Episode Transcript
[00:00:04] Speaker A: Welcome to Start to Finish Motherhood, a podcast for those thinking or already single mothers by choice. Just looking for practical advice for navigating life's relationships. When you decide to have children on your own, it doesn't mean that you're completely alone. I'm Aisha Jenkins and I'm partnering with you every step of your journey.
Hi everybody. I'm here today with a lovely guest. But before I get started, one of the reasons I created the Start to Finish Motherhood platform was so that we can start opening up these conversations around a person's options. So be it single mother by choice, be it fertility options, just the broad range of options that are open to us as black women, as people of color, which we didn't always feel was an open community or open spaces for us to opt into. And so one of the things that I wanted to do was to get in front of the fertility conversations before you reach 39 and it's too late to correct anything that might need correcting. And so as a member and a leader in the fertility space, we talk a lot about the inner workings of the journey, we talk a lot about our experience going through the fertility process. But a lot of this information as you go to your doctor's appointments seems to be gatekept from us. And so you have to ask for these tests, you have to ask for this information instead of it being presented to you as an option. And a lot of times we don't know what we don't know. And so with this episode, I wanted to pull back the curtains just a little bit and talk about some important fertility related topics, your different options, and then to discuss fertility related care both home and abroad. And so we have a lot of single mothers by choice who travel for work, travel for leisure, and we've had a lot of people who are considering an expat life. So that's basically uprooting and moving to live in another country. And that might happen in bits and spurts. It doesn't always happen at one time. So you could get pregnant here in the US using IVF or whatever method you want and then travel to another country for care, or you could move and you can do your entire process in another country. And so I wanted to bring a person who speaks readily and candidly and is well informed on this topic about medical tourism. And so we actually did a YouTube live conversation about this with an OB and it was just so insightful. And so wherever possible, I'm going to redirect to that conversation because the OB that We had on did such a thorough job of talking through some of these issues that we encounter, like pcos, fibroids and things like that that I'm not even going to touch. She did such a phenomenal job. Okay, so first I'm going to welcome my guest, Dr. Natasha, to the podcast and ask you to introduce yourself to my audience.
[00:03:05] Speaker B: Thank you so much for having me. Again, Dr. Natasha Ramanthal, also known as the Medical Tourism RN on YouTube and other social media platforms. But I'm not a physician. I'm actually a doctoral trained registered nurse, and I've worked in the emergency department and post anesthesia care unit for a number of years. I created my YouTube channel about a year ago, and on that channel I cover all aspects of medical tourism for black women if they decide to seek health care or any type of treatment abroad for anything. It can be cosmetic surgery, cancer, fertility treatment, transplants, whatever it may be. But essentially, I started the channel so that I could help educate black women on things that they needed to know to make the most informed decisions about their health care, to have the best outcomes as well as the best experience.
[00:03:55] Speaker A: All right, thank you. And as a disclaimer, like I said, I'm not a doctor, but I'm deeply passionate about the topic, and I have encountered some of the not the best outcomes as it relates to fertility. And so we wanted to put together this episode as to use this information and do with it what you will so to be able to make informed decisions about your healthcare. Okay, so let's talk a little bit about fertility basics. I think we do a terrible job in this country with regards to young women. And there's all the messaging out there that says, prevention, abstinence, don't do it. When I go to my gynecologist appointments, they would ask questions like form of birth control, are you on? And all of these things. But we don't talk about fertility until you realize there's a problem or it's almost too late. So can we talk a little bit about what a basic fertility workup entails and how to engage in that conversations with your doctor? Sure.
[00:04:53] Speaker B: And I have to give my own disclaimer. I did mention I'm not a physician, but although I'm a registered nurse, I do not recommend or refer any clinicians, clinics, services. I simply provide people with information and also information on what countries tend to have or what they offer. So I don't make referrals. I also think that speaks to credibility. I only recommend something that I've used myself. So I just wanted to say that. But to answer your question, I think is a really great question. Fertility workup so there's a number of things that go into a fertility workup. Unfortunately, a lot of times the conversation doesn't come up unless you're either already pregnant or there is an issue. I tell people, if you know what you want, you should be talking about that early on, because pregnancy should not just be. Or fertility in general shouldn't be a topic of conversation. When you think that you want to start a family immediately, a lot of people are like, oh, I'm going to try now. And it's. A lot of it is, is planning. Especially if depending on your age, your medical history and also genetics, a lot of that plays a role. But generally a fertility workup include a number of targeted physical exams for the female. It should be performed with a focus on vital signs if they have any past medical history in terms of any chronic illnesses, any autoimmune diseases. But they would typically work up the thyroid, the breast, and also do a pelvic exam. And those tests will focus on ovarian reserve, looking at your ovulatory function and any structural abnormalities as well. One of the things I like to tell people, because I find that it doesn't come up, honestly, almost until literally there's a lot of frustration or people gone through such a long process if they're having difficulty with. When it comes to fertility, is checking out your male partner.
