Editor’s Note: This is a frank and personal account of one woman’s experience with medical tourism. The information contained within does not constitute professional medical advice. The author’s opinions are her own and do not represent an endorsement of providers by Medellín Living.
I’m 37 and earlier this year, went through the process of freezing my eggs… in Medellín, Colombia.
Many women today spend their 20’s and 30’s pursuing a career; traveling and living abroad; battling an illness or just haven’t found “the one” yet.
All of a sudden, they are in their late 30’s/early 40’s and faced with a dilemma: tick tock.
This post will cover the following topics:
- Why I chose to freeze my eggs
- Why here, in Colombia
- How I chose the fertility center
- Understanding the process and how the medications work
- An outline of the procedure with dates, times, doctor’s appointments, sonograms, and medications
- My personal experience with the procedure including doctors, staff and the center
So let’s begin…
Why I Chose to Freeze My Eggs
I have traveled, lived and worked abroad for the past 17 years and only recently have I been ready to settle down in NYC once again and begin dating with the intention of starting a family.
However, before the family part, I want to build a loving, trusting, communicative partnership with my boyfriend.
This takes time, and I do not want to put a timeline filled with pressure, anxiety, or ultimatums, on our newly developing relationship and more importantly on me.
- Adopt (which I plan to do for the 2nd/3rd child)
- Do not have children (not an option)
- Get pregnant before my partner and I are ready (also, not an option)
- Seek the assistance from a fertility clinic (ding ding)
Making the Decision
This was not a light and easy decision for me. I was diagnosed with MS and it’s a well know fact that getting pregnant with MS has both its rewards and risks.
Women do not develop any new symptoms while pregnant but, as soon as the pregnancy is over, there is a higher chance of new symptoms developing. Because I am not taking medications, my doctor is very concerned about my well-being.
Yet, he so eloquently wrote to me, after asking for his advice: “Family planning is a very important step in an individual’s life and the risk of worsening a neurological condition versus the benefits of starting a family are an individual’s decision for each patient to make”.
However, the MS and my possible neurological reaction to the hormone treatments was not a concern for me either. I was more concerned about the trauma that might be caused to the egg on an emotional, physical and spiritual level before the baby is even born as a result of the procedure.
This is my personal belief so I will not write more about it here and instead stick to facts and experiences.
Why Colombia and How I Chose the Fertility Center
One of the many countries I lived in over the years was Colombia. I spent three years living and working in Medellín. While here, I have had the pleasure of receiving some of the most attentive care with the most state of the art equipment in the cleanest facilities in one of the most beautiful countries.
While here, I have had the pleasure of receiving some of the most attentive care with the most state of the art equipment in the cleanest facilities in one of the most beautiful countries.
Every doctor I had seen, from dentists to gynecologists to ER doctors (after a major car accident), was professional, extremely knowledgeable, available for questions/concerns and took their time getting to know me as their patient and talk to me about the care they were providing me.
And, of course, it is much more cost-effective.
Below is a little similarities/differences chart between the NY/NJ center I visited and Florida centers I had called and the Medellín center.
* Vitrification – An ultra-rapid process that prohibits the formation of ice crystals as opposed to the original technology, cryopreservation, where ice crystals can develop causing thawed eggs to potentially form ice crystals that can fracture and damage the egg.
** Experience – Both centers have only thawed a handful of eggs because while many women have frozen them over the past few years, very few end up using them because they either get pregnant naturally, or they aren’t ready yet.
* Dr. Juan Luis and I exchanged lengthy emails over a period of a week before making my decision; 9 in total in which he answered all my questions and concerns
Cost of Procedure
(approx. totals for the states of NY, NJ and FL / my actual total at InSer in Colombia)
How I Chose the Fertility Center
I had a lot of help choosing the center. My ex-fiance, now best friend, is from Colombia. He called a few of the centers in Medellín and Bogota for me to get information about the procedure and costs. He then forwarded me the names of two doctors in Medellín who spoke perfect English.
I wrote to both of them with my questions. One doctor responded within a day and answered all of my questions about the procedure and forwarded me to the financial advisor about costs.
