Questions About Bangkok IVF Treatment
Thailand IVF specialists at the infertility centers of IVF hospitals in Bangkok answer questions about ICSI, PGD for gender selection, egg donation, costs of IVF treatment, trying to conceive overweight, embryo freezing, frozen embryo storage, frozen embryo adoption, frozen embryo donation, male infertility treatment, semen analysis and more.
References to parents or patients mean the couple seeking in vitro fertilization because they are trying to conceive a test tube baby.
O R A N G E statements are a reproductive doctor at a fertility hospital or the spokesperson for Disavowed Hospital Center.
Couple Interested in PGD Family Balancing: Our main purpose is to conceive a baby boy so I am a bit confused regarding the treatments mentioned, as in which treatment I am supposed to undergo (IVF or ICSI or PGD gender selection) so kindly let me know the procedure only for gender selection. I also wanna know the cost involved for my particular treatment. Is it fine if we come to Thailand on the 14th day of eggs and sperms retrieval? Let me make you sure that whatever procedure mentioned in between 1st to 14th day I will get it done in my home country. I am completely new to the procedure, so please guide me how egg retrieval is gonna take place? Is it painfull? Do u anaesthetize the patient?
Bangkok is seven hours ahead of GMT (UTC) and about 11 to 13 hours ahead of most locations in North America.
Disavowed: “Gender selection is one optional step in the test tube baby process.
You must choose IVF or ICSI.
ICSI is the current prevalent standard everywhere and more effective than IVF.
Dr Disavowed advises all patients to choose ICSI.
It is not required but better and about 20 years more advanced than basic IVF. It also costs more.
The least you can get is IVF with PGD.
The recommended basic is ICSI and you also want PGD.
You must choose IVF-PGD cost:
Baht 150,000 + Baht 99,000 (current special promotion) …
ICSI-PGD costs: Baht 170,000 + Baht 99,000.
If you want to save your embryos for the days ahead and maximize your reproductive options:
IVF-PGD-EF (Embryo Freezing) + FES (Frozen Embryo Storage):
Baht 150,000 + Baht 99,000 (current special promotion) + Baht 15,000 (up to 10 embryos) + Baht 25,000 (annual fee for eight embryos)
ICSI-PGD-EF (Embryo Freezing) + FES (Frozen Embryo Storage):
Baht 170,000 (ICSI treatment cost) + Baht 99,000 + Baht 15,000 + Baht 25,000.
If you produce more than one viable embryo, do you want them saved or terminated or donated to science or made available for frozen embryo adoption or embryo donation programs?
And if you produce only female embryos, do you want them saved or terminated or donated to science or make a frozen embryo donation to an infertile couple?
If you have embryos you do not need this time, do you want to preserve and store them or become an embryo donor?
If you want to have them for your possible future use, then you need to choose embryo freezing and frozen embryo storage (cryopreservation).
Freezing has a fee. Storage has an annual fee.
Study our Frozen Embryo Informed Consent Form.
Of course, the doctor tries to make egg retrieval as comfortable as possible but it is micro-surgery.
He uses laparoscopic surgery to retrieve any suitable eggs.
You should read all the info we have provided to you online and you will have a very good understanding.
Very important is the IVF Informed Consent Form which talks about possible complications such as pain.
Yes, ovarian stimulation can be done in your city.
However, it is vital you understand that is the fundamental foundation of the entire process.
That is what determines the number of eggs that can be retrieved and the quality of those eggs.
It is a skill and experience based treatment. All countries have some excellent doctors. But fertility doctors are not all equal. Choose well.
Yes, the final stages of the process can be done in Bangkok. No problem.
If the treatment foundation you get at home is high quality, you should still get the best possible final result.
But you cannot just fly in and have egg retrieval (surgery) and sperm retrieval immediately.
A more reasonable and practical approach might be something like:
- Day 11: arrive in Bangkok & see the doctor (your local doctor can have you do hormone injections yourself the last few days)
- Day 12: Human Chorionic Gonadotropin (HCG) trigger
- Day 14: Egg retrieval (ovum pick-up aka OPU) and sperm retrieval followed by ICSI or IVF
- Day 17: PGD
- Day 18: Embryo transfer (Cryopreservation of remaining embryos?)
