Fertility Tourism – It Isn’t a Holiday
I really do not like the term ‘fertility tourism’. While catchy and headline grabbing, it suggests that people are thinking “I need IVF, but I need a holiday too; one with good weather, good food and interesting culture. I might as well have my fertility treatment in Italy this summer.” I believe that it is rarely, if ever, as shallow or light-hearted as that. It definitely wasn’t that way for me when I decided to entrust my recurrent miscarriages and infertility challenges to American, rather than British, medical specialists.
It appears that like me, people have felt that going abroad for fertility treatment is something they need to do because they fall outside the parameters of government regulations, have no patience with the slow-moving response time or do not trust the medical standards in their own country. At the time that I was making my own decisions about medical treatment, I had a foot and an arm in each of these camps. Because I was originally from the United States and my parents still live there, it made sense for me to look there first.
When I began trying to conceive at age 36, I had three miscarriages. My inability to maintain a healthy pregnancy was confusing and devastating. In the UK, the NHS has a policy of not investigating the cause of a miscarriage until you have had three in a row. This they base on statistics, insinuating that first and second miscarriages are flukes, not medical problems. I couldn’t, and wouldn’t, wait that long. After my second miscarriage, I did see a private ob-gyn in London, but when push came to shove, I felt let down by the medical system here. It didn’t help that the British hospitals were ugly and shabby, the “care” was uncaring and I was left alone for long periods with no clue about what was going on. When I became pregnant for the fourth time in 16 months, my husband and I went to the U.S. for a slew of genetic tests and I was accepted as a patient by a renowned High Risk Pregnancy medical practice. I did eventually return home to the UK in my last trimester, where I had to go into hospital a month before my due date and gave birth a little over a week later (not the best experience, but I won’t go into that now).
A year later, already labelled a geriatric mother by the NHS at age 39, I began to try for a second baby, with no luck. I waited just a tad too long to request help was told I would not get it, because I had become ineligible for NHS-funded IVF at 40, plus the fact that I already had one child. At that point, I didn’t hesitate to seek out a fertility clinic in the US. Just as I was making the arrangements to spend 2 1/2 months in the US with my daughter, I realized that I had been briefly pregnant when I had a 4th miscarriage at six weeks. It was clear that my fertility problems were multi-fold. It cost about $14,000 seven years ago for the first cycle. With low success rates for women over 40 (about 25 – 30% at that time), and no more money in the bank, my husband and I agreed ahead of time that there wouldn’t be a second cycle.
Forgive me if this sounds snobby, but along with the referrals regarding their medical excellence, I appreciated the smart offices and blindingly white treatment rooms, the personal, encouraging manner of doctors and nurses, and the state-of-the-art equipment at the American fertility clinic. I had to overcome a lifelong phobia of needles in order to have IVF. The staff was amazingly friendly and supportive, helping me and my father (the chosen swordsman for my daily torture sessions) repeatedly until we could handle it ourselves. In short, I felt relaxed, relieved and cared for; something I had never, as yet, felt at any of the GP practices or hospitals in the UK. Even though our first and only IVF cycle failed, I have never regretted putting ourselves in the hands of American doctors. We returned to the UK, feeling that we had given it our best shot and determined to be the best family of three we could be.
Why hasn’t anything changed in the years since? I believe that the UK, as well as other countries with similarly restricted access to fertility treatment, should step back a bit and operate a more flexible policy regarding miscarriage investigations and assisted conception. Why can’t each case be looked at individually, with the age range of 23 to 39 as a guide, but not as absolute criteria? It so happens that I didn’t put off having children for a career; I just hadn’t met the right man and married until I was 35. I had no prior knowledge of, or reason to suspect, any reproductive problems. I fell into that particularly frustrating area of “unexplained infertility,” with guesses, but no firm evidence, about blood clotting, thyroid or simply poor quality and low quantity of my eggs remaining.
Even if women put motherhood off to a more mature and settled age, I wonder why the government doesn’t support, rather than penalize, hard working, ambitious and healthy members of society, so they can start families between the ages of 35 and 45. This is no longer considered middle age. Why turn away women who want to be single mothers, gay couples who want to have children, and people who need to overcome serious medical issues before they get clearance to become pregnant? These people aren’t border-crossing voluntarily in order to bring back a baby as a souvenir. They are forced to go abroad in order to benefit from more relaxed government policies and access to treatment in the US, India, Belgium, Denmark, Spain, Italy and Switzerland and elsewhere. The numbers of fertility patients who are going abroad for IVF, egg donation, surrogacy and adoption, should be evidence enough that the general population wants to embrace parenthood and create family units, contributing a new generation.
Remember the phrase “go forth and prosper?” I seem to remember it from Star Trek, but I have an inkling it may have been said first in relation to Moses in the Old Testament. For those who seriously want to go forth and prosper in the “biblical sense,” tourism is not an appropriate description of their trips abroad. It is more of a journey undertaken to search out and fulfil an emotional, physical and spiritual need; to become a parent is part of the course of life on earth. Therefore, I prefer to coin a new phrase to refer to this phenomenon: a “fertility pilgrimage.” Try it out; it imbues the act of journeying abroad to achieve fertility more specific and meaningful significance.