The other doctor never responded, but the financial advisor did write back 10 days later and gave me the same information about costs and timelines as the first clinic. By that time, I was already committed to InSer Fertility Center and chose to work with them.
Understanding the Process
Dr. Juan Luis Giraldo at InSer spent an hour and fifteen minutes explaining three things to me:
- How an egg gets ready for maturation
- How medications help get your body ready for oocyte cryopreservation
- Why freezing your eggs should be a Plan B
1. How an egg gets ready for maturation
Males produce sperm throughout their entire life, and each sperm has about an 85-day life span, and then they grow again. But the ovaries are like a bank account. There is only one deposit of about 300,000 eggs in around the fifth month while in the fetus stage.
Then, at the start of menstruation, we just keep taking eggs out and never refill our account. Every month we lose between 500 and 1,000 eggs and of those, only one usually gets released from the follicles in our ovaries.
Between the ages of 25 and 30 our eggs are at their best and healthiest. Then there is a slow decrease in quality until the age of 35 as the eggs get older.
After 35, the eggs decrease in quality at a slightly more rapid pace and then by 40 there is a sharp decline in the quality of the eggs.
Of the 1,000 eggs released at the time of menstruation, a chemical in the brain called LH gets released which kills off 999 of the eggs, leaving the best egg. The follicle holding that egg then ruptures, releasing the egg and allowing it to grow into a baby.
2. How medications help get your body ready for oocyte cryopreservation
Different medications are given to stop the eggs from being killed off and to stop the follicles from rupturing and releasing the eggs. (Medications may differ according to each patient.)
A. Elonva – cuts off the LH hormone so that more than one egg can grow in the follicles.
a. One injection in the abdomen; lasts seven days.
b. Additional daily injections after the previous medication runs out are self-administered until the follicles are the correct size for retrieval (for me: six more)
B. Orgalutran – stops the follicles from rupturing AKA releasing the eggs before the doctors have a chance to go in and take them out.
a. Begin injections five days after the first medication is administered, and until the follicles are the correct size for retrieval (for me: five more)
* Ideal follicle size – 18mm
3. Why freezing your eggs should be a Plan B
The doctor clearly stated that freezing eggs should not be seen as a security to having babies.
It should be looked at as an opportunity in case a natural childbirth is not possible. Because, while 80 to 90 percent of the eggs are frozen successfully, only 35 to 40 percent are thawed successfully.
He reiterated that I should still try to get pregnant naturally and rely on this only as a Plan B. This is where my trust in him grew because he was very open and honest about the outcome of the thawing and was very willing to lose me as a patient if I did not feel comfortable with that number.
Furthermore, I do trust him when he says that as the process of thawing gets studied further, the number of success stories will increase. After all, this is still a very new procedure in medicine.
The Procedure: What to Expect
This chart outlines the process with average costs in Colombian pesos and U.S. dollars at InSer.
Please note, the cost in COP remains the same, the cost in USD will change depending on the strength of the dollar. The dollar amounts were correct at the time of service (February, March 2015).
* The reason there are so many follow-ups with sonograms and medication is because they closely follow the growth of the follicles. The first seven days, the follicles begin to grow slowly. By Day 7, the follicle size increases at about 1 – 1.5mm per follicle. Because each woman’s follicles grow a little differently, they have to watch it every two to three days to make sure that they do not remove the eggs until a good number of follicles are at 18mm.
** The follow-up sonograms and doctor’s appointment are at no extra cost. I only had to pay for the extra medication every two days.
*** Anesthesia is included in the cost of the procedure
Dr. Juan Luis was charismatic, charming, silly and serious all in one. He immediately made me feel comfortable with his warm nature and patience. He let me ask him numerous questions and drew charts when describing the process that were ridiculously bad, and we both had a good laugh about it.
Please note that the culture in Colombia is also very different in that every day he would put his arm around me and give me a kiss on the cheek goodbye.
Dr. German took over for Dr. Juan Luis on Day 11 because Dr. Juan Luis was speaking at a conference in Curacao. I knew this was happening and was a bit upset to be losing Dr. Juan Luis but as he reassured me, Dr. German was wonderful and also spoke great English.
