# Support from UK clinics when having tx abroad



## MrsBunny (Oct 2, 2006)

Hi Abroadies, and anyone else reading this

I decided to start a thread to get your thoughts, experiences and opinions on a subject that has been bothering me quite a lot and even more so recently!

It is to do with the support/help given by clincs and hospitals here whilst having tx abroad.
Before going for tx in Spain, I was under a consultant at a women's specialist hospital who said that he would support me during my tx abroad. He did say that he usually worked with a clinic in Cyprus, but that he had helped one other couple with tx in Spain. I was obviously glad of this, but it has brought up several difficulties and I feel now that, although I have been able to have practical things done there like blood tests and scans, I have not been given any support and every time I need something done it is an ordeal!

From the outset, I have informed the hospital of my treatment plan in advance (the consultant gives his e-mail address so I can contact him directly, but he doesn't always reply!) and double checked that I am ok to go to the drop-in clinics to have blood tests done and more recently, my downreg injection. However, my consultant made it very clear that he does not agree with the protocol I'm having and it is 'not how they do things there'. He is still willing to do whatever is required, but it is difficult for him to give opinions and other support as the protocol is so different to his. I must add that he is a 'nice man' and has the patient's interests at heart and in many ways I am lucky to have him 'on my side'.

He rang me the other day because he had heard I had been having problems. The only thing I had complained about was the 1.5 hours wait I'd had at the clinic to get my injection done, which I assume could have happened to anyone as they only have one clinc for all - tx NHS/private/here/abroad. But he was immediately on the defensive and started telling me that it was becoming very difficult for them to help people having tx abroad because of the different protocols (e.g. a nurse might not know how to give a certain injection / the consultant cannot give proper advice). He also mentioned that people would come into the clinic and demand to have a test on a certain day at the request of their foreign clinic and that this wasn't always necessary. There was also mention of getting medication - their pharmacy may not stock a certain item needed and would be reluctant to dispense it (he thought we'd complained about this earlier but we hadn't!). Also he said that because the clinics abroad weren't communicating with them directly, it was unfortunate for the patient to have to be the 'go-between' at what is a stressful time anyway. (I took this upon myself anyway, after hearing that he didn't agree with the protocol).
Anyway, I ended up feeling rather offended with his tone, but more importantly, it made me think that if it was so difficult, they may withdraw this type of service (he did mention this and said that they only do it as a 'favour' to existing patients at the moment).

Ruth from Ceram, the clinic where I am having tx, said that she has heard that certain clinics and hospitals here may be withdrawing from helping people having tx abroad because of the numbers - they have not got time to deal with them as well as their ordinary patients!

It seems that hospitals here do not have a 'system' for dealing with patients having tx abroad unless the hospital/clinic is affiliated with the foreign clinc. For the rest of us, it's a case of asking for whatever we can get and hoping for the best!

So, it would be interesting to hear about any experiences you have had and whether you have felt 'supported' or quite alone and vulnerable, being your own project manager!
I've made a list of things that could be considered:

1. Referral to the foreign clinic - how easy was this? 
(We didn't go to Spain for the initial consultation - I wish we had. My consultant didn't see the need for all the different tests and bits to fill in on the form, he said that his word that we were suitable for tx should be enough! It took much longer than necessary to get the form done, causing much frustration!)

2. Virology screening tests

3. Communication with the hospital - is it easy to speak to someone there / get test results faxed or e-mailed to clinic abroad?

4. Scans, blood tests, injections - how easy is it to arrange these at certain times / get results?

5. Getting medication - I am now using the Italian Pharmacy as it's much easier!

6. Looking for alternative places to get blood tests/scans - how easy is this?

I would be interested in your thoughts about whether there is anything we can do to ensure that people having tx abroad get the support they need in the UK. If hospitals start withdrawing their services, where can people go? I wouldn't know where to go. In an obviously growing 'marketplace', it would be awful if the hospitals here dropped out completely, leaving people to go to possibly unscrupulous and expensive clinics. In general, GPs do not offer support of any kind - may be a few tests but not much else.

Sorry, this has turned into a bit of an epic! But I hope you'll agree, it is an important issue and there are worrying signs for the future. 
Looking forward to reading your comments.

Mrs Bunny xx


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## three_stars (Jan 19, 2006)

Mrs. Bunny,

You are very right about the problems of local support.  Actually I am surprised you even got a GP who would help at all!
My local NHS clinic would not even do an injection so I learned to do by myself.  The belly ones with the short needle are simple but the inter muscular one, especially if it is PIO,  does take a bit of courage at first when trying to get to your own behind with it... I started doing it in my thigh.  As far as his nurses not knowing how to do the injection that is poppycock!!  
One of the DRs their refused even a sperm test for exDP and he was very condescending to me.. obviously not pro IVF what so ever)
I managed to get the very most basic blood hormone tests and pelvic scan at a private clinic but it was bloody expensive and if you needed it on a weekend forget it .  That goes for most treatments in the UK ( DO they think your body just stops for the weekend?)

