Fertility Treatments: How Americans Compare With the World in 2021

By: Lisa Holliman Updated: July 13, 2021, 12:27 p.m.

Fertility Community recently surveyed our users and other communities to get an idea of how Americans compare with the world when it comes to fertility treatments. Our goal was to discover the differences in the types of treatments Americans get compared to the world and how willing Americans are to go out of the country for their fertility treatments.

Overall, we got some interesting answers that should lead to some new questions for research. Read on to learn more about what we discovered.

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  1. The Respondents

  2. Respondents Who’ve Undergone Fertility Treatments

  3. Final Thoughts

The Respondents

The survey was posted both on the fertilitycommunity.com website and public Facebook groups focused on IVF around the world. There were 358 respondents in total, with 141 coming from the website and 217 from Facebook groups.

Of the respondents, 180 came from the US, making up 50% of the total. Other respondents came from outside the US, and the top countries represented were Australia and the UK. Overall, there were also respondents from Europe, Asia, Africa, and the Middle East.

Where Were Respondents on Their Treatment Journey?

The survey split the respondents into three groups – those who had undergone fertility treatments, those who were thinking about undergoing fertility treatments, and those who had no plans to undergo fertility treatments. It’s important to note that not all fertility treatments were IVF.

  • Out of the respondents, 232 had undergone some type of fertility treatment, a little over 64% of the total. Of those 232, 96 were from the US, meaning US respondents made up 41% of the people who’d had fertility treatments.
  • 88 of the respondents had yet to have fertility treatment but were considering it. Of those, 53 were American. Americans made up 60% of the respondents who were considering treatment.
  • 37 of the respondents hadn’t undergone fertility treatments and had no plans to in the future. Of those, 31 were American, making up the majority.

Respondents Who’ve Undergone Fertility Treatments

We’ll only dig into the responses from the respondents who’ve gone through some sort of fertility treatment. This sample size was 232 respondents and 41% of them were from the US.

Respondents’ Relationship Statuses

The majority of respondents were in a heterosexual marriage or de facto relationship.

  • 195 of the respondents were in a heterosexual relationship. Of the Americans, 81 were in a heterosexual couple.
  • Furthermore, there were 16 people without a relationship (single), of which 5 respondets were from America.
  • Only seven respondents were part of an LGBTQ couple, with four of those from the US. Of those, one couple was a male couple with one trans member who was male assigned female at birth.

Age at the Time of Treatment

Age is an important factor in fertility, since a woman’s chances of getting pregnant decrease as she gets older. Our survey measured to see which age group the respondents fell into.

  • Only three respondents were between the ages of 20 and 24, with two from the US.
  • 32 of the respondents were in the 25-29 age group, with 14 coming from the US.
  • 60 participants were between 30 and 34, with 28 from the US.
  • In the 35-39 age group, there were 86 participants with 39 of those from the US.
  • In the 40-44 age group, there were 46 respondents with 14 of those from the US.
  • There were two participants in the 45-49 group and two participants in the 50+ group, each with one person from the US.
  • A few respondents answered (6 total + 2 from US) in a way that the age category could not be identified.

These numbers are consistent with the average age of fertility treatments – 34, and make sense, considering many women are trying to have children in their 30s and are aware of their declining fertility.

Most Common Fertility Treatments

Respondents who had undergone fertility treatments were asked about the types of treatments they’d had. It’s also important to note that quite a few of the respondents had more than one type of fertility treatment. It’s common to start with milder forms of treatment and move to more intensive treatments if those aren’t effective.

While most of the treatments should be familiar, note that natural IVF refers to IVF that doesn’t rely on stimulation medication and instead works with a woman’s natural cycle (learn more on natural IVF).

Mild (mini) IVF also works with the woman’s cycle but also uses stimulants to increase egg production. Mild (mini) IVF uses lower doses than standard IVF (Learn more on mild (mini) IVF).