A lot of times that should be done in conjunction with when the female partner is actually going ahead and having her workup. Because there are times and oftentimes we find that the male partner may have a low sperm count or have something else going on, but no one is thinking about it. They simply look at the person who's housing that baby to be or babies to be.
[00:07:04] Speaker A: And that's what I found. So a lot of times when a woman thinks about pursuing single mother by choice, she's either using a known donor, that is someone that you can see, you can look at, you've seen them walk the street and you've asked them to make a donation. And so this is a person whose sperm probably might not have been tested. So then they have to go through the process of getting it tested. And then you have sperm that you can purchase from a commercial sperm bank. And so in either scenario, you want to be working with the medical documentation that gives you information about sperm count, that gives you information about sperm motility, because you want those little swimmers to actually be able to find your Egg without a GPS unit. Now I know that I had to initiate the conversation with my gynecologist and I was about in my early thirt and I got a good response. In terms of being able to have these conversations, what are some of the things or flags you should look for in terms of one feeling safe to advocate for yourself or when it's time to find a new provider.
[00:08:09] Speaker B: Before I answer that, I wanted to ask you because you gave a little bit of your experience when it comes to a sperm donor. And I know they check sperm motility and other things in the US I know that they require a medical history questionnaire for a donor. I wasn't sure about that outside of the US if it's required outside of just looking at sperm, do they also look at the additional genetic history if there are any abnormalities, chronic illnesses, autoimmune? Are you aware of that? Because that's something that I know is.
[00:08:39] Speaker A: Required in the U.S. i'm not 100% that, but I do know from having members of the community who are Canadian and who are in European countries, who have sought care in European countries that they typically work with some of the same banks. I know for Canada you need a Canadian compliant sperm bank in the US and there are sperm banks that are specifically Canadian compliant that meet basic requirements. But I believe in Canada what it does that the donor has to be known. So you can not known to you, but it cannot be an anonymous donor. So I think it's something around release information to be a Canadian compliant sperm bank. But across the board, if you're using a sperm bank, each country will have some pretty stringent criteria and I would almost guess, and it's probably something I can look up if it's across the board. I think where they vary is in terms of the legal requirements and what gamete you can work with. So I know some countries, they want to match you phenotypically. So for the one clinic that I was looking at and I started going through the process, they would ask for a picture of me so that they can match the egg donor or the sperm donor to me or my partner.
[00:09:58] Speaker B: Right.
[00:09:58] Speaker A: And so I think that there are those types of requirements, but I think basic safety regulations are going to be the same now within the US I know that the state of New York has additional criteria on top of what the basics are. So that's just in terms of the health requirements. So when we're talking about using sperm from the sperm, there's also shipping. Does it ship to a different country? Right. Because it's a tissue donation. So tons of legalities around that. The other question you asked about was about genetics. Each from my understanding of the nine or so sperm banks that I've researched here in the US they do have basic genetic screenings. Now if you are a person and you know that there are certain types of genetic conditions that are prevalent in your family history, your family line, then you can go and get some additional testing and you can also ask that the donor gets additional testing. Like if you've fallen in love with the donor and you want to use that donor, then you want to, you say, hey, I'm carrier for, let's say, God forbid, sickle cell, I need you to get tested for this or what have you. So there are things that you can specifically ask for. But when I went through my treatment, I got pretty much a basic level genetic panel for myself and then my donor also had a genetic panel. And so we did not like overlap. There were no conditions that we had to be worried about and that was covered by my insurance. So yeah, if you're working with a sperm bank, they will typically tell you what your options are for that.
