Travelling Far for Fertility Treatment: pros & cons

The number of people travelling a long distance for fertility treatment is on the rise.

Anecdotally, the top 3 most common reasons to travel for fertility treatment are 1) there aren’t any local options, 2) to save money, 3) or there are more appropriate options elsewhere that aren’t available locally.

Some potential clinics might be other locations within your country.

Some common locations abroad are: Mexico, Turkey, Czech Republic, Georgia, Cyprus, Denmark, Ukraine, Spain, Portugal, Greece, Barbados, India, Dubai, Albania, Brazil, Latvia, Dominican Republic, Costa Rica, Thailand, Canada, and the USA.

This isn’t a full list, but gets you starting to expand what might be possible.

Whatever the reason and wherever you go, there’s a lot to consider. Some pros and cons of the reality of travelling for treatment are below, so scroll down to image if this is a possibility for your future baby-making plans.

Pros of traveling for fertility treatment

There are exceptions, but here are more details about the potential benefits of travelling abroad or out of province/ state/ country for fertility treatment.

• It can be much cheaper. Fertility treatment can be very expensive. You probably didn’t need me to tell you that. It’s a gut-wrenching reality for a lot of people, not being able to afford local options. Insurance or government-funded programs might cover some or a portion of your treatment but for too many people it’s not enough. It can be the cost of the treatment like in vitro-fertilization (IVF) with your own eggs, for donor eggs, donor sperm, donor embryos, surrogacy or another reason. Depending on your situation, the costs can be cut up to a half or even a third if you travel farther for treatment, even when you factor in flights and accommodation – finding cheap flights can be key and there are so many sites dedicated to finding cheap flights. This might be the difference between having a baby or not, which is life-changing. For example, the price of donor eggs is significantly lower in a few countries than in Canada or the US. Or you might be able to do 3 potential rounds of IVF but only 1 or none if you attempted at a local clinic.
• If there aren’t options locally, then you might be stuck with travelling far, especially if you live a remote part of the world or country. Or, the wait times might be too long. This reduces your options and is the luck of where you live and may be a problem with the healthcare system that you live within. Neither of these are your fault. Another reason might be that you no longer are eligible like cut-offs by age. For example, in Ontario you can’t do IVF past 42 with your own eggs but in Mexico there are clinics that do.
• They might have more inclusive laws for LGBQTIA+ (eg, Georgia is better than Cyprus) like it’s not legal for you in your country if you’re 2 dads in Italy.
• They offer a guaranteed program where you get your money back if you don’t get pregnancy or have a live birth after a certain amount of IVF rounds. This can be very appealing, especially if you know you’ll likely need more than one round of IVF with your own eggs. Perhaps your low egg reserve indicates this. You can ask your doctor and the doctor you’re looking at elsewhere for their input.
• Expanded opportunities for finding gestational/surrogates. More surrogates are available in some countries and parts of the world than others. Costs for surrogates can also be lower elsewhere which could be the difference between trying or not.
• You might want a specific type of treatment or testing that isn’t done anywhere locally like HLA and KIR TypingImmunology treatments, ovarian rejuvenation (PRP), IVF/ICSI +\- PGT-A, PGT-M, PGT-SR, embryo glue, or immunology testing.
• You might want to see a specific doctor who specializes in the condition that you have such as in endometriosis, RPL (repeated pregnancy loss), or DOR (diminished ovarian reserve). Some specialists niche down even further and you trust them and only them to give you the healthcare that you need.
• Potentially your currency is better than wherever you travel to so your money gets you more. For example, your British pounds can get you a lot in Barbados, or your Canadian dollar does better compared to the Mexican currency or pesos right now.
• Getting donor eggs or sperm from someone in a country that has the same race as you or your partner and you can’t find the same race nearby.
• Getting more hands-on care. Anecdotally, I hear this all of the time that local clinics just aren’t set up to provide the airtime with their patients that abroad clinics can. Clinics abroad that are part of a fertility ‘health tourism’ in particular are known for providing much more luxurious and comfortable services and even added time with their doctor than clinics closer to home. They might provide more regular communication than your local options, which can reduce stress.
• Combine the treatment with a vacation in some cases. That can be very appealing. This can also potentially reduce your stress not juggling work and by being on vacation so that you can focus on self care and your fertility.
• If can stay with friends or family, that might be a benefit or just a bonus.
• If you work from home, it might be possible to work while away and potentially take less time off work which can be appealing for some people.
• Some home clinics or nearby clinics are set up to partner with clinics abroad or elsewhere and make it a smooth and much easier experience, such as ‘satellite monitoring’. This means less time away and most if not the majority of the time close to home and only flying out for transfers or other procedures. A common example is CNY across the USA.
• Higher success rates sometimes. You can’t necessarily trust that information if it’s in a country you don’t know the standards or regulations. In Canada we can’t within clinics and in the US you can compare with SART but you also have to do research that not everyone has the skills to do, and that’s not your fault if that’s a challenge.
• They use technology your clinic doesn’t use locally.

