You are here

Medical Procedures
Fertility Vacation

Consider a TMTT Fertility Vacation to Thailand



TMTT & our partnered companies visiting our affiliate fertility clinic in Bangkok

 

A Thailand Fertility vacation is where one travels to Thailand in order to undergo one or more fertility procedures available in Thailand.  Thailand is the ideal destination for fertility procedures because it has the latest medical technology, unrivaled patient care and substantial cost savings - at an exciting and beautiful tourist destination. 

Thailand Medical Travel and Tourism (TMTT) have the resources and personnel to make your visit to Thailand as pleasurable and care-free as possible.

 

TMTT Affiliate Fertility Specialists / Credentials

Our affiliate clinic is a Royal Thai College of Obstetricians and Gynecologists (RTCOG) accredited fertility center and has an established a reputation as being one of the most successful fertility clinics in Thailand.

They will provide specialized treatment from a wide range of options based on the latest academic principles and medical techniques. Couples can be seen for initial consultation by appointment on short notice, within a few days, following which treatment can commence.

Appropriate treatment plans are arranged to suit couples’ requirements.  Services are provided to couples in an environment of care, warmth and suppor

Our affiliate embryologists also have had extensive professional training as follows:

  • Assisted Reproductive Technique at National University of Singapore, 1992
  • Workshop on Biology of Assisted Conception at Bourn Hall Clinic, Cambridge, 1994
  • European Society of Human Reproduction and Embryology workshop on Assisted Fertilization by ICSI at AZVUB Belgium, 1995
  • Workshop on ICSI of Assisted Conception at Bourn Hall Clinic, Cambridge, 1997
  • Hands-on Preimplantation Genetic Diagnosis at Singapore General Hospital, 2001

Women and fertility clinic

Our affiliate clinic can offer you a high standard of healthcare for women at every age. Prenuptial investigation and pregnancy care (antenatal care) are provided with fully equipped and clinical skill.

Menopausal symptoms are treated as well as providing promotion and support of the health of menopausal women.

The focus is on Infertility investigation and treatment and we have the resources to provide the best treatment available.


Laboratory


Affiliate fertility laboratories boast a very sophisticated air filtration system and world class embryo manipulation and culture system. Our skilled embryologists pride themselves on their attention to detail in all aspects of embryology practice up to the highest standard.

Operating room

The operating room has been designed to the highest standard and boasts the up-to-date facilities for both laparoscopic and hysteroscopic surgery.

Fertility Clinic Services Offered

 

  • Semen analysis
  • Ultrasonography
  • Hormone evaluation
  • Intrauterine insemination (IUI)
  • Gamete Intrafallopian Transfer and Zygote Intrafallopian Transfer (ZIFT & GIFT)
  • In Vitro Fertilization (IVF)
  • Intracytoplasmic Sperm Injection (ICSI)
  • Percutaneous sperm aspiration and Testicular sperm extraction (PESA & TESE)
  • Cryopreservation
  • Blastocyst Culture
  • PGD (Preimplantation genetic diagnosis)

 

Semen analysis

Semen analysis is performed to determine whether a man has a fertility issue. Male fertility issues affect more than one-third of the couples who are unable to have children.

Semen analysis includes evaluation of volume, liquefaction time, sperm count, sperm motility and sperm morphology.  Quantification and identification of non-spermatozoidal cells and detection of antisperm antibodies are also part of semen analysis.

Ultrasonography

Ultrasongraphy can be used to evaluate and monitor growth of the fetus in pregnant women in every trimester as well as evaluation of the presence of follicles (the sacs containing developing eggs) and the thickness of the uterine tissues in women undergoing ovarian stimulation in infertility treatment. Ultrasonography can also show abnormal conditions such as ovarian cysts, hydrosalpinx, adenomyosis or fibroids (benign tumors in the uterus).

Hormone evaluation

Women who have suffered from unusual patterns of menstruation including irregular periods and unusual vaginal bleeding may have unbalanced or abnormal hormone levels. Blood tests for hormone levels can help us to diagnose the condition in order to find the appropriate treatment. Also, men with abnormal semen analysis results may have abnormal hormone levels. Medical treatment may be possible in male infertility caused by abnormal hormone levels.

Intrauterine insemination (IUI)

IUI involves the injection of prepared sperm from the husband into the woman’s uterine cavity via the cervix. This procedure is normally painless and takes only 10-20 minutes on an outpatient basis. The chance of pregnancy is approximately 10-15% per cycle. IUI should be performed in cases where the woman has healthy fallopian tubes, and the sperm preparation is satisfactory. This technique would be offered for cases of unexplained infertility.

