When Ambika Gopalakrishnan's second attempt at having a baby through in-vitro fertilisation (IVF) ended in yet another miscarriage, she was naturally disappointed. However, she was determined to give it another shot. Her doctor, a well-known fertility expert in California, was also hopeful that she would succeed the third time.
But cost was a big consideration for Ambika who had been paying out of her own pocket for endless rounds of fertility treatments that had gone on for five years. Says Ambika, "Before IVF, I went through eight intrauterine insemination (IUI) cycles and saw three different doctors in South California. I also tried acupuncture and other alternative treatments which claimed to help me conceive."
After two IVF attempts, Ambika knew that another cycle would set her back about US$12,000, and that was not counting the medication that she would need. She says, "Even though I was confident that I would be able to conceive, the cost was just too high in California and my insurance does not cover the treatment. Neither did it cover investigative tests like laparoscopy, which was recommended should I proceed with my third attempt."
Ambika, a university professor who lives in Los Angeles with her film producer/director husband, decided to explore similar but cheaper treatment outside the United States. It was a toss between India - her home country - and Singapore where she had relatives. After careful consideration and discussing her options via email with doctors in both countries, she decided on Singapore. Not only would she have her relatives with her, but the city, known for its state-of-the-art medical care, made her feel comfortable. "I had been to Singapore as a tourist and knew that Singapore was very tourist-friendly and was reputed for its efficiency in most things. I knew I could expect world-class treatment."
The fertility centre she had in mind was the Centre for Assisted Reproduction (CARE) at the Singapore General Hospital. Dr Roland Chieng, a specialist at the centre, had been recommended to her by her relatives. Says Ambika, "Dr Chieng was kind enough to give me his personal cell number, which is unheard of in the US, and I was able to talk with him to decide a course of treatment. When I met him in Singapore, I found he was very personable and put all my doubts to rest."
The couple arrived in Singapore in May 2006. In the first month, she had an investigative laparascopy done to check for any underlying causes of infertility such as cysts or endometriosis. Once that was cleared, she started her treatment. The whole IVF cycle took six weeks and to her delight, she was successful the first time. Says Ambika, "The process was quite easy as I had been through this twice and knew what to expect. I miscarried one of the two embryos very early and was in danger of miscarrying the other one. But after some weeks of bed rest, I was able to return to California when I was 10 weeks' pregnant."
For the rest of the pregnancy, she was jointly cared for by both Dr Chieng (through email) and her obstetrician in California. Baby boy Akhil arrived on 26 March 2007, weighing a healthy 6 pounds 11 ounces. Ambika was overjoyed. "Our impressions of Singapore and CARE were fantastic and I would say the same even if I had not had a successful outcome, just because everyone was so wonderful and caring!"
She added, "Dr Chieng was patient, attentive, and answered all questions that my husband and I - and even my mother - had. The nurses, especially the ones who helped him with the actual embryo transfer and surgeries, were very caring, attentive to detail, and conscious of patients needs. They were all extremely sweet."
Ambika also found the facilities at SGH to be very clean, comfortable and comparable to hospitals in the US. "In fact, I have already suggested SGH to some of my friends," she added. Ambika estimated that she spent about US$7,000 for her entire medical treatment in Singapore, including the IVF procedure, medication, and the laparascopy. After taking into account the cost of business class airfare for two, and food expenditures throughout the four months, she reckons that she saved about US$4,000 by making the switch to Singapore. And already, she is planning to return.