# Planning a treatment abroad.. please help



## mms (May 25, 2009)

hubby and I have suffered for 3 years with unexplained infertility and tried everything from IUI to ICSI, laparoscopy and hystroscopy,  and nothing worked for us until “surprise” .. I had a spontaneous pregnancy and carried to full term.. my DS is now 6 years old and we have been trying for a second one for almost 5 years now.. again went through ICSI, PGD, PGS, Imperical Immune treatments, FET.. you name it.. nothing is clear as to the cause of infertility..  we live in the Middle East and have decided to give it one more shot abroad with some of the worlds top fertility centers with the highest success rate. I have consulted with ARGC in London and IVI centre in Spain.. now both centers have totally different approaches and both will cost us a fortune keeping in mind that we will have the extra costs of traveling and accommodation.. we have £40k to spend for one last chance which basically is enough for one round of IVF so we need to make a wise decision. I would need to know out of the experience of people on this board how would they rate those two centers or any other centre they would recommend and why.. ARGC think that the reason could be an Immune dysfunction. IVI don’t believe much in Immune a issues and think i would have a higher success rate with a single FET.. and not a multiple fresh transfers (previous cycles were always 2-3 embryo transferes and almost always a fresh transfer except for one.. and I have PCOS) .. I’m 35 and have a very good ovarian reserve but lately have noticed that my endometrium is not thickening beautifully like it used to.. both centers think this is an issue they can treat.


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## bombsh3ll (Apr 19, 2012)

It is 5 years since I last cycled, (DE in Spain at FIV Marbella), but I am pretty sure that £40k would still stretch to several cycles either in the UK or Spain, factoring in travel, even if you went for fresh DE with all the bells and whistles like immune treatment. If you only have the mental, physical, emotional, social resources or other personal reason for deciding on one last cycle, that's one thing, but with £40k you are not financially limited to one cycle, unless you need to pay a surrogate or have other unusual expenses. 

I have no experience with IVI centre, but can highly rate FIV Marbella. I would have gone back there had it not worked, which I could not say for my prior two experiences in Cyprus and Edinburgh. 

Even without any knowledge of this particular clinic, my advice would be to consider Spain above the UK for a number of reasons. For the treatment I had, it was not any less expensive than the UK, so that wasn't a deciding factor for us. Spain do however have differences in approach and what is allowed. For example, I was able to make an informed choice to have three embryos transferred. In the UK I would have struggled to be allowed two. 

At the time I cycled, Spain had already moved towards a much more gentle stimulation rather than the aggressive doses of gonadotropins still being used in most UK clinics. They had much lower OHSS rates. Granted it was not me undergoing stimulation, but having had OHSS badly twice myself, I would not want to inflict this risk on the donor on my behalf. 

You do not mention if you are considering any form of donor treatment, but if donor gametes/embryos are involved at all, Spain has anonymity, the UK does not. 

The legal situation re ownership and use of embryos created was also different and more clear in Spain than in the UK. For example papers signed by both of you at the time mean you still have the right to use embryos created should your husband die or you divorce/split up. In the UK this is far more muddy and there have been some heartbreaking cases as the result of this legal minefield. 

FIV did ICSI as standard for all their patients and I understand that this was the case throughout Spain. We needed it anyway, as although I had tubal infertility, we found out incidentally when booking our first cycle that my husband had lousy swimmers. FIV had my husband give his sample in advance on our preliminary visit, washed and treated it so that only the best ones were left, then froze it so we had the peace of mind of knowing there was a good sample waiting on the day of EC, which really took the pressure off. No UK clinic offered us this. 

I'm not just biased because it worked, we found the whole attitude in the way we were treated much better in Spain. We had much more of a say in our treatment. They respected my reasons for choosing DE as well (at 31 with good reserve, access to DE in the UK would have been very difficult if not refused outright). 

Good luck with whatever you decide, I hope your treatment is successful wherever you decide to go!

B x


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## Spanglyboo (May 18, 2014)

MMS

My first thought is that £40,000 is a probably the cost of a cycle at ARGC from what I have read but cycles abroad are usually better value

What is the treatment plan at IVI if they don’t really believe in immunes? I imagine a lot of the bill at ARGC will go on the immune side of things

I would have thought that especially abroad you would get at least 2 cycles for that amount of cash


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## mms (May 25, 2009)

Thank you ladies for your response

At ARGC the total cost of cycling would be between £20-30k .. cost of air tickets would be another £4K.. cost of accommodation and daily expences would be another or not less than £6-10k.. so that pretty much sums up to £40k
At IVI the costs were slightly less.. keep in mind that even at Spain where they don’t believe in Immunes, they almost always want to do a FET which means we will have to go back again to Spain and pay additional charges for traveling.. on top of IVF+ICSI I will need to do PGD since both Hubby and I are carriers of a single gene mutation .

