Fertility treatment can be an incredibly difficult process: from the emotional roller coaster of hoping, waiting and possible disappointment to the hormonal upheaval associated with all the medication - and, the financial burden.
It’s mainly cost that impels some couples, usually Jewish, to travel to Israel for fertility treatment. Israeli citizens have the right to subsidized IVF, but even paying privately for IVF in Israel generally runs at less than half the average cost in the United States.
Some couples come as"fertility tourists," staying several weeks to complete a round of treatment. Others fly back and forth and some move to Israel outright. Here five couples share their experiences.
IVF and religious tourism too
Alex and Theresa had been trying to conceive for three years, in New Mexico, but only had one miscarriage to show for it. Diagnosed with “unexplained infertility,” they did one round of IVF, that had been only partially covered by work insurance – and which failed.
“We started looking at overseas options,” said Alex, 35. They researched Mexico, because it was near the border, and South Korea because of the high success rates there, but felt the language barrier would be too wide.
“Israel is the leader in IVF worldwide,” Alex said, noting also the high level of English. He found a Haifa-based IVF medical tourism center and was impressed by how the doctor, Shahar Kol, took a Skype call with him right away.
Last February, the couple booked a six-week stay in Israel. “We wanted to visit the Holy Land,” said Alex, who, along with Theresa, 30, is Christian.
Compared to the U.S., they found the treatment less aggressive – less medicine, shorter protocol – and loved having the doctor’s cellphone number to call anytime. They also found the price, $6,000, including medicine – competitive. They transferred two embryos and froze eight (also included in the price).
They stayed in Israel until they received a positive pregnancy test, and in October, gave birth to twins: a boy and girl. “We’re so happy, we couldn’t have picked a better place,” Alex said.
Lori goes back home
At first Lori was impressed with the willingness of the doctors in Israel to get her pregnant. The 40-year-old had come to Israel with her fiancé, David, for his job. Back in Australia, where fertility treatments are partially covered, doctors would not proceed because her hormone levels were too high. But her Israeli doctor was not concerned.
Yet after one failed treatment, despite loving their life in Israel, Lori and David decided to return to Australia to do IVF. “It just isn’t worth it,” she says, noting that they tallied up the cost of medication and treatment in a Tel Aviv private hospital, which came out to $12,000. In Australia, it will cost her A$5,000-A$6,000 (about $4,100-$5,000 in U.S. dollars).
She also was not happy with the service in Tel Aviv. “They don’t tend to give you all the information, so there’s no enlightening you or bringing you into the big picture. It’s more like, ‘I’m the doctor, and I know best, so do this.’ I felt rushed through everything, that I wasn’t getting enough information, no one sitting me down and telling me, ‘Here are your options, this is what I suggest you do.’ I didn’t get any of that.”
They are not sure how long they are going back to Australia for—maybe one round of I.V.F, maybe for good—but, she says, “I’m looking forward to my doctor and the communication I had with him.”
If it doesn't work: 'We'd have to relocate'
Eli and Pamela traveled to Israel just for IVF, which they paid for out of pocket. Even though Eli grew up in Israel, he hasn’t lived here in years, so doesn’t have Israeli health insurance. Besides, Pamela, 41, is American. They live in Los Angeles.
“We had two main reasons – financially, we realized how insanely expensive it would be in LA – and even with the flights it would be half as much in Israel,” Eli said, citing a cost of around $7,500 for treatment in Israel, with medication, versus $30,000 in California. “Also, there’s the family flavor. It’s a good opportunity to spend quality time with the family,” he said, noting how they spent a few weeks here to do IVF and hang out with their family, twice.
Their first embryo transfer in failed, and their second resulted in a miscarriage. They intend to return this winter to transfer the last of their frozen embryos.
“If our third try is unsuccessful, it will not have been an advantage, economically,” Pamela said, figuring in all the vacation time and travel expenses. “If we did another round [i.e., retrieving more eggs, then fertilizing them, then transferring embryos month after month], we would have to relocate.”
Former Israeli uses rights: 'It was worth it'
Tali did not plan to move back to Israel. Both she and her Israeli-born husband were settled in the New York area. But after four cycles of fertility treatments in New York, which put them out $40,000, the 33-year-old decided to stay in Israel while her husband remained in the States.
“I took a leave of absence, and came to stay with my family,” she said. Her husband came to visit when he could, working remotely from Israel on his American hi-tech job.
Because Tali had been paying her Israeli health insurance fees over the years, her IVF was free.
(Israeli citizens who have not been paying their health insurance fees or who have been out of the country for more than a decade must reestablish residence here, by applying to be returning citizens. And even if you pay a one-time fee of ILS 10,000 to reinstate your health insurance immediately, there’s a mandatory waiting period of up to 150 days for IVF and organ transplants).
After eight months and two cycles of fertility treatments, Tali finally got pregnant. She stayed in Israel until the end of her first trimester and then returned to New York.
“It was worth it financially,” she said, noting that taking a break from her high-pressure job was also a boon. “IVF is directly affected by stress,” she said, “not to mention the money.”
Does she feel guilty about taking advantage of the Israeli health system, even though she and her husband don’t live here?
“No. Hell, no,”’ she said. “I’m a citizen, I’m paying kupat holim [Israeli National Health Insurance.] I’ve paid my dues.” She said that most people don’t understand what most women go through, both financially and mentally, to try to have a baby.
“I’m very appreciative that I was so lucky to come to Israel for IVF,” she said. “I would do it all over again.”
Making the big move
Aviva never planned on doing fertility treatments in Israel. In fact, the 30-year-old California native just wanted to live in Israel for a few years with her husband. “We both love to travel, so we thought it would be fun.”
They were already settled in their jobs and daily life in Israel when they received genetic test results they had done in America: They were both carriers of a rare genetic disease. In order to have a healthy child, they’d have to do Pre-implantation Genetic Diagnosis to select a healthy embryo, a process which can only be done with in vitro fertilization.
Aviva didn’t tell anyone – either in Israel or in California – that she was doing IVF. And that made it hard. When her first embryo transfer failed, she felt very homesick. “It would have been more helpful, support-wise, to do it in America,” she said.
But in the end, for Aviva it was worth it. They’re currently expecting their first child. “I feel lucky I could do IVF in Israel - not only have I saved tens of thousands of dollars because it is covered by the state, but there is so much familiarity and acceptance of it in Israeli society and I have found the quality of care to be at a very high level.”
This is Part 4 of Fertile Ground, Haaretz's series on IVF in Israel. For the rest of the project, click here.