Gamete Intrafallopian Transfer and Zygote Intrafallopian Transfer (ZIFT & GIFT)

The ovaries are stimulated with fertility injections as IVF protocol. The eggs are retrieved vaginally. The retrieved eggs are examined and the two or three of most mature eggs are mixed together with the prepared sperm. Both eggs and sperm are immediately transferred back through a fine catheter into the fallopian tubes. The remaining eggs are inseminated in-vitro and the embryos can be frozen for future use.

The ovaries are stimulated with fertility injections as IVF protocol. The eggs are retrieved vaginally. The retrieved eggs are examined and the two or three most mature eggs are mixed together with the prepared sperm. Both eggs and sperm are immediately transferred back through a fine catheter into the fallopian tubes. The remaining eggs are inseminated in-vitro and the embryos can be frozen for future use.

With regard to ZIFT, the retrieved eggs are mixed with prepared sperm and incubated for 18-20 hours. The fertilized eggs are examined and only two or three embryos are subsequently transferred back through a fine catheter into the fallopian tubes. The remaining eggs are inseminated in-vitro and the embryos can be frozen for future use.

GIFT & ZIFT are primarily recommended for couples who suffer from unexplained infertility, cervical hostility and minimal endometriosis. Now these techniques are less common since IVF can offer  a high  pregnancy rate and is less invasive. We may recommend this technique, however, in special circumstances, such as repeated failure with IVF especially in older women with open fallopian tubes.

In Vitro Fertilization (IVF)

IVF is the most effective treatment for couples with absent, blocked or damaged fallopian tubes and also in cases of unexplained infertility where artificial insemination has been unsuccessful. The woman is given fertility injection to stimulate her ovaries.
The chances of pregnancy depend on number of eggs obtained and fertilized. The eggs are retrieved vaginally using ultrasound guidance, under general anesthesia after the final injection of ovulation induction. The fluid within the follicles or egg sacs is aspirated and then examined in our IVF laboratory to identify the eggs. After egg retrieval, the sperm is subsequently added to the eggs and incubated in the laboratory for a further 24-48 hours. If fertilization has occurred, the zygote should then divide into two, and subsequently three, four or more cell embryos. The fertilized eggs (now called embryos) are transferred into the uterus through the cervix 48-72 hours after egg collection.

The procedure is normally painless procedure, and takes approximately 15-20 minutes. The chance of pregnancy is approximately 30-40% per cycle.

Intracytoplasmic Sperm Injection (ICSI)

ICSI is the technique that can assist fertilization in couples with severe male infertility. In IVF/ICSI treatment, after egg retrieval, very few sperm are required and the sperm can bypass egg penetrating by the ICSI. The special equipment, called micromanipulator, is used to enable our embryologist to manipulate the eggs and sperm under the control of high-powered microscopes. The egg is held and the sperm is injected through the outer layers of the egg by the micromanipulator. The fertilized eggs are examined and the good quality embryos are transferred into the uterine cavity as with IVF treatment.

Percutaneous sperm aspiration and Testicular sperm extraction (PESA & TESE)

In cases of azoospermia (no sperm found in ejaculated semen), surgical sperm retrieval using PESA & TESE techniques can offer chance of using husband sperm in IVF/ICSI treatment. Surgical sperm retrieval may be a treatment option for men with an obstruction preventing sperm release, due to injury or infection, congenital absence of the vas, vasectomy and some cases of non-obstructive azoospermia.

The procedures are carried out under general anesthesia and only are outpatient basis. If enough sperm is retrieved, it is possible to freeze sperm for future use. The sperm obtained is consequently used to inject the eggs using ICSI.

Cryopreservation

Generally not more than three embryos are transferred to the uterus or tubes in infertility treatment in order to avoid multi-fetal pregnancy. It is possible to freeze the excess embryos for future use. The advantage of freezing embryos is that they can be transferred in a future cycle without the woman having to undergo the same treatment and surgery. The embryos can be frozen for up to five years, although this can be extended to ten years in exceptional circumstances.

Blastocyst Culture

Generally human embryos, obtained from IVF treatment, are routinely transferred into the uterine cavity on either Day 2 or Day 3 after egg retrieval. Using With special culture techniques for embryo development, it is possible to successfully culture embryos up to the blastocyst stage (Day 5 after egg retrieval) and transfer the blastocyst stage embryos into the uterine cavity via the cervix. This technique can offer higher chance of implantation and consequently pregnancy rate in the specific group of infertile couples. Some couples may benefit from an early transfer rather than continued growth to the blastocyst stage. Therefore, blastocyst transfer should be an option for the couples with certain specific conditions.