[00:11:34] Speaker B: So great. Okay, so back to your question about health advocacy. I didn't know be some of the legal things. I didn't know about the medical history part in outside the U.S. but medical advocacy, and this is important no matter what aspect of healthcare. I think it's really important. It's funny because even as someone who's a part of the healthcare landscape or healthcare systems, navigating it for others, for loved ones, sometimes is so daunting that I say to myself, my gosh, what about people who don't know what the inner workings are or have issues with literacy or language or some other barriers? I could only imagine. But I think it's really important to say that you have to be a self advocate for your. You have to advocate for yourself. And that means just learning how to be direct about what you think in terms of what you believe you need for your health, your body best, what you desire, and particularly when it comes to fertility. In that entire journey, what it is that you would like to do, I think it's important that you explore our options. Don't have anyone prescribe anything to you in terms of treatment or going down a particular path, because there are a lot of biases that we all have. But especially in medicine and especially in the United States, people come to work with their biases and don't leave them alone and that affects treatment. So. So it means that we both have to listen to providers and what they have to offer in terms of clinicians and options for you based on your health history, based on what your desires are, and also whatever means you may have. And unfortunately in the US a lot of that revolves around finances and what's covered and not covered under insurance. If you are insured or maybe you're underinsured, all of those pieces. But from the discussions with your providers or your clinicians, making sure that you're a good self advocate for yourself, it has big benefits for you on your health journey on a whole. But then also when you get to that point, hopefully when you have a baby or babies, making decisions for them as well, because self advocacy is ongoing, it never stops, especially in health care. So if you have good self advocacy skills, it'll make you feel more in control and make life decisions that are best for you. I think that's probably the most important thing. I think that when people are in health scenarios, they're already feeling a bit vulnerable. So feeling like you have some form of control because it's your body, you want to make sure that you're involved in the decision making for that and that your needs are made known at the very beginning.
[00:14:10] Speaker A: All right, so you heard me geek out about sperm and different procedures. So I'm going to give you this opportunity to geek out about the international aspects of of health care and fertility in particular. So your bread and butter, you're thoroughly researched in this. So let's talk a little bit about specific to fertility treatments. What are some of the differences you've seen with regards to the US versus international care coverage? Listening to and having patients feel comfortable advocating for themselves.
[00:14:44] Speaker B: So there's a lot of differences. Actually, I would say the biggest differences between maybe the US and abroad when it comes to fertility are respect for the mother's birthing plan. It's just that there's more of a focus on what is covered by your insurance. In the US many offerings like midwives, doulas, water births, a lot of those things are not covered by insurance. And unlike if you were to have a physician in a traditional hospital setting, it's because literally midwives and doulas are not considered essential care. So if a mother wanted to go the route of a midwife or a doula in the US it could be quite expensive because it's just not covered. Not many insurance cover midwives in particular, but midwives and doulas and then in other countries actually it's commonplace to have midwives and doulas and they're actually part of the pregnancy journey. They literally are with you throughout the journey. At home, doulas in particular are talking and providing support to you and your family members, whoever they may be, and just providing support for you during that process and even after. And midwives are actually running units, labor and delivery units across the world. And literally the doctors come on maybe in the morning and they sign off to them. So I find that it's really interesting about how different it is between the US and these other countries, but there's also a major difference when it comes to medication options, C section options, and breastfeeding on the yes, in the US There's a lot of widespread use of medication to induce labor rather than natural options and just allowing the whole birthing process to take its course. A lot of times if you ask why, it's, oh, it's time consuming. Not that there's danger to mommy, danger to baby, it's time consuming. So I feel like it's almost like factory led. But in other countries, natural birth methods are encouraged. Breastfeeding is supported throughout the entire country. It's not uncommon to to have a mother breastfeeding in public and in a lot of public places. And it's not seen as anything derogatory, unlike here in the US and when it comes to C sections outside of the US it's usually a last resort and it's due to some type of distress with mother or baby. Unlike here in the US Where a lot of times it's like, oh, you want your baby born on the 15th? Okay, we're going to do on the 15th. Or the doctor's schedule is C sections are done every Wednesday. So your baby's going to be born on that Wednesday. That's typically how it's done here in the U.S. yes.
[00:17:17] Speaker A: And I asking for a friend or telling for a friend, I will or will not admit that a friend actually did try to pinpoint the birthday of one little person. And it, what do you call it?