  • 65 of the participants had been treated with IUI (intrauterine insemination). Of those, 39 were from the US.
  • For natural IVF, 19 participants had undergone treatment. Of those, only two were from the US.
  • 14 participants had undergone mild (mini) IVF, with 9 coming from the US.
  • 200 respondents had gone through standard IVF. 89 of those were from the US.
  • There were 17 respondents who’d undergone IVF using egg donors. Of those, six were from the US.
  • 23 respondents used IVF with sperm donors with six from the US.
  • Only seven participants underwent IVF with embryo donation, six of which were from the US.

For fertility treatments, the numbers between the US and the rest of the world were relatively the same. Embryo donation and mild IVF seem to be slightly more popular in the US than in other countries, but a larger sample size is needed for more accurate statistics.

Standard IVF appears to be the most popular choice for the US and around the world. There may be a few reasons for this popularity. Many patients start with less intense fertility treatment, such as medications or IUI, and if those are unsuccessful, they move on to IVF.

Many people also start with standard IVF, skipping over less intense treatments. Fertility treatments can be expensive and both physically and mentally exhausting. Many people feel that standard IVF is their best chance of getting pregnant, and so they start there.

Number of Treatments

Participants were asked how many fertility treatments they’d had in the past.

  • 82 had only one treatment, 23 of those came from the US.
  • 57 respondents had two treatments, with 35 coming from the US.
  • 93 respondents had more than two treatments. 38 were from the US.

These percentages make sense. For many patients, it only takes one treatment to result in a successful pregnancy. However, if the first treatment doesn’t work, there are usually more complicated issues. These patients often wind up having several treatments before achieving pregnancy, if at all.

Local vs. International Fertility Treatment

Respondents who’d undergone fertility treatments were asked whether they had their treatment locally, in different state or internationally. Local meant they stayed in their own state, while international meant they went out of the country.

  • 199 of the respondents had their fertility treatments in their home states, with 76 of them coming from the US.
  • 18 responders had their treatment in a different state, with 15 from the US.
  • Only 20 of the respondents went out of the country for their treatment and five came from the US.

It’s important to note that these numbers reflect people who had done treatments both in their home state and internationally. Some people stayed in their home state but traveled several hours or more to get to the fertility clinic.

These numbers show that most people still seem reluctant to go out of the country for their fertility treatments. There are several reasons people may stay in their home country. They may feel that it’s cheaper and easier to stay local. They may feel that their home country offers the best care.

For Americans, they may choose not to go with international treatments because most popular international clinics are very far away, for example in europe:

  • Spain

    Spain is the most popular country abroad for IVF treatments. The costs among the highest in Europe but are still significantly lower than in the States. Spain’s success rates are high, and they are willing to accept patients up to 50 years old.

  • Czech Republic

    The Czech Republic is often chosen for overseas IVF treatment because the cost is so much lower than in the US or the UK. As long as clinics are licensed, they should be both safe and effective.

  • India

    While many still think of India as a third-world country, it has some of the world’s most advanced medicine. Not only is India one of the most affordable places for IVF and other fertility treatments, but they also have high success rates and are willing to treat women up to age 55.

  • Greece

    Greece is not only an affordable destination for IVF overseas, but the country is also known to have short wait times if you require donor eggs. While the government does have stricter rules regarding maternal age and same-sex couples, the quality of care is superb.

What Do Respondents Look for in a Fertility Clinic?

Struggling with infertility is a sensitive issue and people are often selective in choosing a fertility clinic. We asked respondents what were the main things they looked for in a fertility clinic. Note that respondents were able to choose more than one factor, so the numbers will reflect multiple answers.

