What is an IVF vacation?
An IVF vacation is when one leaves home to undertake a cycle of in vitro fertilization, often with the added benefit of huge cost savings.
What is in vitro fertilization (IVF)?
In vitro fertilization (IVF) is a therapeutic protocol in Assisted Reproductive technology (ART), due to a couple’s infertility. IVF is usually attempted after natural methods and other methods like intrauterine insemination (IUI) have failed. During IVF, a woman’s ova (eggs) are removed and fertilized by sperm outside the body and grown in a medium which mimics the uterus. The fertilized eggs, or zygotes, are then transferred back into the intended parent several days later. During a normal monthly cycle, a woman releases 1-2 eggs at ovulation, usually between cycle day 12-14. During an IVF cycle, a woman is given medication to create more eggs to increase the chance of pregnancy.
What is involved in vitro fertilization (IVF)?
There are basically five steps in the IVF and embryo transfer process:
- Ovarian stimulation and monitoring;
- Aspiration of the ovaries and egg collection;
- Sperm collection;
- Embryo transfer;
Fertility medications are prescribed to control the timing of the egg ripening and to increase the chance of collecting multiple eggs during one of the woman’s cycles. This is often referred to as ovulation induction. Multiple eggs are desired because some eggs will not develop or fertilize after retrieval. Egg development is monitored using ultrasound to examine the ovaries and urine or blood test samples to check hormone levels, if needed. The length of time may vary based on ovarian response to medication, but is usually around 10-12 days.
Your eggs are retrieved through a minor surgical procedure which uses ultrasound imaging to guide a hollow needle through the pelvic cavity. Sedation and local anesthesia are provided to remove any discomfort that you might experience. The eggs are removed from the ovaries using the hollow needle, which is called follicular aspiration. Some women may experience cramping on the day of retrieval, which usually subsides the following day; however, a feeling of fullness or pressure may last for several weeks following the procedure. Aspiration is usually done around 12-13 days after ovulation induction.
Sperm, usually obtained by ejaculation, is collected on the same day as follicular aspiration and is prepared for combining with the eggs.
In a process called insemination, the sperm and eggs are placed in incubators located in the laboratory which enables fertilization to occur. In some cases where fertilization is suspected to be low, intracytoplasmic sperm injection (ICSI) may be used. Through this procedure, a single sperm is injected directly into the egg in an attempt to achieve fertilization. The eggs are monitored to confirm that fertilization and cell division are taking place. Once this occurs, the fertilized eggs are considered embryos. Insemination occurs on the same day as aspiration.
The embryos are usually transferred into the woman’s uterus 3 or 5 days later. At this point, the fertilized egg has divided to become a multi-celled embryo. The transfer process involves a speculum which is inserted into the vagina to expose the cervix. A predetermined number of embryos are suspended in fluid and gently placed through a catheter into the womb. This process is often guided by ultrasound. The procedure is usually painless, but some women experience mild cramping.
These steps are followed by rest. A Beta HCG blood test is typically conducted two weeks post embryo transfer to see if pregnancy has been achieved. If a pregnancy test and potentially an ultrasound will be used to determine if implantation and pregnancy has occurred.
How successful is in vitro fertilization?
The success rate of IVF clinics depends on a number of factors including patient characteristics and treatment approaches. It is also important to realize that pregnancy rates do not equate to live birth rates. In the United States, for example, the live birth rate for each IVF cycle started is approximately:
- 30 to 35% for women under age 35
- 25% for women ages 35 to 37
- 15 to 20% for women ages 38 to 40
- 6 to 10% for women ages over 40
When comparing success rates of different clinics in our IVF vacation network, it is important to know what type of pregnancies are being compared: chemical pregnancy, clinical pregnancy, or live birth rate. A chemical pregnancy is one confirmed by blood or urine tests approximately 2 weeks after embryo transfer, but a miscarriage may still occur before confirmation through an ultrasound which takes place at 7-8 weeks. A clinical pregnancy is one verified by ultrasound and a heartbeat. After a clinical pregnancy has been verified, a miscarriage may still occur, but it is less likely.
What if I don’t produce healthy eggs?
IVF may be done with a couple’s own eggs and sperm or with donor eggs, sperm, or embryos. Some couples choose to use donor eggs, sperm, or embryos because of genetic concerns. Donor eggs are used in approximately 10% of all assisted reproductive technology (ART) cycles.
Are there any side-effects of an IVF cycle?
IVF can certainly be a hormonal roller-coaster. In addition, to the natural mood swings induced by artificial hormones, feelings of swelling in the abdomen are common, and it is normal to feel some discomfort after follicular aspiration. Thus, it is important to modify your activity during the later stages of a cycle.
What are the risks associated with in vitro fertilization?
As with most medical procedures, there are some potential risks. The risks of in vitro fertilization depend upon each specific step of the procedure.