- Depart Bangkok that day or any other day of your choosing. You are encouraged to discuss this with your local fertility specialist.
“However, sometimes your fertility specialist and the embryologist decide the best chance of success would be achieved by allowing the embryo to develop four days or five days.
If your schedule is too tight, you limit their professional options.
Most important is that you have determined to your own satisfaction as a result of comprehensive medical testing in your city that you and your spouse have no pre-existing conditions and are suitable candidates for infertility treatment.
Fertility challenges are not a problem. But certain medical problems can put you out of bounds, for example uterine or ovarian cancer or fibroid tissue.
And if The Father has male infertility problems, he will need special male infertility treatment like TESE. Get semen analysis done and a male fertility test.
A good local doctor can determine all that in your city and be a tag-team with the Thai reproductive doctors of the SMART Center.
“But the result will only be as good as the weakest link in the chain.”
Patient Trying to get Pregnant: In past years, I've done many IVF cycles in several other countries, consulted more than a half-dozen different specialists, and have hundreds of pages of medical documentation. Do you need or want any of that old documentation?
Reproductive Doctor: “Yes, I do. But please summarize the: a) year; b) how many eggs; c) how many embryos; d) medicines used; and e) the result. I will give you the summary paper when we meet.”
Gender Selection Patient: The web page says that PGD costs Baht 99,000. This seems very cheap compared to your competitors! Is this price correct? Does this price include medications, etc?
Fertility Dr: “The price is correct. PGD costs Baht 99,000 (US$3,300 ±). If you'd like to do a boy transfer, you have to do IVF and PGD screening which costs Baht 249,000 (US$8,300 ±).”
Gender Selection Mother: I am a mother to three girls. I am interested in PGD for family balancing and to have a little boy. My obstetrician here in Australia is happy to do whatever she can this end for me so that my time away from home is minimal. I am interested in the steps needed to take and the cost of the treatment. What does the treatment involve and what can be done here in Australia?
Disavowed Hospital Infertility Center: “Australians who require family planning are welcome. If you can spare 20 days in Bangkok, I would recommend you have our SMART Center fertility doctors supervise and manage the entire course of infertility treatment. It is not a requirement but we prefer it.
We monitor ovarian stimulation multiple times using extremely advanced 4D ultrasound technology and adjust hormonal treatment precisely to get the best possible result and avoid Ovarian Hyperstimulation Syndrome (OHSS).
This diligent supervision of the treatment has resulted in OHSS occurring only once or twice per year of controlled ovarian hyperstimulation (COH) cycles and we are decreasing it further.
You CAN do that elsewhere without our continual monitoring of the effects of the drugs, but the stimulation and drugs impact on success substantially by affecting number and quality of eggs produced.
YES, you can have your obstetrician control the ovarian hyperstimulation if qualified in this field of medicine and your obstetrician can monitor the effectiveness of the drugs using 4D Ultrasound if the doctor has access to that technology.
Our fertility specialist can get personally involved starting approximately Day 12 of the cycle and inject the Human Chorionic Gonadotropin trigger medicine to complete maturation of the eggs in the follicles and promote ovulation.
We'll then do sperm and egg retrieval on Day 14.
Only a few of our patients in Bangkok need a doctor or nurse to do the hormone injections since it is done with an easy-to-use subcutaneous injection pen modeled after insulin pens. Subcutaneous injection pens are simple, reliable, adjustable, ready to use and designed to minimize errors.
“It's the 4D Ultrasound monitoring and precise adjustments in drugs used and dosage that are crucial to successful treatment.”
Patient: Do you offer “short-course IVF”?
IVF Doctor: “Yes. Short course means we start the treatment after the woman's period and it takes around 20 days to finish the process. Ordinary course means we start the treatment around seven days before the period so it takes around 30 days. I do both and the cost is the same.”
Patient: How much do you charge to enable a fertile couple to have twins?
Infertility Physician: “I charge the same. The chance of having twins is around 30-40%. I just put one more blastocyst embryo in. The length of time the couple would need to stay in Bangkok depends on many factors. If they use their own eggs, around 20 days. If they use donor eggs, around seven days.”