[00:17:29] Speaker B: Backfired. Backfired verbally. But I had the opposite experience. I didn't try to do that. And my first child is born on my father's birthday.
[00:17:39] Speaker A: Oh, man. So I actually did. And it wasn't intentional, but it was that I wanted to deliver with my OB practice and I wanted to deliver with my specific OB. And I was about 39 weeks. So I was in between the 39 and 40 weeks and she gave me options for days. And so I picked a day that I thought was going to be after my daughter's graduation. But it, I looked at the calendar when I was planning the date and I was looking at an older calendar, so it was a few days. My second was delivered a few days before my daughter's kindergarten graduation. So I'm like, I have a two day old or three day old and I'm going to a graduation.
[00:18:21] Speaker B: I.
[00:18:21] Speaker A: After you deliver, you can barely walk, your innards are still jello. And I'm just like, oh my gosh. So anyway, anyway. But I digress. Okay, so I'm about to give you more opportunities to geek out because I have three questions that I wrote down as you were talking. So when you were talking about midwifery care and in countries other than the US it brought to mind called the Midwife, which is a PBS show. And like you said, the midwife actually handled the care. What does the fourth trimester look like internationally? You've delivered the baby, you've taken the baby home. Does someone come to visit you? Is that covered typically by insurance?
[00:19:01] Speaker B: How does that look? Yeah. And so, to be honest with you, a number of countries outside of the US tend to have universal coverage or something quite similar to that, where you're either paying a minimal amount of money because the government handles your care along with even postpartum bonding time with your baby. Every country is a little different in terms of the length of time, but you have bonding time, you're still getting, your job is secure, you still have somewhat of a paycheck after a certain amount of time. But what happens is a lot of countries are paying for doulas or midwives to come to your home after you've been released, or some are having it at their homes as well. If they give birth at home, it's not required to go to a facility after it. It's only you come in when you do your postpartum checkup, you and the baby, if it was delivered at home, they're there with you. If they weren't delivered at home, maybe you were at a facility. Once you're discharged, you have regular visits where they come to check you, they check the baby, and physically they're checking you. But they're also trying to find out a lot of other things about your emotional health. Having a baby, although it's one of the most joyous things in the world, it's also exhaustion, going through the entire pregnancy and then finally delivery, you come out of it and it's one of the things that is not paid close attention to, which is why they term it the fourth trimester. It's basically the 12 weeks after giving birth. So it's just as important for the mother's health as the first three trimesters. Yet, unfortunately, this is when mothers have the least interaction with their healthcare, at least in the US it's not. So outside of the US A lot of attention is paid to the mother just as much as it is to the baby in that fourth trimester, because you can expect fussiness, crying from the baby, likely a lot of exhaustion for you as mom, because newborn babies are just learning to adjust to life outside the womb. But it's also a time where, although it can be a happy moment, women tend to develop postpartum depression as well. And it's likely to be blown off as just exhaustion. Oh, you're a new mom or you just gave birth, it'll pass. And it's something sometimes a bit deeper. So if it can be caught early on, what happens is a lot of times they bring in social services where they can have someone come in, make meals for you or your family, take the baby so that you have X number of hours to yourself, whether it's to just rest or do nothing. Maybe if it's not making a meal, maybe they're educating even whoever's in the family, if they're old enough. Maybe you have a partner, maybe you have older children that are old enough to learn about the new dynamics of the household. Because birthing order is real. Everyone thinks it's great that this baby's here, but then they're like, when's the baby going back? It's a sibling, so they take care of those things as well. So it's extremely helpful. And it's sad because a lot of that is not offered in the US A lot of times what's offered if you have insurance is tied to a little bit more phone call related to avoid hospitalizations, making sure that you're not bleeding, you're not all of those things, are you? If you had episiotomies and all these other things, are you okay? And that's fine. But it's so different from having someone physically come to your home and participate in your new household and talk and offer support and listen to you about how they envision their new household. And maybe you can offer some suggestions that are just helpful because you've seen it before.
[00:22:33] Speaker A: Yes. Okay. Oh, man. I'm flashing back to what would have been helpful with my two girls. Okay, so we're talking a lot about the experience, what is covered. So if I am US based and I just happen to be in another country, let's say I happen to go into labor in another country, I've got US based insurance, or I'm visiting for six months, I'm a nomad, I'm there for six months. What's covered in terms of insurance? How does that work generally?