  • The biggest factor for the majority of people was the clinic’s success rate. 128 listed success rate. 62 of those were from the US.
  • The second-largest factor was the price. A total of 101 respondents chose price, with 40 of those coming from the US.
  • The third biggest factor was the respondent’s distance from the fertility clinic. 96 of the respondents chose distance with 45 coming from the US.
  • A clinic’s reviews and reputations were important, but not as important as success rate and price. 91 of the participants wanted a clinic with a well-known professional medical team, with 31 of those coming from the US.
  • 70 of the patients valued doctor evaluations when choosing a clinic with 32 coming from America.
  • 21 respondents wanted clinics with high evaluations on review sites like Trustpilot, etc. 13 of those were from the US.
  • The least important factor was the types of fertility treatments a clinic offered. Only 19 respondents listed a variety of treatments offered as a factor, with 10 from the US.

Respondents were able to fill in their own responses as well. Several respondents chose a clinic based on how they were treated. They wanted to feel like the doctor treated their case individually and that the staff cared about them.

A few respondents also chose a clinic based on who their insurance or national healthcare accepted. Respondents also preferred clinics that a friend was happy with.

The three biggest factors make a lot of sense. The success rate is obviously important because people who undergo treatment want the clinic with the best possible results. Price and distance are more practical choices, but since IVF is so expensive, people have to consider the cost and their budgets. Patients also realize that they’ll need to visit their IVF clinic at least several times throughout the process, so distance can be an issue.

It’s interesting to note that finding a clinic with several different types of fertility treatments was the least important of the options. It seems counterintuitive that people wouldn’t value a clinic with a variety of options. However, this number does line up with the number of people who’ve had standard IVF. If most people are looking for standard IVF, they can get that at most clinics.

Side Effects During IVF

Patients who’d undergone IVF were asked about any side effects they experienced during the procedure. They were allowed to choose more than one option and could add any side effects that weren’t listed.

  • The majority of participants, 91 said they experienced no side effects. Of these, 44 were from the US.
  • The most common side effect was severe stomach pain and bloating. 85 of the participants experienced this side effect, with 24 coming from the US. As many of the patients underwent IVF, this number makes sense, since the associated stimulants and follicle growth can cause bloating.
  • Nausea or vomiting were the next most common reported side effects. 62 of the patients reported this side effect and 25 of those came from the US.
  • 60 patients in total experienced significant weight gain within three-five days. 23 of those came from the US.
  • The other side effects were less common. 25 of the respondents experienced feelings of faintness, and seven were from the US.
  • 16 had shortness of breath, with eight coming from the US.
  • Only five participants had decreased frequency of urination, with two of these coming from the US.
  • Several patients reported experiencing mood swings during IVF. This effect is common, as many of the hormonal treatments can cause shifts in mood and the procedure itself can be stressful.

Side Effects After IVF

Many patients experience side effects after going through the IVF process, typically when they’re in the two-week wait to see if they’ve achieved pregnancy.

  • 59 of the participants said they didn’t experience any of the side effects after IVF. 27 came from the US.
  • Of the participants in this survey, the most common side effect after IVF was mild bloating. 46 patients said they experienced bloating, with 16 coming from the US.
  • The second most common side effect after IVF was mild cramping, with 38 participants and 16 of those coming from the US.
  • 32 of the respondents reported constipation after IVF, with 18 of those coming from the US.
  • 28 participants experienced breast tenderness. 9 of those came from the US.
  • Only 12 of the respondents reported excreted a small amount of blood- or clear-colored fluid after the procedure. Of those, 2 were from the US.

Respondents also had the option to fill in their own side effects. A few said that their bloating and cramping were severe. Two of the participants experienced Ovarian hyperstimulation syndrome (OHSS).

Final Thoughts

When looking at America and the world, it seems that opinions and decisions are pretty similar.

This survey shows that people largely still have traditional views about fertility treatments. Most want affordable, proven treatments. They don’t want to travel too far and prefer treatments like standard IVF over less tested treatments like natural and mild IVF.

It’ll be interesting to see how fertility treatments progress over the next few years as a younger generation reaches the age to start a family.

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