Preimplantation Genetic Diagnosis (PGD)

PGD is being used increasingly at the Fertility Institutes to dramatically improve the chance of a successful IVF pregnancy in couples where prior IVF failures have remained unexplained. It has been estimated that over half of all IVF failures are not able to be explained by an apparent problem with embryo "quality". For many couples however, this statistic is quite misleading. Most IVF centers look very closely at the appearance of embryos under the microscope as they attempt to determine a "good" or "high quality" embryo from those of lesser quality.

We are now able to examine the most important internal genetic code of the embryo as well. And with these new genetic tools, we have come to learn that some embryos that appear on the surface to be of the highest quality may carry a genetic code that makes them poor choices for attempting to establish a healthy pregnancy.

We have also now learned that other embryos that might have been classified as less than optimal based on their appearance, and may not have been selected for return to the mother may in fact be of the finest quality.

PGD allows confirmation, for the first time, of the suspicions of our IVF scientists that simply observing and grading the appearance of an embryo may  fall far short of being able to provide reliable information to patients who have failed IVF. The good news is that PGD is now available at the Fertility Institutes for couples who have been met with failure in a prior IVF cycle or cycles.

Frequently Asked Questions


Who should consider IVF?

  • IVF may be used to overcome female infertility in the woman due to problems of the fallopian tube, making fertilization in vivo difficult. It may also assist in male infertility, where there is defect sperm quality, and in such cases intracytoplasmic sperm injection (ICSI) may be used, where a sperm cell is injected directly into the egg cell. This is used when sperm have difficulty penetrating the egg, and in these cases the partner's or a donor's sperm may be used. ICSI is also used when sperm numbers are very low. ICSI results in success rates equal to those of IVF. For IVF to be successful it typically requires healthy ova, sperm that can fertilize, and a uterus that can maintain a pregnancy. Due to the costs of the procedure, IVF is generally attempted only after less expensive options have failed.

IVF can also be used with egg donation or surrogacy where the woman providing the egg isn't the same who will carry the pregnancy to term. This means that IVF can be used for females who have already gone through menopause. The donated oocyte can be fertilized in a crucible. If the fertilization is successful, the embryo will be transferred into the uterus, within which it may implant.

IVF can also be combined with preimplantation genetic diagnosis (PGD) to rule out presence of genetic disorders.

How successful is IVF with the TMTT affiliate?

  • Fresh Cycle Transfer
    • 34 years old and younger: 40.7%
    • 35-39 years old: 35%
    • 40 years old and older: 22%
  • Frozen-Thawed Embryo Transfer
    • 34 years old and younger: 60%
    • 35-39 years old: 33%
    • 40 years old and older: 20%


IVF success rates are the percentage of all IVF procedures which result in a favorable outcome. Depending on the type of calculation used, this outcome may represent the number of confirmed pregnancies, called the pregnancy rate or number of live births, called the live birth rate.

How much does IVF Cost?

  • The cost of IVF rather reflects the costliness of the underlying healthcare system than the regulatory or funding environment, and ranges, on average for a standard IVF cycle in the U.S. (2006 USD) at $12,500  ($18,000 to $20,000 with medication).   The cost per live birth is highest in the United States ($41,000[2]) and United Kingdom ($40,000[82]).  Thailand has substantially lower prices per IVF cycle and per live birth.  Please let us know if you would like us to quote you an IVF cycle price.

Typical procedure pricing considerations;
The patient will pay for either IVF or ICSI (which includes IVF) not both

  • Both procedures include harvesting
  • Embryo transfer procedures are an additional costConsultations are billed separately.  Most patients have 1- 3 consultations
  • Pricing for specialized procedures if they are added to the IVF package (TESE, MESA, PGD, cryopreservation, etc).

Typical medication pricing considerations per IVF cycle;

  • Hormone Stimulation: Priced per injection.  Normally, patient will need approximately 10 injections
  • Hormone support including:
    • Hormone support after egg harvesting and before Embryo transfer
    • Hormone support after Embryo transfer
  • Optional: Hormone Nasal Spray or Hormone Injection: This hormone can be given 7 days before period.

Is there additional cost if there is a sperm donor?

  • The fertility specialists use California Cryo Bank for sperm donation. The patient has to pay them directly. They will ship sperm to the clinic.  The only cost would be the shipping cost of approximately 5000- 10,000THB (approximate $150- $330).