Dr. German had an even bigger personality and joked about being surrounded by hormonal women: his two teenage daughters, his wife going through menopause and all the women that come to the center. It was very funny actually.
Extremely helpful, polite and very nice. All of the nurses are studying English and try hard to explain everything as best they can.
When they need assistance, they have a number of doctors to call on as well as the financial director, Sandra, and the marketing director, Catalina, who speak very good English.
InSer, the fertility center, is located in one of the wealthiest neighborhoods in Medellín. It is tucked away on a quiet street with little distraction and noise. It is very easy to get to and it is very modern and clean.
They have an outdoor patio for patients to sit while waiting for their appointment as well as vending machines, a fish tank and lots of pictures of all the women they have helped through IVF, thawing and other procedures.
Everything is squeaky clean, bright, light and spacious. It felt very safe and comfortable being there.
I experienced no side effects throughout the entire procedure, except that my breasts got larger and my stomach felt a bit full. Other than that, nothing.
However, Dr. Juan Luis gave me his cell phone and personal email to get in touch with him if anything came up. Thankfully, I never had to use it.
Self-Administering the Needles
I had never given myself an injection before, and here I was, 8 p.m. Saturday evening staring at a pretty long needle that I had to shove into my abdomen.
I called my boyfriend on Skype and made him watch me as I did it, for moral support. He was no help because he started to freak out and tell me he could never do it! Go figure… men. Haha.
At 7:59 I finally worked up the courage, because I had to. I felt nothing. I was shocked. It didn’t even feel like I put anything in my body!
Then I slowly pushed the applicator into the needle until all the fluids entered my abdomen. I gently took it out, wrapped it up and put it back in the box with the hopes I can get it through customs and take it home as a souvenir.
Within a few minutes, I did feel soreness where the needle was but my boyfriend assured me that that was normal, and minutes later the pain subsided.
So very easy. I went into the center, paid for the procedure and then was brought into the “operating room.”
The anesthesiologist asked me a few questions about past surgeries and allergies and then they began the drip.
Dr. German came in and joked around a bit and the next thing I remember, I was pushing a mouth guard out of my mouth, trying to breathe. I was awake, groggy but awake. A little while later I was in a bed slowly waking up from the anesthesia.
The procedure had taken about 10 minutes, and it was another 30 minutes before I felt comfortable to get up and start moving around, slowly.
Within a few hours and I started to feel pain and discomfort in my abdomen which was expected. The doctors told me it usually lasts about one to two days. It felt like a bowling ball was weighing down my abdomen, and whether I was just sitting, doubled over with some pillows underneath my chest or taking a walk, I could not get comfortable.
I took two Dolex (Tylenol), which took about one and a half hours to feel relief. I also took an antibiotic as a precautionary measure since they did introduce a foreign object into my body.
The best news is that they told me they were able to get 12 of which 10 are good for freezing based on the number of chromosomes the eggs have (48)!
Later that afternoon, still a bit sore, my boyfriend and I hired a car to take us to Santa Elena (a beautiful town in the mountain 40 minutes from Medellín) to spend the rest of my days in Colombia relaxing, enjoying the view and eating some great food.
We decided to stay at La Montaña Magica for a nice getaway surrounded by nature. We also chose this place as our final destination because I wasn’t in any condition to travel far, and it is very close to the international airport.
Not to mention they grow their food on the property and raise their own animals. And the best part, they offer all types of massage including a couples massage which we got for 50 percent off because we are staying in the middle of the week.
Since arriving, my first doctor, Dr. Juan Luis, wrote to me twice already from his conference checking up on me, seeing how I feel and reassuring me that I can write to him at any time with questions.
Overall, this has been an extremely positive experience, and I would honestly recommend it for all women who are approaching “that age,” want children but are not quite ready to have them.
Besides the cost savings being amazing, Colombia is a beautiful country in which to spend two weeks while still having access to the internet if you need to continue working.
The center also works with other fertility issues, but I know nothing about them. The website is in English if you want more information.
You can also write to me if you want more detailed information about a patient’s perspective. But, the only other things I have to add to the information here is how smoothly and wonderfully it went.