[00:23:04] Speaker B: So that is individually based and that. And meaning it's health plan specific. And then even when you say, oh, I have X insurance or I have Y insurance, then it goes down to the plan level. What is in your plan? So what I tell people is no matter where you're going and when you're planning to go, especially if it comes to fertility, if you're pregnant and you are further along, close to possible delivery, and maybe you didn't even intend to deliver, you just want to have a short babymoon time away, be prepared for the possibility of giving birth at any moment. I always say call and ask your individual plan, say, hey, I'm going to be going out of the country. Tell them where you're going and ask for a few things. You want to know what hospitals and obs are available and under your plan, what's covered, what's not covered, and also if something is not covered, if you do use services, is there anything that can be reimbursed? Because maybe they don't even have coverage in wherever you decide to go. And that's also an option. They may reimburse you for a percentage of the cost that came out of pocket for you to seek any type of care. I did this not for fertility, but I decided to go out of the US for a month, told them where I was going and said, I have three young kids. And I said if something happens, I need a pediatrician. I also look for just a primary care. And I also asked for the top two hospitals, meaning like close to wherever I plan on being in, wherever I am. And they gave me the hospitals that are under them, that are covered, gave me physicians that were covered under them. But I also asked about what if I can't make it there, that's actually on the other side of the country. And they were like, if that's the case, if it's an emergency situation, certainly you'll be reimbursed. If it's not, if it's something foreseeable, then they believe that you can find a way to get there. So it depends because a lot of people also don't have international coverage. I happen to work for a local company. Local meaning it's a US based company and their headquarters is US but it's global. And I don't know if that's the only reason I may have that international coverage because when I share that with people, some people tell me, oh, I don't have international coverage. But some don't call literally. It doesn't mean that you work with a global company, literally. Some of these big companies actually do have providers in a number of countries, but people don't ask and they end up paying out of pocket.
[00:25:27] Speaker A: Yeah, I would have never thought to ask. I'm always thinking if I need to be evacuated for emergency life threatening situations. I know that my company has international locations, but this is definitely now something that I would look into because we do travel and we do work internationally. So I could imagine that happens. But it would never to me to do these calls before I head out for a trip. And I'm going to schedule a trip next year and I've got young kids and so now you've given me something to think about.
[00:25:58] Speaker B: Okay, so dental too, by the way. Especially because the kids, sometimes they just do something and they might fall, chip a tooth or something.
[00:26:05] Speaker A: Yeah, because it's funny you mentioned that because I did do a baby moan to Singapore when I was about in my second trimester with my first child. And one of the reasons I felt comfortable doing it was because I had researched and I knew Singapore had top rate medical coverage. What are some things that we should look for if we're considering going abroad for an extended period of time? Is there like a certification that we should be looking for? If we're looking for international health care?
[00:26:33] Speaker B: Not. It is, yeah, it's an accreditation. So the Joint Commission, which is based in the US and it's a nonprofit organization that accredits any health care body on it's a regulatory body actually that is like top standard for quality of care. They do accreditation for hospitals, large medical facilities, labs, anywhere that health care is given, they are there to do the accreditation. And it's like the gold standard. Now they have a branch called the jci, the Joint Commission International. Excuse me. And I mention it on every one of my videos because I tell people, listen, even though I'm giving you information, do your own research. Because the Joint Commission International has a website that's free that everyone can go on and you can actually put in whatever country it is and you can see a list of JCI accredited facilities. And what happens is you don't always see every provider like clinician that's in it. But what happens is clinicians that work at these Facilities are required to upkeep their skills, their, their accreditations, their certifications and their licenses. Because what happens is JCI does a regular accreditation process, but there are times where they do surprise visits. And also if anyone may have called in and said, I think that this is unsafe, they will make a surprise visit. And literally, if they find something wrong, it'll shut them down. Everything will shut down right then and there. So that's why I tell people if I'm doing this for myself, I use the jci. If I'm going abroad and I know I'm going for some type of treatment or care, intended care, not necessarily emergency, but it's good to use an emergency as well. I hadn't thought about it when I was going out of the country to say, is it JCI certified? But if I were seeking healthcare treatment abroad, I would look to see if they had the JCI accreditation. But on a whole, there are six things I tend to tell people to look for when it comes to fertility treatment abroad, because it's important to consider. So it's going to be like, obviously the cost of treatment. And I say that because the Average price for one IVF cycle in the US can range from 15,000 to 30,000 and even more depending on the center, the person's individual medication needs, their history