (known as acrochordons)
  • Skin discolouration (known as acanthosis nigricans) where the skin looks ‘dirty’ on the arms, around the neck and under the breasts
  • Mood swings
  • Depression
  • Lack of sex drive
  • Weight gain especially around the middle of the body
  • Difficulty in losing weight
  • Cravings and binges
  • Irregular or no ovulation
  • Difficulty in becoming pregnant
  • Recurrent miscarriages

PCOS creates a vicious cycle of hormone imbalances, which has huge knock-on effects throughout the rest of your body. With PCOS, the problem often starts with the ovaries, which are unable to produce the hormones they should, and in the correct proportions. But linked to this is the very common problem of insulin resistance. Women with PCOS very often have difficulties with blood sugar levels which can cause weight gain and the excess insulin can stimulate your ovaries to produce yet more testosterone. Half of all women with PCOS do not have any problems with their weight, yet they can still have higher insulin levels than normal.

How is Polycystic Ovary Syndrome diagnosed?

The most widely accepted criteria for the diagnosis of PCOS says that you should have two out of these three problems:

  • Infrequent or no ovulation
  • Signs (either physical appearance – hirsutism or acne – or blood tests) of high levels of male hormones
  • Polycystic ovaries as seen on an ultrasound scan

The Seven Nutritional Steps to beat Polycystic Ovary Syndrome

Good nutrition is the foundation of your health and you should never underestimate how powerful it can be.  It is the fuel that provides you with the energy to live your life and it gives your body the nutrients it needs to produce your hormones in the correct balance.  The better the supply of those nutrients, the more healthily your body will function.

The fundamental aim of my nutritional approach to PCOS is to target a number of areas simultaneously so that you get the maximum effect in the minimum amount of time.  

Here’s how:

  1. Switch to unrefined carbohydrates (eaten with protein) and never go more than 3 hours without food to keep your blood sugar levels balanced
  1. Eat oily fish and foods rich in Omega 3s to help your body to become more sensitive to insulin so it can overcome insulin resistance
  2. Cut out all dairy products for 3 months to bring levels of male hormones under control
  3. Eat more vegetables and pulses to which helps control male hormones
  4. Cut right back on or cut out alcohol for 12 weeks to allow your liver function to improve
  5. Cut down on caffeine to give your adrenal glands a rest
  6. Cut down on saturated fats and eliminate trans fats to help control the potentially damaging inflammatory processes PCOS causes in the body
Polycystic Ovary Syndrome

Best Supplements for PCOS

The use of certain vitamins and minerals can be extremely useful in helping to correct Polycystic Ovary Syndrome, along with a good diet.

Chromium

Chromium helps to encourage the formation of glucose tolerance factor (GTF), which is required to make insulin more efficient. A deficiency of chromium can lead to insulin resistance.  It also helps to control cravings and reduces hunger. Can help to reduce insulin resistance associated with PCOS

B vitamins

The B vitamins are very important in helping to control the symptoms of PCOS. Vitamin B2 helps to turn fat, sugar and protein into energy. B3 is a component of GTF which is released every time blood sugar rises, and vitamin B3 helps to keep the levels in balance. Vitamin B5 has been shown to helps with weight loss and B6 is also important for maintaining hormone balance and, together with B2 and B3, is necessary for normal thyroid function.

Zinc

Zinc helps with PCOS as it plays a crucial role in the production of your reproductive hormones and also regulates your blood sugar.

Magnesium

Magnesium is an important mineral for dealing with PCOS because there is a strong link between magnesium levels and insulin resistance – the higher your magnesium levels the more sensitive you are likely to be to insulin.

Co-Enzyme Q10

Co-Q10 is a substance that your body produces in nearly every cell.  It helps to balance your blood sugar and lowering both glucose and insulin.

Alpha lipoic acid

This powerful antioxidant helps to regulate your blood sugar levels because it releases energy by burning glucose and it also helps to make you more insulin sensitive. It also has an effect on weight loss because if the glucose is being used for energy, your body releases less insulin and you then store less fat.   

Omega 3 fatty acids

Omega 3 fatty acids taken in supplement form have been found to reduce testosterone levels in women with Polycystic Ovary Syndrome.

