Having fertility treatment overseas can be very different from having treatment in the UK.
More people are now choosing to travel abroad for fertility treatment, particularly those who need donor eggs or sperm. It can be difficult to decide where to go when there are so many clinics across the world, often promising what seem to be high success rates for relatively low costs.
Although many people have positive experiences of treatment abroad, there are some things to think about before making any decisions.
Key points to consider
- What are the rules and regulations in the country you are considering?
- Do you have a clear idea of the cost including travel and expenses?
- Do you know how success rates are calculated?
- Is it easy to communicate with the clinic?
- If you are having donor treatment, do you know what the legal situation is about payments to donors and donor anonymity?
- Are multiple birth rates similar to the UK?
- Is counselling and support available?
- Have you read up about the clinic, the country and travelling abroad for treatment?
Rules and Regulations
In the UK, all clinics offering IVF are regulated and inspected by the Human Fertilisation and Embryology Authority (HFEA). They have to meet certain standards to keep the licenses which allow them to treat patients.
In other countries, there are not the same strict regulations, so you may need to check things you would take for granted here. It is worth asking how fertility clinics are regulated and inspected in the country you are considering, and whether there are any rules they have to follow.
You may want to ask what systems they have in place to keep your medical details confidential, and to make sure eggs, sperm and embryos are cared for safely in the laboratory.
Cost of treatment
The prices on clinic websites can be lower than the real cost of treatment, so check what is included and ask how much your total bill is likely to be before making a decision. Ask the clinic for a breakdown of everything you may need to pay for.
When you are working out the price of treatment overseas, don’t forget to include the cost of travel and of staying abroad, and of meals out if you are staying in a hotel.
Make sure you know how many visits you would be expected to make to the clinic and how long you would need to stay. This can vary and makes a difference to the overall cost. Ask how much notice you are likely to get before you need to travel to the clinic, as booking late can be more expensive.
You may need scans or blood tests in the UK. Some overseas clinics have links in the UK to provide this, but you may need to sort it out yourself.
Ask if your medication will be prescribed and provided by the clinic, or if you will have to arrange to get this in the UK. There may be extra costs if you need private prescriptions in the UK.
You will need medical travel insurance as standard travel policies are unlikely to give the right cover, so find out how much this will cost.
Success rates
The success rates clinics use in the UK have all been verified by the HFEA, and are published in a similar way to each other, so you can compare success rates between clinics. There isn’t the same process in other countries.
Sometimes people decide to travel abroad because of what seem to be very high success rates. Look carefully at these as they may be showing rates for younger women and for pregnancy rather than live birth. They may give figures for a short period rather than for a whole year. If a clinic has success rates which seem unusually high, there may be a reason other than better outcomes.
Communication
You will need to be able to communicate with the staff at a fertility clinic, and if you don’t speak the language, you want to be sure there will be an English-speaking member of staff available.
In some clinics, the doctors will speak fluent English. If this isn’t the case, will you feel comfortable having a translator in your consultations? Check whether there is an extra cost for having a translator.
You need to know how you will get in touch with the clinic during treatment, and be confident there will always be someone you can contact if you need to.
Embryos
In the UK, there are guidelines about how many embryos can be transferred when you’re having treatment. It can be tempting to think twins or triplets would be an ideal solution to your fertility problems, but there are real risks. You are more likely to miscarry or to give birth prematurely if you are pregnant with more than one baby, and there are more likely to be long-term health risks for the babies once they are born. You can find out more about fertility treatment and multiple births on the HFEA website https://www.hfea.gov.uk/about-us/our-campaign-to-reduce-multiple-births/
Ask the clinic about their multiple birth rate – in the UK the average is 6%. If the rate is much higher than this, you should be concerned. A good clinic will not need to put back more embryos to have a good success rate. Remember, if you were going to get pregnant with twins, you will still get pregnant just putting one embryo back at a time
Using donor eggs or sperm
Many people travel abroad for treatment with donor eggs or sperm because they are worried about long waiting lists here in the UK. In fact, some UK clinics can offer donor treatment without a long wait. You can check the waiting times for donor treatment at clinics on the HFEA website https://www.hfea.gov.uk/choose-a-clinic/clinic-search/ and by contacting clinics directly.
The rules about donor eggs and sperm are different in each country. In the UK, children born through donor treatment will be able to find out about their donor parent once they are adults. In some other countries, donors are completely anonymous. Check what you will be able to find out about a donor before you have treatment.
In the UK, donors are screened for infectious diseases and conditions that could be passed on to children, and you should make sure there are similar tests where you are having treatment.
Here, sperm donors are only used for ten families, but in some places there aren’t any limits, which increases the number of families your child may be related to.
If you are using an egg donor, check whether you are going to get all the eggs from the donor or whether they are shared with other recipients.
There are also different rules in each country about how much people are paid to be donors, and how clinics can recruit them.
Surrogacy
If you are going to have treatment using a surrogate abroad, check the laws about this in the country you are going to. Surrogacy abroad can be complicated as you will need to get a parental order to become the legal parent/s of your child in the UK, and the rules about who is legally responsible before this happens can vary. It is advisable to take specialist legal advice before entering into any agreement.
You may want to check how surrogates are recruited and what agreements the clinic makes with them. This information from the government about surrogacy overseas may be helpful https://www.gov.uk/government/publications/surrogacy-overseas
Counselling
In the UK, everyone having treatments like IVF or ICSI will be given the opportunity to have counselling. This emotional support can be really helpful, and UK clinics also make sure everyone using donor eggs, sperm or embryos has “implications counselling” so they are fully prepared.
If your clinic abroad doesn’t offer any counselling, you can find a qualified specialist counsellor through the British Infertility Counselling Association (BICA) https://www.bica.net/find-a-counsellor, but you will have to pay for this.
Support
If you choose to travel abroad for treatment, there may not be the support you would expect if you are being treated here. Any problems or questions you have with the clinic or your treatment when you’re at home will need to be sorted out by phone or email. The HFEA can’t deal with difficulties at clinics abroad or complaints about them.
Do your homework!
If you are choosing a clinic yourself, look carefully at the clinic website and the information they give. You should be able to find out about the treatments offered, but remember that in some countries only heterosexual couples are eligible for fertility treatment.
You are likely to start your search online, and you may find reviews or discussions about clinics from patients who have had treatment there. These can be helpful, but they aren’t always impartial and one person’s experience may not be the same as another’s.
Some clinics in the UK have close links abroad, and it can be useful if your UK clinic suggests a clinic overseas. It is still important to make sure you feel comfortable with the overseas clinic though.
Your initial contact with the clinic will probably give you some idea about the clinic and how it is run. Are there English-speaking staff available to answer your questions? How much time are they willing to spend talking to you?
You should be wary of a clinic which is so eager to take you on as a patient that they are not interested in asking about your own medical history. A good clinic should want to see all your relevant test results and know about your medical history.
It may seem there is a lot to think about before going abroad for treatment, but it is good to be aware of any problems that might come up. Many people have travelled abroad for treatment without any problems by making sure they have done their research thoroughly beforehand, and we have heard from people who have received excellent care.
You can find more information about treatment overseas on the HFEA website https://www.hfea.gov.uk/treatments/explore-all-treatments/fertility-treatment-abroad/
Updated July 2022 with the Fertility Network UK Advisory Board