and medications alone can account for 35% or more of the charges. So looking outside of the US is certainly worth looking at other options. Many countries can provide high quality care at a low cost. The second thing I tell people to look at is language. Whatever your native language is, it's not that you would not receive quality care by not knowing the language. You just want to know the availability of clinicians to communicate with you in a language that you're familiar with. You don't want to be trying to use your little bit of Spanish or whatever to try and learn about. Not when it comes to baby and mommy's fertility. We want to know, and a lot of places have translators. There are a lot of physicians that are educated in the us, Australia, uk, Canada and other places and then go back to their home countries. And so they do know English, they know a number of different languages, French, Spanish, et cetera. So I think healthcare is so nuanced that you don't want to leave room for interpretation. So just ensuring that the offer is there for whatever language you need. And honestly, these days it's not an issue. Language governing bodies, number three, and that goes to the jci. But also what's important is in country who is the regulatory body for fertility clinics. This is critical in country because you want to know, yes, JCI is there and for me that's gold standard. But I want to also know who's a regulatory body for fertility clinics, because I just want to look it up and see is a clinic or part of that particular regulatory body. And usually they're very stringent also. So that's another reason why I say you just want to check. The other thing is flight, hotel and travel costs, right? So a lot of times people use medical tourism. This one is called fertility tourism. It's just the umbrella of medical tourism. They use that as a method, obviously, because it is lower cost, not lower quality, but lower cost. But sometimes when you factor in the flight, hotel, travel costs and whatever is encompassed into that package for your fertility treatment, and also if you have to go back again, all of those pieces, it may not work out to your benefit. There's a myth that medical tourism is always going to be cheaper. That's not always the case. Depending on your circumstances and where you decide to go. If you're in South Florida and you decide to go to India, the cost for the flight alone, that's astronomical. But then maybe the treatment is really low because in India you can get anywhere from 85 to 90% of the costs that you pay here in the U.S. so all of those things need to be taken into account when you're thinking about your overall end to end process for fertility. And then also local fertility laws. So there are many laws and regulations that are in support of those going through IVF using donors. But you need to do your due diligence because you may not meet the criteria in a particular country. I know in some countries and I'll it'll come to me as we're having the conversation. But some of them criteria where you have to use a family member for donation of eggs versus in other places, that's not an issue. And then some places you have to be married, there's so many things. And then LGBTQ and all of those things. So you want to make sure the local fertility laws of where you are intending to go and then the last one, just location of your frozen embryos and eggs. Because some countries may have limits on the number of frozen embryos. That is really important before you even get to determining where you want to go. If you just look at those six things for your choices and determine which one would work better for you based on your personal situation and what you desire, you'll be able to make a choice A lot easier. A lot faster as well.
[00:32:21] Speaker A: You are speaking my language. You should just see my face light up. Because I'm just like. All of these things were things that I encountered. So first, let me take a step back. All right? Some questions. I know from being in the Exodus community and from watching some of your videos on Mommy Tucks and things like that, getting plastic surgery, that when you talk about the jci, you also, it goes down to the individual physician, not the facility.
[00:32:49] Speaker B: No facility. But what happens is those who are running the actual accreditation process at the facility have to submit documentation showing proof of everyone's credentials. They can call it at any time. And what happens is a JCI accreditor will go around to every part of that facility and they can just. I'm a nurse. It hasn't happened to me. And I've heard horror stories. But typically what happens is they can walk up to you at any point and say, where's the such and such? Meaning like, where's the exit? Where's the such and such plan? Down to where's the crash cart? I was emergency department to the all these things. Now, if you're in the midst of taking verified plus patients and bells are ringing and the code is going, you may not know all of that right then and there, but guess what? You have to answer that to the JCI at that point, or something is going to be dinged on your accreditation. I tell people, instead of trying to look for the clinician and their credentials, look for the facility, because the facility typically has those with those credentials and they have to keep them up in order for them to keep their accreditation. So it's almost like you're killing two birds with one stone. But you can opt to go the other route where maybe you've heard about a particular clinician who has a really great success rate and you want to use that person, you can see where that person is tied to in terms of facility. They may have their own private facility, see if it's JCI certified, or they may work at particular facilities, and if so, check which ones are JCI certified. So it can go either way. I just said that you can kill two birds with one stone if you go JCI route because they're checking all the credentials of those clinicians under them.