Amino Acids

Certain amino acids can be very helpful for PCOS as they can improve your insulin sensitivity and also can have an effect on weight loss.

N-Acetyl cysteine

In women with PCOS this amino acid helps reduce insulin levels and makes your body more sensitive to insulin. Study using NAC in women who were clomiphene resistant and had ovarian drilling.  After ovarian drilling, the women given NAC compared to a placebo showed a significantly higher increase in both ovulation and pregnancy rates and lower incidence of miscarriage.

Arginine

Arginine can be helpful in reversing insulin resistance. In one study, a combination of both arginine and N-acetyl cysteine were given to women with Polycystic Ovary Syndrome.  The two amino acids help to improve blood sugar and insulin control and also increased the number of menstrual cycles and ovulation with one women becoming pregnant on the second month.

Carnitine

Carnitine helps your body break down fat to release energy and can help improve insulin sensitivity.

Tyrosine

Tyrosine is helpful for women with PCOS who are overweight as it helps to suppress the appetite and burn off fat.

Glutamine

This amino acid is useful for helping with sugar cravings as it can be converted to sugar for energy and so takes away the need to eat something sweet.  It also helps to build and maintain muscle which is important for fat burning.

Branched Chain Amino Acids (BCAAs)

BCAAs include three amino acids leucine, isoleucine and valine. They are important in PCOS because they help to balance blood sugar and having good levels of these BCAAs can have a beneficial effect on your body weight

Inositol

A study used inositol (2,000mg) in combination with NAC (600mg), significant increase in ovulation rates.

Having a good diet, regular exercise, controlling stress and taking key nutrients will help in getting your hormones back in balance and reducing the negative symptoms associated with PCOS.

More information can be found on www.naturalhealthpractice.com

Continue Reading

EGG DONATION

IVF Spain Update Us on Claire & David and Laura & Ian Progress

Published

on

Claire & David IVF Spain

During the first week of August, Claire (42) and David (35), the winners of this year’s Fertility Journey, visited our clinic for their first embryo transfer.

They were pleased to share with us the emotion and joy created by their short stay in Spain;   

“We have spent some time in Alicante ahead of the transfer, relaxing in the area and preparing for our next visit to IVF Spain. Our experience with previous treatments with UK clinics has been very stressful but in Alicante, we have spent most of our time preparing for treatment by relaxing on the beach!”

Claire and David arrives at IVF Spain after having been trying to get pregnant for 7 long years and experienced 3 failed ICSI treatments with their own eggs. IVF Spain discovered that the quality of the embryos was poor and that they had always been transferred on day 3 of their development with a bad morphology. In order to increase their chances of getting pregnant the clinic recommended an egg donation treatment – a fertility treatment which that greatly depends on matching the perfect donor to the patient.

To protect both patients and donors Spanish law requires that the donation process must be completely anonymous.  In addition, donors must be in good condition and younger than 35. Moreover, both donor and patient must share a phenotypical resemblance: hair colour, BMI, eye colour, and so on.

Dr Herea

Claire and David were grateful that so many women in Spain were willing to donate their own eggs, enabling others less fortunate, the chance of forming a family.

“We are really grateful that there are people willing to donate eggs. If we are being honest, it has taken a while for us to understand the Spanish anonymity rules for egg donors, but we have taken the time to consider this. It’s hard not having control or letting another person being in charge for something related to your baby. However, we even think now it is better that way, because the more you know, the more you want to know and we do prefer knowing nothing and leaving it in the clinic’s hands.”

There are other factors, however, that are crucial to achieving a successful pregnancy: the quality of the embryo and the microenvironment of the endometrial lining. This means that a successful pregnancy also depends on the successful communication between the embryo and the endometrial lining.

When we discovered that Claire didn’t have a single positive pregnancy test, we suggested to perform an endometrial biopsy to analyse the retrieved sample by means of the ER Map® test (Endometrial Receptivity Map) and accurately determine the receptivity of Claire’s endometrium during the window of implantation (the moment when the endometrial lining is receptive).

”The test results showed that Claire’s endometrium was post-receptive, meaning that a transfer performed on day 5.5 of progesterone (like in 70% of cases) would not end up in a successful pregnancy” explains Dr Natalia Szlarb.