Ovary stimulation carries the risk of hyper-stimulation, where the ovaries become swollen and painful. This condition, “Ovarian Hyper Stimulation Syndrome”, or OHSS, is usually rare, mild, and involves the following potential side affects: nausea, vomiting, lack of appetite, or a feeling of being bloated. More severe symptoms which occur in 1% of cases, include the following:
- Severe abdominal pain;
- Severe nausea or vomiting;
- Decreased urinary frequency;
- Dark-colored urine;
- Shortness of breath;
- Ten pound weight gain within three to five days;
Egg retrieval and the use of laparoscopy carry the typical risks related to anesthesia. Additionally, there is a slight risk of bleeding, infection, and damage to the bowel, bladder, or a blood vessel. Less than one patient in 1,000 will require surgery to repair damage caused during the egg retrieval process.
The chance of a multiples pregnancy is increased in all assisted reproductive procedures. There are additional risks and concerns related to multiples during pregnancy such as increased risk of premature delivery.
Assisted reproductive technology (ART) involves a significant physical, financial, and emotional commitment on the part of the couple. Psychological stress and emotional problems are common, and even more so if IVF is unsuccessful.
How many embryos should be created or transferred?
The number of embryos that should be created or transferred during any single IVF cycle is open to debate and is a discussion for you and your fertility doctor before you go on an IVF vacation. It will also depend on age, factor, and whether embryos are transferred at day 3 or day 5.
Why take an IVF vacation?
The answer is different for every woman: a) the desire to save money (and you can save a lot), b) the desire to take one’s mind off the hormonal rigors and obsessions of an IVF cycle, and c) at the very least if you’re unsuccessful, you’ve ‘gotten something out of’ the money you’ve spent, a vacation experience (IVF is by no means a certainty, and the number of women who go through multiple times is staggering.
How much money can I save by taking an IVF Vacation abroad for fertility treatments?
Considering the average cost of IVF in the US starts at $9,000 – $12,000 without medication, and closer to $18,000 – $20,000 with medication, you can save thousands of dollars even after an IVF vacation. It is very possible to save up to $10,000 with an IVF vacation.
Are there tests I need prior to taking an IVF vacation?
Like any procedure, it is essential to decide if you are a good candidate before traveling on an IVF vacation. Thus, you will need to complete the following tests at home, and the results need to be sent to the doctor at least 2 months in advance of an IVF vacation for assessment:
- Day 3 FSH;
- Semen analysis;
- Uterine cavity evaluation;
- Infectious disease screening for male and female;
- If you have these tests already done, tests are typically good for 6 months;
- You will also complete a health questionnaire and medical history to share with the doctor;
Should I be concerned about culture / language barriers on my IVF vacation?
This is a question that only you can answer. Will these countries be exactly like ‘home’? The answer is no. You will undoubtedly find some people who do not speak English, but all IVF Vacation Center doctors speak English. If you’re a person who likes adventure, you will have no trouble at all. If you are a person who wants everything to be exactly the same, you’re probably better off cycling at home instead of taking an IVF Vacation.
How long do I have to be away from home?
Given the various stages of the process, a minimum of 19 days is usually required to be away from home for your IVF vacation.
Is there a way to shorten the trip?
The only way to shorten the experience of a regular IVF cycle is to have a doctor at home who will prescribe medication and do initial monitoring. This may defeat the purpose as savings achieved by purchasing medication abroad will not be available.
What factors can reduce my chances of success with IVF?
Factors such as being overweight, smoking, drinking alcohol, recreational drug abuse can all lead to infertility.
How much lead time do I need before being treated?
Typically, we will need at least 2 months to organize your IVF vacation experience.
What if my partner can’t come for the whole length of my IVF vacation?
The male partner can be in the country with you on an IVF vacation for as little as 3 days, during sperm donation.
How long after embryo transfer will I have to wait before I find out if I am pregnant?
You will typically take a Beta HCG blood test approximately 2 weeks after the collection of the eggs. If the test is positive, it is usually repeated several days later to ensure it is a viable pregnancy.
Do I have to have my doctor’s support at home?
It is important to have a doctor’s support at home after your IVF vacation as you will likely need to have them prescribe certain medications both pre and post-cycle.
Do I have to take any medication before traveling for an IVF vacation?
Depending on your doctor, you may be required to take medication to suppress your system and align your cycle with your travel dates for your IVF vacation. This may include a contraceptive pill timed precisely to ensure your cycle falls at a specific time on your IVF vacation.
Do I have to take any medication after transfer?
A woman may be required to continue to take estrogen and progesterone for up to 16 weeks after transfer to support the pregnancy.
What if I have extra embryos after transfer?
Extra embryos can typically be frozen for later use at a much reduced cost, as the woman does not need to go through all the steps of the IVF process again, just a frozen embryo transfer (FET).