DE is not an option for us because a) we need an HLA matched sibling for our affected child and b) for religious reasons. I’m 34 and have good ovarian reserve and create beautiful embryos (expanding blastocysts) so I don’t think our issue lies with the quality of eggs, but rather with implantation which could be a malfunction of the endometrium and or Immunes! 

At ARGC I was told that the do Immune tests on blood samples. According to my simple research it seems that NK cells in the blood are irrelevant to the uterus and for a proper immune test we need to undergo an Endometrium biopsy!! Which draws some question marks and will have to speak to the doctors again and get an informed explanation.. however, ARGC continues to have a very high success rate and there must be a reason as to why they keep having high success rates! 

It is a very hard decision but I will try and consult FIV Spain and see what their approach is and try to compare


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## Spanglyboo (May 18, 2014)

What about Czech or Cyprus?


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## mms (May 25, 2009)

@spanglyboo.. haven’t thought of it to be honest!! Perhaps because I didn’t hear much about very high success rates compared to ARGC and IVI... and I could be wrong!


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## bombsh3ll (Apr 19, 2012)

I personally wouldn't recommend Cyprus despite the lower prices. I did my first cycle there (North/Turkish Cyprus) and the standards of clinical care were below that in a European country. Whilst not all clinics may be the same, I would have concerns.

The sperm was left for some time in an unlabelled pot in a warm room. I was left unmonitored to come round from the anaesthetic after EC, and my husband who had gone to the bank to get their payment found me choking on my back unconscious with no nurse in sight. Half of my eggs "disappeared" between EC and fertilisation. The same happened to another woman there at the same time. That clinic did a lot of donor cycles, and I have always had my suspicions. They also didn't have vitrification, just the older style freezing technology, so it would have been pointless to freeze our surplus embryos. We only found this out at the clinic and I was heartbroken to have to let them perish/be donated as I had planned on having frosties should the fresh cycle not work out. 

It was pretty scary driving through the checkpoint between north and south, particularly as I travelled alone to be there for 10 days whilst my husband just came for 2 days to give his sperm. There were soldiers with guns and I was questioned about why I was crossing. Most of the flights from the UK are into Larnaca which is in the south (Greek side).

Seeing an ambulance go past with the driver smoking a cigarette whilst there also just made me really uneasy about the standard of medical care there if you had an emergency. It was cheap, allowed up to 3 or even 4 embryos transferred and no waiting list, but I wouldn't recommend it.


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## Spanglyboo (May 18, 2014)

There is a nice clinic in south Cyprus that follows the uk’s hfea guidelines


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## Cloudy (Jan 26, 2012)

Just sat having a coffee and had a thought about your situation (curse of being a Moderator, FF and it's ladies are never far from my thoughts!). Have you considered contacting Serum in Athens? You can fill a form in online and they can do Skype consultations. They do some immunes (not as extensive as ARGC) and have good reports from lots of ladies on here. Plus I would think Athens has lots of flights being a capital? I've also heard it's a nice place for a holiday and there's loads of information and knowledge about the clinic in the Greece Section: there is a very comprehensive FAQ about the clinics there too.

Hope I have complicated your thoughts more, but it's always seemed quite a good middle-ground clinic between the Spanish approach and the Immunes-based clinics xxx


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## mms (May 25, 2009)

Oh Cloudy that’s so nice of you that you keep thinking of us and try helping us out with suggestions 😍❤... I appreciate that a lot.. 

I remember I contacted Serum long long time ago, I can’t remember what they told me but I remember I thought they weren’t right for us.. will have to go back to old emails and see what did we discuss in those emails. 

Thanks a lot ❤❤


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## Cloudy (Jan 26, 2012)

Ah ok no problem  I contacted loads of clinics over the years and some just don't "fit" with you do they. Although in my case I think my problem was I thought they nearly all sounded good and ended up wanting to go everywhere! 

Good luck xxx


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## miamiamo (Aug 9, 2015)

agreed with Spanglyboo, and would also recommend clinics in Czech and Poland. Eggdonationfriends has a good article on how to interpret success rates.


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