What information and medical test results to I need to provide prior to my Thailand Fertility Vacation?

  • First, you will need to complete a health questionnaire and medical history (specific to the physician) to share with the physician.

The three critically important tests prior to IVF are; semen analysis; blood tests for ovarian function (FSH,LH,PRL,TSH,AMH); and the ultrasound scan.  These tests should be performed  by a lab that has a demonstrated competency in this specialty area as the entire treatment depends upon these results. These tests are easy to perform and inexpensive. Test results are typically good for six months.  For safety reasons, you and your partner’s blood should be tested for HIV and Hepatitis.  We suggest all test results become available to the IVF specialist 6-8 weeks prior to departure on the IVF Vacation in order to assure adequate time for evaluation and follow-up.

How long do I have to be away from home?

  • Given the various stages of the process, a minimum of 7-10 days is usually required to be away from home for your Thailand IVF vacation.  10 days is preferred. However, if you have hormone injection in Thailand, you will need to add additional 10 days, making the total stay of about 3 weeks.

Is there a way to shorten the trip?

  • For shorter stay, the doctor recommends a minimum of 7-10 days presuming that you have had hormone injections in your home country prior to the trip.  The doctor recommends that you arrive in Thailand no later than the 10th day after menstruation.

The patient should still have ultrasound scan and hormone check during her hormone injection at home.  For patient who will have hormone injection in the US prior to the trip, the Thai clinic will still perform the following upon arrival in Thailand;

  • Hormone assessment for wife
  • Viral Screening for husband

How can I increase my chances of success with IVF?

  • The main potential factors that influence pregnancy (and live birth) rates in IVF have been suggested to be maternal age, duration of infertility or subfertility, bFSH and number of oocytes, all reflecting ovarian function.  Optimal woman’s age is 23–39 years at time of treatment.

Other determinants of outcome of IVF include:

  • Tobacco smoking reduces the chances of IVF producing a live birth by 34% and increases the risk of an IVF pregnancy miscarrying by 30%.
  • A body mass index (BMI) over 27 causes a 33% decrease in likelihood to have a live birth after the first cycle of IVF, compared to those with a BMI between 20 and 27. Also, pregnant women who are obese have higher rates of congenital abnormality, miscarriage, gestational diabetes, hypertension, thromboembolism and problems during delivery.
  • Ideal body mass index is 19–30.
  • Salpingectomy before IVF treatment increases chances for women with hydrosalpinges
  • Success with previous pregnancy and/or live birth increases chances
  • Low alcohol/caffeine intake increases success rate
  • Level of DNA fragmentation as measured e.g. by Comet assay, advanced maternal age  and semen quality.
  • The number of embryos transferred in the treatment cycle.
  • Other factors of semen quality for the sperm provider.
  • Women with ovary-specific FMR1 genotypes including het-norm/low have significantly      decreased pregnancy chances in IVF.Some studies also suggest the autoimmune disease may also play a role in decreasing
  • IVF success rates by interfering with proper implantation of the embryo after transfer.
  • Aspirin, however, was shown by a meta-analysis to not improve pregnancy rates after IVF.

How will I be able to communicate and deal with cultural issues in Thailand?

  • Most Thai physicians and their staff speak English.  However, TMTT will assign you a personal assistant, fluent in Thai and English, who will be the liaison between you and the medical personnel.  They will also be generally available to you as your personal assistant during your stay in Thailand.

     
Are there any special pricing offers available?

  • There is currently a 10% discount for medication and hormone stimulation for patients who come back for 2 or more cycles.

  
Can you recommend / assist in procuring lodging during our trip to Thailand?

  •  We have a wide variety of accommodations from 3 star to 5 star hotels as well as service apartments very close to the clinic.  They include daily breakfast, wi-fi internet connections, Kitchenettes, laundry appliances (depending on room type) etc.


Do you have partners (or someone on staff) who will provide ground transport to and from the airport and all medical appointments?  What is the associated cost?

  • Yes, TMTT will provide all such services.  Upon request, we will provide you a full list of services and related prices, if any.

Do you have partners (or someone on staff) who will provide concierge services such as arranging sightseeing, restaurant recommendations, etc.?

  •  Yes, you will have a personal assistant assigned to you during your Thailand visit.  She/he will help with coordinating your daily activities.  Pre-booking of sightseeing, dinners or any tourism activities are also available.  We can leave the activity date open.  However, please inform our ground team member 24-48 hours prior to the activity.

Is it possible to select the gender of the baby?

  • The gender of the baby can be selected by sperm selection with an 80% success rate.