Treatments abroad

What about treatments abroad?

The three main reasons that could lead people to consider treatment abroad:

1. The treatments are cheaper abroad.

2. The results are better abroad.

3. The proposed treatment is banned in Switzerland by the law on medically assisted procreation (LPMA).

 

We wish to moderate some of these arguments and to draw your attention to several problems that may arise.

Far be it from us to say that in Switzerland, we are the best; there are excellent centers abroad, but we regularly have patients who come back after some bad experiences.

Treatments in Switzerland are of excellent quality; the centers are regularly checked by the cantonal and federal authorities must transmit their results annually to a national registry. The Federal Statistical Office publishes the results annually. Some centers are certified, with accredited laboratories, as it is the case for the CPMA and Fertisupport.

 1. The treatments are cheaper abroad

In Switzerland, the investigations to determine the causes of infertility and some medically assisted procreation treatments are covered by health insurance, however the in vitro fertilization treatments (IVF) are not reimbursed.

The ease of travel in Europe and the use of competitive airfares (low-cost) to get to major European cities are interesting for couples planning to travel abroad. Indeed, there are many exciting offers on the internet with sometimes very competitive prices.

We wish to caution you:

Generally the prices advertised apply only to "basic costs" and additional costs often come are added on to the advertised price: blood tests, investigations, special treatments.

Also, one should take note of all the "hidden" costs: living expenses abroad, airfares, because even though low-cost prices are sometimes very cheap, prices during infertility treatment may be much higher as one has to travel at the last moment. One must leave work, take time off and often for both partners, which generates significant costs.

For contacting the centers abroad, email is used in most cases and this, while convenient, can be stressful when the response is not as expected, not understood or at worst does not come ... It can sometimes be very frustrating not to talk with the doctor and to always have contact with "intermediaries" - even if they are very competent.

More generally, it is very difficult to have an idea about the quality of these centers, located mostly hundreds or even thousands of kilometers from home. If you have frozen embryos, what would happen if the center closed? How are the embryos preserved? What are the security measures? Remember that the goal is the birth of a healthy child.

Couples who resort to treatments abraod usually have a difficult and stressful journey. Psychological support and constant availability of the team are very important to reach the much desired result.

2. The results are better abroad

It is true that pregnancy rates published by some centers are exceptionally high. We want to make you aware of the fact that each couple is different and that the announced pregnancy rates often involve the most favorable situations.

 In addition, it is often difficult to know whether these figures refer to IVF treatment success rate, by transferring one or two embryos, or the rates obtained by egg donation, etc.

On 5 June 2016, the Swiss people accepted an amendment to the LPMA to resort to pre-implantation diagnosis (PID). This change in the law allows us, among other things, to freeze embryos (before only zygotes could be frozen) and to extend the freezing period from 5 to 10 years.

These changes will allow us to better identify the embryos capable of giving a pregnancy and to reduce the number of multiple pregnancies.

Also note that IVF is not always indicated as first-line treatment, and that ovulation stimulation treatments, surgical treatements (of fallopian tubes, endometriosis, etc.) or intrauterine inseminations can be very suitable. These treatments are covered by health insurance in Switzerland. More than 40% of pregnancies obtained in the CPMA, were conceived by these techniques.

3. The treatment envisaged is prohibited in Switzerland

Indeed, the LPMA prohibits a number of treatments, in particular:

Egg donation, embryo donation, the use of surrogate mothers, sperm donation for unmarried couples, single women, lesbian couples.

All these treatments are available in Europe (though few countries allow the use of surrogacy).

Note that in Switzerland, contrary to popular belief, it is perfectly legal to let the embryos develop for 5-6 days (prolonged culture or blastocyst).

However, we wish to make you attentive that a number of questions must be asked before using these treatments:

With egg donation, for example: How is the choice of the egg donor made and what investigations were done? How old is she? Does the center use the same donor for several couples or is it reserved for one couple? How many embryos will be transferred? Does that the center have the sufficient quality criteria? What are the results? Does the law allow children to access the identity of the donor on reaching adulthood? And more generally, is the couple ready to receive an embryo whose egg comes from a donor?

Couples are sometimes uneasy about these issues and often use discussion forums and websites to find answers. Specialists in reproductive medicine and psychological support team are available to help you. Note also that some treatments may cause significant legal difficulties. For example, the parentage of a child born to a surrogate mother can pose many problems because in Switzerland it is the woman who gave birth to the child who, at first, is considered the legal mother.

 

In conclusion :

In Switzerland we have excellent results and the recent amendment to the LPMA will allow us to offer new services such as preimplantation genetic diagnosis (PGD), embryo freezing (as well as zygote freezing), thereby reducing the risks associated with multiple pregnancies and limiting the number of treatments by a better identification of the embryo to be transferred.

Our CPMA specialists are of course available if you have any further questions.

 

 

CPMA, Rue de la Vigie 5, 1003 Lausanne, tél: 021 321 15 80