[00:34:32] Speaker A: All right? And so then to put a finer point on some of the things you talked about in terms of when you're pricing out whether it's more financially feasible to go abroad versus staying domestically, one of the things is if you have to have Multiple cycles. So I had ivf and so if my IVF worked on the first try, then I'm golden. But if I had embryos left and my IVF did not work on the first try, then I'm potentially flying back and forth to Spain, to Barbados, to European facilities for additional treatment. So that's something to factor in. And then shipping. So I'm US based and a lot of international clinics will use US based sperm banks. And so some people in the community will get surprised by you have to pay insurance on the shipping containers, which could be like 5$600, which is a bit of a shock, but really a drop in a bucket after all you've spent. Right, but it's a shock to not anticipate that. And but then if I were to Google and I were interested in fertility tourism, what terms would I use to do my search? Because I know we talked about babymoon, we talked about medical tourism.
[00:35:48] Speaker B: You can search fertility tourism or you can say medical tourism for fertility. You can also just Google the term. What are the best places for IVF treatment outside of the U.S. i always say outside of the U.S. only because I'm based here. But you probably have listeners worldwide, maybe outside of their home country or where they reside and they will have a list that comes up. The only thing I'd say is there are some that are sponsored. So make sure you're digging a little bit deeper because sometimes if they're sponsored, those are the ones that kind of start at the top that are listed. It doesn't necessarily mean they're the best, but they've paid for theirs to be at the top of that Google search. So when you see there are certain places that show up pretty regularly where you can know, oh, those are the best because they show up every year. This country is well known for, not necessarily for a particular clinic, maybe for several clinics. So they're known for that specialty. We have that and then we have some where it's just literally one clinic in that country does it and they're well known for that. And that's like Barbados and that happens in Mexico and Puerto Vallarta. There's only one and they have that. They're the only one, I think in Central and South America, I believe, to have this. I forget the technology, but it's the technology where you can select the gender of the baby.
[00:37:07] Speaker A: Okay, gender selection. Okay, so last two questions that I promised because we could both geek out. Are there particular countries that are better known for ivf?
[00:37:17] Speaker B: Yes, there are. I have, I Actually, and I have to. I'm just going to refer to a video that I did.
[00:37:22] Speaker A: I thought I saw it on one of your videos. Okay, so we'll put a link to that video.
[00:37:27] Speaker B: Let me just share. It was like, 14 countries, right? I did a lot of research, and I was like, someone asked me specifically, a viewer, could you cover babies? It was twofold. Because I knew black women in particular. The mortality. The infant mortality rates and the maternal mortality rates in the US Were deplorable on a whole, but specifically for black women. And I'm just like, we are considered a developed country, but they can't get this right. And I think it's intentional. And so I said, let me just look. Because what I've noticed is a lot of people in the same Exodus Summit community that you mentioned were talking about they were pregnant. And because of some of the racism or the biases that they've experienced, they were considering either delivering abroad, or some people were interested in becoming pregnant abroad. Maybe they didn't have fertility issues, but they decided, yes, I want to become a parent, but I don't want to do it here. Let me at least travel to a place that has low infant mortality and low maternal mortality rate. So I have the best overall experience from end to end in terms of my care. And So I have 14 countries that I listed in that. It's called so youo Want to have a baby. 14 best countries for IVF, and they're not in any particular order. It honestly depends on those six things that I mentioned, what you're looking for, your personal circumstances, of course, cost, and then also the governing bodies and the regulatory issues, because, again, I remember Israel was one of them. And I know they're engulfed in war right now. But one of the things that I remember specifically about Israel and the IVF treatment, it was extremely successful. The problem was, I believe you could not do it if you were. I think you could do it if you're single, but you couldn't do it if you were eligible. I think I don't want to get it wrong, but there were stipulations like this for certain countries. So that's why I'm telling people, make sure that you look at what your scenarios are and say, okay, I need to make certain that this would not be an issue if I were to go to this country for my fertility treatment.
[00:39:27] Speaker A: Yes. And then my last question is, so are we seeing an uptick in the number of black women of color, people of color, LGBTQIA folks traveling internationally to get medical care or fertility care, medical care for certain.