Patient Trying to Conceive: Does overweight disqualify a woman from getting IVF from you even if everything about her reproductive system is reported to be normal and she has no problems being under anesthesia? If weight is a factor, what Body Mass Index range is acceptable in order for you to provide infertility treatments?
IVF Specialist: “Obesity has effect on success rate. She has to lose her weight before treatment in order to increase the success rate. BMI should not be over 25-30 kg/cm2. She may try even if she can't lose weight. There is no need to use a surrogate mother.”
IVF Patient: Can unmarried couples get infertility treatment from you?
Thailand IVF Doctor: “Yes, if they carry the pregnancy by themselves. Actually, we don't know whether a couple are legally married or not. Whenever the couples come together, we always think that they are husband and wife.”
Patient: What factors about the relationship of two persons not legally married do you consider when evaluating their candidacy for your infertility treatment?
Infertility Physician: “None.”
Can you help same-sex couples produce their own child?
IVF Specialist: “No.”
IVF Patient: How can I control my period so it will come on time? I'm afraid my period will come late and delay the whole treatment? Is it a problem?
Reproductive Doctor: “We use birth control pills for controlling your period. I suggest you take birth control pills starting from Day Three of your period. The best time for you to come to Thailand is based on your LMP (last menstruation period) which I define as 'bleeding on the expected date'.”
Egg Donation Patient: My wife is not young. At what age should a wife consider using the eggs of a donor rather than her own?
Fertility Dr: “After you have tried your own eggs and you get poor quality eggs or no eggs, if you are over 45 years old, or when you have entered menopause.”
Patient: Is there anything parents/patients can do themselves to increase the success rate of fertility treatment?
Dr: “The most important thing you can do to increase the success rate of these procedures is to relax and avoid getting stressed.”
Patient: Can you tell me how long I will have to be in Bangkok for IVF and PGD if I don't start my cycle with a local IVF centre & I decide to start my cycle with you instead? What is my next step? Is there any need or advantage for me to contact my local fertility center?
Reproductive Doctor: “You have to stay in Bangkok around 20 days. If you'd like to shorten your stay, you may do some injections in your hometown. I prefer you start with me. I will give you the timeline, you just let me know when was your last period and when you'd like to do treatment.”
Patient: You say “costs ABOUT” on some pages. What are the exact costs? We cannot go there knowing only the “ABOUT” costs.
All prices are in Thai Baht (฿) and we state precisely how much is charged whenever possible. Everyone who is not Thai and doesn't have a Baht bank account, will need to exchange money to pay fees. Currency exchange rates change 3-4 times each day. Until the moment you buy the Thai Baht needed for the infertility treatment, it will be impossible for you to know exactly how much the amount will be in your local currency. Until then you can know the exact price in Thai Baht but only "ABOUT" how much the fee will be in your local currency.
IVF Patient: What legal procedures are involved if my biological child is born in Thailand? Would that child be considered adopted?
Fertility Dr: “There are no Thai legal procedures involved. You must contact the embassy of your own country regarding their requirements in order for you to take your baby or babies back to your country.”
How can a single American man have a child in Thailand?
Infertility Physician: “We don't provide this kind of service.”
Surrogate Mothers & Surrogacy in Thailand
Thousands of people each year get fertility treatment in Thailand, including about 5,000 persons from abroad. In the past, this sometimes included using surrogate mothers. Although not yet technically illegal and in a gray area of Thai law and ethics, exploitation and abuse of surrogate mothers and some recent sensational news stories have made it too hot a topic for most fertility doctors and all hospitals in Bangkok.
Infertility treatments are a well-established branch of Thai health care. The legal side of it is merely a boring but necessary bureaucratic process, not a barrier or an obstacle. Even surrogacy is acceptable and medically indicated in some cases.
Latest in Thailand: The current draft of the law on surrogate mothers and surrogacy in Thailand being considered by Parliament makes it illegal to use a surrogate unless she is a direct relative. Few fertility doctors providing treatment in Thailand and only those who are highly commercialized with high overhead pushing them to the extremes of ethical limits are going to push a surrogate or help you arrange a local surrogate who is not a relative from July 2011 onward. Every reproductive doctor knows the Thai Medical Council's perspective on this topic and that it will become not only unethical but fully illegal any day.