All in all I decided to stay in France while (ex)DP stayed in UK for the past 8 years.. mainly because of the fertility treatments and more recently for the support while abroad. ( DId not help our relationship at all!)  That said I have had plenty of trouble here as well.  But at least you can get blood tests and scans done paid out of your pocket but reasonable when you need them.  I still get no support as my GYN is not a fertility DR.  IF I were using another IVF DR. here he would likely be very snotty about using someone else's protocol as well.  They can site all the medical reasons they want but I put it down to ego mostly.  One thing they don't seem to deal with well is the different names of meds from abroad but the pharmacist or a little of your own internet research will tell you equivalent names for different countries.  Usually your clinic abraod will also know.  There are not really that many different ones and honestly the protocols are not so very different. Any trained IVF specialist should certainly be aware of all types of protocol used in fertility treatments.

Ok that was just my little morning rant on the subject.
I think it is a real problem for UK women and maybe elsewhere as well.  The few places that do have a link to an abroad clinic seem to really make a huge profit on this to the point where your tx abroad is not much cheaper then in UK!  As the Uk  govt + HFEA seem to be anti tx abroad as well, it does not help "our" cause at all.
You would think they would be glad that all of us take an initiative to go abroad and pay it ourselves.  Think how much more burdened the UK system would be if we didn't!

bonnie


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## nikkis (May 29, 2006)

I had a couple of cycles at London Womens \Clinic in Cardiff/Swansea before deciding to go abroad for DE

I must say that they have been wonderfully supportive and encouraging, even tho the systems used in my Spanish clinic is totally different to theirs..they just were interested to see how this other clinic did it but were happy to do my scans (and charge for it, of course)

If anyone is in this area I would definitely recommend them..I cant see why any private clinic would not assist, especially when its a nice little earner, although of course I can understand that their own patients should take priority..

If private UK clinics had any sense they would devote a little room to other women using clinics from abroad and could make a killing, Im sure
Nikki


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## Morvern (May 16, 2005)

My clinic were fine too. I had an IUI and an IVF at Care Manchester and my consultant said they would be pleased to help in any way they could if I went abroad. And actually they were great - one of the nurses did an intramuscular injection for me (for free) and they did my pre-IVF scans without any problem too. In fact after I got pregnant they did a couple of scans for me for free because they assumed that I had had successful treatment with them (naughty of me not to tell them, I know, but hey they've had thousands out of us). 

The only thing to remember is that the UK clinic cannot take responsibility for you or interpret any of your test results. You have to take responsibility for yourself and relay the results back to your clinic abroad. So long as we all know where we stand I don't see why it should be a problem for UK clinics.

Morvern


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## roze (Mar 20, 2004)

Hi, the Lister Hospital in London used to have formal links with Ceram; is this not the case anymore. They charged around £800 for the support service and they have satellite clinics in the UK.

To be honest, I used to get support - free- from the Lister when I first went to Spain but this soon died out due to taking up their resources- even though they suggested I go to Spain in the first place!  I was not impressed by the £800 package as it was an administrative mess and very unclear as to what you were getting for the money. I do think most women need to go independently for meds and scans in the UK however this is not ideal as we do need support and monitoring. Fortunately in London Harley Street is rife with scan and blood test clinics so I never had any problems however this does cost a lot of money. TDL do blood tests and pregnancy tests with a referral letter from a Dr, even from abroad. I got my last meds from the Italian pharmacy when the Ukraine meds ran out.

Some blood tests were done by my GP however I went privately on some occasions for speed. Last time I had the whole lot done in France when on holiday for less than half the cost of the UK!  You could say that my resulting child is very much a child of central Europe!

The clinics I have been too,is IVI in Spain and ISIDA in Kiev have all been responsible in insisting that women have health checks and a Drs referral letter before they agree to treat - this rules out anyone with serious health issues such as heart problems, for whom pregnancy can be dangerous. Other clinics may be more cavalier, I don;t know. but whats for certain is that the tx which requires HRT can be dangerous for some women, hence its best to check with your own GP before commencing this.  All in all, the piecemail approach that women have to take in getting IVF/donor tx abroad is not satisfactory from a holistic healthcare point of view. However given the NHS resources, I do not think much is going to change.  More and more people are seeking general health care abroad privately due to waiting lists here and the same issues apply to them.

best of luck with your treatment,

roze


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