Cons & potential solutions

On the flip side, here are potential challenges and for some, options to remedy the situation.

• Unforeseen costs of travel. Sometimes it ends up being more than you’d think when it comes to accommodation, travel and time off work. Check the clinic for discounts at hotels and other accommodations like Airbnb and VRBO or other rental arrangements. Whether you’re Canadian or American, hold onto every receipt because you might be able to claim it on your taxes or be covered by insurance.
  • Canadian’s can find cheaper deals YYZ deals or from the nearest city to you.
  • Americans can find flight deals at the Dollar Flight Club.
  • UK and European residents can find deals through EasyJet and Ryan Air among many others.
• Risks in transporting eggs, sperm, embryos in some situations. If you transport there is a risk even with the greatest insurance and track record of the courier company. In many situations you don’t need to move your precious cargo.
• If you need to work with a local clinic for monitoring, sometimes they clinic closed on weekends or has restricted hours for people who aren’t their patients but the hours are different compared to the hours that your clinic abroad needs your scans or tests.
• Being away from home. If you have pets and can’t bring them, losing that comfort especially if feeling unwell is a drawback. The comfort of home might be welcome at a time like this. Being near your loved ones might be important too, although virtual opportunities are better than ever.
• Getting the medication ahead of time or potentially trying to travel with them. Eg can’t bring from the US to Canada quite often. This can get tricky when it comes to border crossing and refrigeration. Check before you buy and plan ahead. There are also might be different kinds of medication there versus here.
• Potential jet lag. This is often not factored in and it might impact how you feel, so consider scheduling it so that you feel OK before injections start or before a transfer. Sleep is important for fertility, your doctor will probably tell you. If you can, consider arriving there a few days early to adjust to the time difference.
• Needing to return in the future for a transfer and risk you can’t get there because of weather or global event, such as the scenario like a pregnant surrogate or frozen embryos that were in Ukraine when the 2022 war broke out or if there’s another pandemic closing air travel like for the Covid-19 pandemic.
• Potentially a language barrier if you don’t speak the official language of that country. Usually that’s not an issue in the fertility clinics, but it’s possible, and of course travelling around could cause language barriers and unforeseen castles. There are also apps like Duolingo to help ahead of time to learn some of the language and there are apps to translate easily.
• Cultural differences and sometimes discrimination. This could be a huge factor, depending where you’re considering going. This could also be in the ‘pro’ side if you need to travel for more appropriate and less discriminatory care. Talk to people on the ground. Get to know individuals in local support groups to check this out. Word of mouth might be the most important. Get to know the local culture and just do your homework.
• Some places in the world prohibit you from couriering your precious cargo like sending or receiving sperm, eggs or embryos. In that situation you have to always travel there for transfers or to donate to someone locally or willing to travel there. This can add to unforeseen costs and can heighten anxiety for some people, being far from their eggs or embryos etc.
• Some places you have to prove you’re married with a marriage certificate and they require that you’ve been married for a certain amount of time. You might not be married or have a parter so don’t qualify. Hopefully have the choice to find somewhere else more inclusive but that could be a con if it was your front-runner.
• Extra work for you in some cases. It can work out great if you coordinate with your doctor at home to write prescriptions, local pharmacy to fill prescriptions, and do some monitoring like blood tests but it often requires some education and research for your primary care physician/ GP to get this done. Sometimes you still have to travel far to satellite clinics or wait longer times for medication to come in.
• Feeling a bit more isolated. That’s where fertility coaches and local support groups can be helpful. That’s the upside of such a global, plugged-in world, that you can connect from anywhere.

Access should be improved in Canada. Many fertility experts and advocates, including myself, are advocating for there to be a federal strategy and better access across Canada. As part of advocacy, access should be improved. I was interviewed by Canadian Affairs in for their article on access to treatment.

In the US, Resolve is working on ensuring every state provides access, especially as some states are bringing in legislation that removes options such as IVF or surrogacy.