Human trafficking of Vietnamese surrogate mothers by Taiwanese criminals in Thailand (they could not have successfully operated without complicity of certain fertility doctors) has caused most Thais to view surrogacy with suspicion and disapproval even if it is not yet against the law at the moment of publishing this.
For years, certain highly commercialized “health care for (big) profit” IVF centers have considered surrogate mothers a cash cow to help cover the extremely high cost of their extravagant, overstaffed, high rise rented offices in the center of Bangkok's financial or business districts. It can be debated whether the mother should have received the major share of the money paid by the infertile parents instead of most of it going to the IVF center and whether a surrogate mother should be a capitalist tool and item of trade. But many Thai people consider the practice unsavory, unethical, un-Buddhist and that it should be made illegal.
It is possible a reproductive doctor with high overhead may still be selling surrogate mothers but we don't know any infertility center where the mother and baby and parents are protected, the mother gets MOST of the money, and we feel confident recommending it. If you know of any, please tell us and we will publish the details.
Most of these questions and answers about surrogacy and surrogate mothers are from the period 2007 to 2009. After that we were no longer able to find any good value for money service we could recommend for needy couples.
They are still good questions and still useful info for any couples considering using a surrogate so we keep them for your reference. Prices are very out of date.
Current recommendation of Thai fertility doctors and hospitals in Bangkok is use a relative if you need a surrogate. That is also their first suggestion for an IVF egg donor.
Egg donation is also coming under intense scrutiny in Thailand. Major hospitals in Bangkok will not provide egg donors directly but some fertility doctors are still able and willing to help infertile couples make private arrangements with egg donors.
As of the third quarter of 2011, we have no recommendation for surrogate mothers in Thailand so do not ask.
I am a single male wishing to become a father. Can I get egg donation and a surrogate in Thailand?
“We don't provide this kind of service.”
At what point/stage is a surrogate paid or at what point/stage must the parents pay for the cost of the surrogate?
“The parents/patients pay the entire fee at the beginning. If the surrogate does not get pregnant, we will refund approximately 90% (ninety per cent) of the compensation paid to her. However, we usually suggest they try again.”
Do the parents pay the surrogate or do they pay you?
“They pay my agency.”
Is the surrogate paid in installments or a lump sum?
“We will pay the surrogate in installments. However, we collect the entire amount because we need it as a deposit.”
Is a deposit required to book and reserve a surrogate? If so, how much? When is that paid? How is it paid?
“The parents/patients must pay before starting the treatment. They may pay by bank transfer.”
Can patients/parents pay by credit card?
“For medical expenses, yes. But for egg donor compensation or surrogate compensation, they must pay in cash only.”
My wife is over 60. I'm under 40. We want two children using your egg donors and surrogate mothers & my sperm. Can you help us?
“We will provide both an egg donor and a surrogate for couples only after we have interviewed both persons face to face.”
Have any past patients using a surrogate encountered any difficulties and how were they resolved?
“Yes, some have experienced various difficulties but we were able to solve all the problems.”
What is included & excluded in the compensation for surrogate mothers?
“The compensation includes everything except antenatal care, medicines, vitamins, maternity clothes and delivery. All these things the patients/parents must pay, are itemized and clearly billed by the hospital throughout pregnancy and will total approximately Baht 25,000. For maternity clothes, I think I will waive that for them because it's not a large amount of money. For delivery at our large, ISO-certified, private hospital where my infertility center is located, a Caesarean section is around Baht 50,000 (US$1,471±) and a vaginal delivery is about Baht 40,000 (US$1,176). We can also give patients the option of having their baby delivered at either of two other large, modern, private, well-equipped, highly-qualified, fully-licensed ISO-certified hospitals in Bangkok.”
What if there are unforeseen complications? Will that incur additional expenses?
“When there are complications, sometimes we cannot estimate the exact cost in advance such as pre-term delivery which may cost over Baht 1 million (US$29,412±) if they are triplets. Patients receive an itemized bill from the hospital for all services provided and pay that amount.”
For twins born to surrogate mothers, must the parents/patients pay the stated delivery fee plus an extra fee?
“There is an additional fee which will go to the surrogate. The hospital cost of twins in cases where there were no complications, will exceed the cost of a single child by approximately US$300).”
Is it true that Thai law considers a child born to a Thai surrogate mother to belong to her and her husband and not the biological parents?