“Before coming to IVF Spain, we had never heard of an endometrial study or ER Map. The fact that the endometrial study analyses the best time to transfer the embryo could make a big difference to our treatment. We were really impressed with the accuracy of the test. Our ER Map test result was post-receptive and although this was initially a concern, we later came around to the view that knowing the best time to transfer the embryo would increase the chances of success, and this might have been the reason our other treatments in the UK had failed” – Claire and David.

There are other key factors, however, to achieve a pregnancy such as the male factor. David suffers from teratospermia which implies that 96% of the ejaculate sperm cells have an abnormal morphology. Luckily, we were able to improve David’s sperm quality and fertilize the retrieved eggs.

We now wish them the best of luck!

Although it will not be until mid-September when Laura (41) and Ian (44), the 2018 runners-up visit us in Alicante for their embryo transfer, they already talked about the differences between IVF Spain and former clinics. They were impressed at how extensively their case had been studied by our fertility specialists.

Laura and Ian IVF Spain

“I think the longer you have treatment the more difficult it becomes. When you begin there’s a naivety along the lines of, ‘we’ll have one, maybe two goes at IVF and have a baby in our arms’. After 7 treatments (and lots of add-ons) the feelings completely change. You feel terrified that it won’t work, and you’ll never become parents. You’re scared it will work and you’ll lose the baby again (Laura and Ian have experienced 5 losses). You’re scared of physically going through the treatment as you’ve had so much. Each test and treatment creates fear – fear that it will hurt, be traumatizing, that it will give you more bad news. Then there’s the impact on your own mental health and emotional well-being. Can I handle this? What if the results say something’s wrong with me? Will I blame myself? It starts to really damage your mental health and well-being. Financially you start to feel that you’re risking everything, and it may not pay off.

For us we have renewed hope with IVF Spain. We have undergone tests that we’ve never had before (ERA, NK biopsy and KIR). We have paid for lots of very expensive blood tests and drugs but never received this kind of analysis. So, we feel as though the treatment is now specifically for us.

This creates more positivity, a feeling of being cared for and that maybe, just maybe, we’ll get to be parents.

Plus, we’re now using donor eggs. The hope starts to soar and with that comes excitement. Hope is the only thing that keeps you going and overcoming the fears I mentioned. This opportunity with IVF Spain has given us hope that we thought we’d lost.”

Laura is 41 years old and has already been through traumatic losses including an ectopic pregnancy. Due to this and to the fact that Laura suffers from trisomy 22 syndrome, our medical team at IVF Spain recommended an egg donation treatment to increase their chances.

The couple is thankful for the egg donation process being anonymous, as otherwise it would be really difficult to find a donor:

“For us, it’s taken some of the pressure away. I can’t imagine how difficult it would be to choose a donor ourselves. But putting your complete trust into someone else’s hands is hard.

We’ve explored whether it would be better for our future child to know the donor. I think that’s something we’ll never know. But we hope that he/she will understand our decision to choose an anonymous donor. It would be good to know a little more about the heritage of the donor but then we also know that we often don’t even know our own heritage. We’ll make sure Spain is a key part of their story.

It’s also really odd to not know who this person is. What they look like and personality. What’s motivating them to help us. One of the things I’ve been really consumed with is the gratitude you have for this person. I’d like to thank them but can’t.

Anonymity means we have a chance to become parents. Without it there’d be a shortage of donors like there is in the UK. For us, this makes it a wonderful gift – a chance to hopefully find a donor that is perfectly matched to us genetically (due to the KIR tests) as well as in physical looks.

I can’t stop thinking about what our future child will look like – but I think that’s quite normal” says Laura.

Immunologically speaking, finding a matching donor for Laura is certainly a challenging task, which is why IVF Spain suggested that we find out her KIR via a blood test. Ian was also tested for his HLA-C in order to determine whether the maternal – foetal interaction will be optimal or not.

Thanks to the KIR-HLA-C genotyping test it is possible to determine if the uterine KIR and the embryonic HLA-C will both be compatible. If so, the pregnancy will carry on successfully; if not, then the most probable outcome will be an unviable pregnancy and subsequent miscarriage.