[00:39:43] Speaker B: And I'm sorry, it just came to me. It wasn't Israel, it was Greece. I apologize. Single people can get ivf, but gay lesbian couples are not allowed to have that care in Greece, not Israel. So. Yeah, so the uptick, yes, absolutely. And a lot of that has to do more with cost and the fact that even if you're insured, a number of aspects of treatment are just not being covered or covered fully. And so people hear about different options by word of mouth and they're looking at it more and more as another option. Also, with the growing community of those who are making their exodus to just move to another country, pick up and move, they're hearing, you're hearing more and more positive experiences of people living abroad. And obviously a huge part of living abroad is your wellness. And it's not simply physician experiences. It's the food, it's the environment, it's all of these things. Are you walking more? Do you have less of the daily rat rates that you tend to experience in the US So when people hear more about the wellness aspects and how well people are doing and then on top of that, to hear the actual medical care was, bar none in terms of the quality, and then they hear the cost and that it's so much less expensive than what they are paying with having to pay co pays, having all these other pieces to insurance and it's not being covered. Why not use it as an option? So, yes, there has been a huge uptick in all aspects of medical, but yes, as well as infertility. But I will tell you that when it comes to medical tourism, the top three to four are cosmetic, which is the umbrella of all the mommy makeovers, Brazilian butt lifts, breasts and all those things. Lipo, cardiac, and then also dentistry. And then the fourth, you'll see ortho people are doing a lot more hip replacements, knee replacements, all of those ortho surgeries abroad. And then transplants, you'll find hair transplants, lung and heart transplants. Even people will wait because a lot of times they cannot get on the list or they're too far down on the list here, and for whatever reason, they're able to get on it there. And I don't know if that has to do with finances. Maybe someone who's a native to that country doesn't have the finances, so I'm not certain. But transplants on a whole is another reason people are going abroad.
[00:42:01] Speaker A: Okay. And then if you're a single mom by choice or someone considering fertility treatments. If you're in any fertility spaces, you can search those spaces and see what clinics are commonly referenced as people having had good positive experiences. Like for years I've heard about certain clinics in Spain, certain clinics in Barbados, certain clinics in Prague, Greece, if you are African American or deeply brown, things of that nature. So definitely search the different communities that you're in as well. Dr. Natasha, thank you. We have barely scratched the surface on fertility options and I must say that I appreciate black women who are doing the heavy lift and opening up these conversations and just starting to get people to realize that you have so many options available to you. So let's start taking advantage of those options. But where can my listeners find you if they want to check out your different videos on the top 14 places to get IVF? Care to check out the live that you we did with the ob? Where can my listeners sure.
[00:43:08] Speaker B: Thank you so much for having me again. You can find me on most platforms, but my YouTube channel is medical Tourism. I think I'm the only medical tourism RN on there. But you'll find all the videos. There's some shorts. You'll also see the live that I did with Aisha and a physician where we talked about reproductive health on a whole. That was a really great session. Very informative. I just want all of you in listening proximity to just know what is out there and available to you. Never be afraid to ask questions. I encourage you to write down questions because you're not going to remember everything and sometimes you get a little nervous when you do get in a room with a clinician. I even do it and I'm a nurse but I write everything down because I want to know everything. And if someone gets a little agitated because it seems like you're asking too many questions and maybe you need to reconsider who that provider is for you because you know your body best and no one should be flinching. They should be encouraged to see you having so many questions and feel that you are empowered because to me that's the ultimate collaboration. When a patient is engaged with their clinician, it can go so far and you'll have the best outcomes ever.
[00:44:17] Speaker A: Thank you for spending this time with me and listeners. There you have it. Until next time.
[00:44:23] Speaker B: Thanks for having me.
[00:44:24] Speaker A: Bye now.
[00:44:26] Speaker B: Foreign.
[00:44:31] Speaker A: Thanks for listening to Start to Finish Motherhood with Aisha. If you want to keep the conversation going, follow Start to Finish Motherhood on Instagram or email me at aishastarttofinishmotherhood.com if you love this episode, please share it with anyone who's thinking of becoming a single mother by choice, Anyone who's already parenting as a single mother by choice and just looking me for advice on navigating it all, or a friend or family member who's looking to support someone else's single mother by choice journey. Until next time. Bye now.