“The child belongs to the surrogate. So she must sign a document giving the rights of a parent to the child's father (the patient).”
Will the Thai birth certificate state that the male patient/husband is the father?
After the district office issues the original Thai birth certificate, who will get that document?
“The hospital staff will get it for you.”
How many days after the birth will the official birth certificate be issued?
“It takes seven days.”
Will the hospital staff take care of processing and obtaining the official birth certificate?
“Yes ,the hospital staff take care of it for you.”
Do you issue any documents for the embassy of the patients confirming the husband is the genetic father of the child and wife is the genetic mother and the mother named on the birth certificate was only a surrogate?
“Yes, I will be happy to prepare a document for them.”
Please tell me more about the document the surrogate "must sign to give the right of the parent to the child's father." Is it a form? In what language?
“All of those types of document are supplied by the foreign national's (patient's) embassy and they very from one country's government to another.”
Are any of your surrogate mothers married? Have any of them had children before?
“Almost all of them have had kids before, but they are not legally married to anyone and have no marriage license. If a surrogate was ever legally married and registered the marriage and has a license, the surrogate must get legally divorced and have a certificate of divorce before going through the surrogacy process.”
If a surrogate is married, does her husband have any rights in this matter of her being the surrogate for another couple's baby?
“See the previous response.”
Are there any Thai barriers or Thai obstacles that would hinder or prevent them taking the baby out of the country?
“Depending on the laws of their own nation, they might need to go through an adoption process in their country. If your baby gets a passport from your embassy here in Bangkok, he or she or they are able to go anywhere.”
Are there any insurance costs for surrogate mothers?
“No, there are none.”
Do the prospective parents need to pay a living allowance to cover the food, maternity clothing and travel expenses of the surrogate?
“They only need to pay for her maternity clothes.”
What is the costs of the surrogate's check-ups, ultrasound exams, blood tests and any other tests once pregnant?
“Approximately Thai Baht 3,000 (US$88±).”
Does the doctor charge a "finder's fee" for finding the surrogate?
“No, I don't.”
What will be the legal costs of the surrogacy process?
“There are no legal costs per se. However, in some cases, if patients/parents need a document published by a law firm, they will need to pay for them themselves. The cost varies between Baht 30,000 (US$882±) to Baht 50,000 (US$1,471±).”
For what legal services will the patients/new parents need to pay?
Do you recommend using a surrogate mother?
“Yes, but ONLY if they cannot carry the pregnancy on their own (e.g.; the mother has had a hysterectomy done).”
Do the potential benefits of using a surrogate clearly outweigh the potential risks?
“The parents have to weigh those by themselves.”
Can I have a surrogate mother use her own eggs?
“No. But the mother of the couple can use donor eggs and put the embryo in the surrogate.”
When a surrogate is used, whose names appear on the birth certificate as the parents of the child?
“The woman who gives birth must be the mother. Regarding the father's name, we can put the name of the infertility patient's husband.”
Do biological parents need to adopt their own genetic child?
“It's up to the laws of their country and their own needs.”
What are the relevant Thai laws on the subject of surrogate mothering?
“There are no laws or regulations now. A law may be enacted in 2-3 years.”
How many medically, psychologically and emotionally pre-screened surrogates to you have at present?
How can prospective parents review surrogate candidates?
“We have profiles.”
Is there any additional charge if a Caesarean section is required or the mother experiences any other complications?
“Yes. The patients/parents will need to pay all the costs related to that pregnancy (e.g.: Toxemia, postpartum hemorrhage).”
If there is a pregnancy, where will the surrogate reside?
“At her home in Thailand.”
Are there any other additional costs for the surrogacy procedure? Are there any hidden costs?
“There are no hidden costs. But the patients do need to pay for antenatal care, medicines, vitamins, maternity clothes and delivery cost.”
What are the costs of delivery?
“For a vaginal birth, the cost is approximately Thai Baht 30,000 (US$883±). For a caesarean section the cost is approximately Thai Baht 50,000 (US$1,471±).”
Are there any additional costs for a twin pregnancy?
“Yes. If the pregnancy results in twins, the patients/parents will need to pay an additional Thai Baht 50,000 (US$1,471±).”