“We carried out the KIR-HLA-C genotyping and concluded that the patient had a KIR AA. It is known that KIR expressed by the natural killer cells present in the maternal part and the HLA presented by the trophoblastic cells together will influence the outcome of the pregnancy. With Laura’s KIR AA variant, the sperm would have to be HLA C1 C1 and the HLA of the donor should be as well HLA C1 C1; as her husband has a HLA C1 C2 variant, we will treat her with a medication that reduces her immune-genetic reaction. We believe that not paying attention to this issue in the past is what may have caused the implantation to fail” suspects fertility specialist Dr Isabel Herrera.

We tend to recommend a single embryo transfer, as it has been proven that on patients with an immunological profile such as Laura’s, a double embryo transfers would increase the immunogenetic reaction, hindering the achievement of a pregnancy” says Dr. Herrera.

It is also known that these cases tend to have a higher risk of pre-eclampsia, late spontaneous abortion or miscarriage.

Until their transfer day the couple will try to enjoy summer just as any other couple would;

“I’ve tried to just carry on as normal. Remain healthy, take pre-conception vitamins. Reach out and get support through the Donor Conception Network in the UK and connect with other people going down the DE route via online forums. It’s quite isolating and scary so it’s important to reach out and not feel so alone.

I’m trying to relax a little – not so easy with work but it’s a work in progress. I need to get that bit sorted now treatment is on the horizon.”


Continue Reading

FERTILITY 360

Egg Freezing: Is It An Fertility Insurance Policy

Published

on

Egg Freezing

‘Should I freeze my eggs’ is a question many women consider and for many different reasons. Perhaps they have not found the right partner or they are at a particular stage in their life when they are simply not ready for a child, but at the same time, do not wish to miss the opportunity of producing and storing eggs before their biological clock gets the best of them, or before the quality of their eggs degrade making it harder to become pregnant in the future.

With many fertility clinics offering egg freezing to their patients, the procedure has transformed from one only undertaken if there is a medical need (perhaps before embarking on a course of treatment which is likely to affect fertility) to what has been termed by some as a fertility ‘insurance policy’ allowing women the opportunity to take steps now in an attempt to preserve their fertility just in case they are unable to produce viable eggs in the future. However, the value of that ‘insurance policy’ continues to be a matter for debate with wildly varying quoted success rates, which remain relatively low, and at a not unsubstantial cost. Yet many take the view that a backup plan is better than nothing at all, even if it offers no guarantees.

However the decision to freeze is only the first of many decisions to be taken which can have significant consequences in the future. For example, should the egg be frozen on its own, or should it be frozen as a fertilised embryo? The embryo is thought to be more robust than the egg increasing the prospects that it would survive the freezing process but comes with less flexibility to meet changes in the woman’s circumstances. The genetic makeup of an embryo is set by the choice of sperm used to create it (whether known or through anonymous donor sperm) and cannot be changed if, for example, the woman meets a new partner before she is ready to have children. Furthermore, if a woman and her partner separate before the embryo is implanted and the partner withdraws his consent for the embryo to be stored or used, it may have to be destroyed.

The decision of when to freeze the eggs is also an important one. From a medical perspective, the advice seems to be to freeze early on rather than waiting till you are in your mid to late 30s and 40s and using egg freezing as a last ditch attempt to preserve fertility. Whilst this may well be sound medical advice, there can be legal ramifications. That is because in the UK, it is only possible to store eggs for a maximum of 10 years after which they must be destroyed. The only exception to that rule is if the woman, or in the case of freezing embryos, her partner, are or are likely to become prematurely infertile. In that case, if the correct steps are taken before the 10 year time limit expires, the time for storage can be extended.

The choices that freezing offers are undoubtedly beneficial – but in making decisions about what and when to freeze guidance should be taken from both your medical and legal team.  As with all forms of insurance, a full assessment of the risks and the possible future consequences is needed to ensure the choice you finally make is the one most likely to provide you with the best outcome in your particular circumstances in the future.

Liz Bottrill is a Partner in the Family Law Team at Laytons Solicitors with over 25 years’ experience in the field. She has a particular interest in the law relating to children and fertility.

Continue Reading

Trending