Khendra Riley was 39. She had just broken up with her fiance. Her ovaries, doctors said, may not be releasing eggs regularly.
She’d wanted a baby since she turned 30. It seemed impossible.
In vitro fertilization seemed the only option left, but the St. Petersburg flight attendant’s health insurance didn’t cover it. The near $30,000 quotes she got from two Tampa Bay clinics were out of reach.
She was scrolling through Facebook soon after and saw that a friend had given birth through IVF. The post mentioned the Barbados Fertility Centre.
In February 2023, Riley gave birth to Karsyn. Her healthy 7½-pound daughter was conceived with donated sperm and implanted in her womb on the Caribbean island. Making her dream baby cost about $20,000.
“I’m literally awestruck every day,” she said. “I can’t believe I actually have the baby that I wanted for so long.”
The global fertility tourism market — sometimes dubbed the “procreation vacation” — was valued at $417 million in 2021. It’s expected to be worth $6.2 billion by 2030, according to an analysis by Grand View Research, a market research firm that produces reports on more than 800 industries. That growth is fueled by the rising costs of IVF treatment, more women delaying having a family and the limited financial help available in the United States for women struggling to conceive.
Among married women of child-bearing age with no prior births, about 1 in 5 are unable to get pregnant after one year of trying, according to data from the Centers for Disease Control and Prevention. Yet many insurance companies don’t consider fertility treatments as medically necessary.
Twenty-one states have laws requiring that insurers cover some fertility treatment but only 15 of those include IVF, according to the National Infertility Association. Florida is not among the states mandating that insurers cover fertility treatment.
Studies show that women with a bachelor’s degree or more education are more likely than women who never attended or completed college to undergo fertility treatment. Association CEO and president Barbara Collura said governments and companies need to take more steps to make IVF available to low- and middle-income families.
“Too many will face financial barriers when it comes to accessing medical care they need to build a family,” Collura said in an email. “Access to family building options shouldn’t depend on someone’s zip code.”
Thailand and Turkey are among the most popular destinations for U.S. women seeking treatments abroad, but the proximity of Mexico is now drawing more U.S. clients too, said Josef Woodman, CEO and founder of Patients Beyond Borders, a medical tourism consulting group that advises providers and governments.
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Explore all your optionsCancun and Tijuana are the most popular destinations in Mexico, according to Medical Departures, a medical tourism website. A single cycle for IVF in the country costs about $4,500 with another $3,500 for medication.
Woodman expects travel abroad for IVF to continue to grow but added that the treatment requires an average of 2½ cycles to become pregnant.
“That’s a lot of travel, a lot of appointments, a lot of emotion,” Woodman said. “You might save money but is it really worth it?”
The Centers for Disease Control and Prevention cautions that traveling abroad for medical treatment can be risky and that standards for licensure, credentialing and accreditation may be lower than in the United States.
Women traveling from the United States make up more than 90% of the 1,100 patients treated each year at the Barbados Fertility Centre, said medical director Juliet Skinner.
Prospective mothers typically begin a medication course before their visit. During their stay, eggs are extracted, fertilized and transferred to the uterus.
The clinic is on the southern side of Barbados, just 50 feet from the Caribbean Sea. Skinner believes its success is in part because patients turn their trip into a vacation and are removed from the normal stresses of daily life.
“They’re not running around trying to find a parking space in New York,” she said. “Here, they’re wondering should they lie on the beach or by the pool.”
But Skinner has no illusions that it’s the low cost of treatment that attracts patients.
A single cycle of IVF in the United States can cost between $15,000 and $30,000, according to Forbes. Even with the cost of flights and accommodation, the Barbados clinic can cost as much as 40% less, Skinner said.
The incubator equipment and lab facilities her clinic uses are no different or cheaper than those in the U.S. The facility is accredited by Joint Commission International every three years. But the clinic does not spend as much on buildings or malpractice insurance and takes a smaller profit margin, Skinner said.
“The infrastructure costs of American health care are very high,” she said.
Lakeland couple Moya and Lawrence Pugh had been trying for a baby for a year when they approached a Tampa clinic. Moya was 41 and knew time was running out.
The couple were quoted almost $21,000 for one round of treatment and told that the medication could add another $6,000. Her insurance with Florida Blue did not cover the treatment.
“While we cannot comment on a specific member’s situation due to Health Insurance Portability and Accountability Act privacy concerns, we can confirm that coverage of infertility treatment depends on the individual health plan and benefits,” the company said in an emailed statement.
A friend who works in the medical field told Moya about traveling abroad and she was quoted just over $8,000 for the same treatment in Barbados. Although a little reluctant to get medical treatment outside of the United States, the couple did their own research on the clinic before signing up.
Toward the end of a two-week trip in September 2022, three fertilized embryos were implanted in Moya’s uterus. She returned home and waited two nerve-racking weeks before taking a pregnancy test.
She couldn’t help but “cheat” and took a home test a day early. It was negative, as was the one she took at her gynecologist’s office the following day.
“It’s a very emotional road,” she said. “Knowing that I went through all of that and the injections are very painful — you put your body through physical pain and stress.”
The couple decided to have one more try, this time turning the May 2023 trip into a vacation. Moya “cheated” again on her pregnancy test two weeks later. This time, the strip said “pregnant.”
She gave birth to Harriet in January.
Even with the cost of implanting another embryo and a second trip, the Pughs estimate they saved several thousand dollars by going outside the United States.
“No words can capture that moment of hearing her cry,” Moya said of Harriet’s birth. “The journey didn’t matter, the painful shots didn’t matter — it was just a moment of perfect bliss.”
But there is no guarantee with IVF.
Linda Hoang, a marketing professional and blogger from Edmonton, Alberta, Canada, had been trying for eight years to get pregnant with her partner, Mike. Doctors listed her case as unexplained infertility, the term for women under 35 with no obvious health issues who are unable to get pregnant after a year of trying.
Hoang and her partner went to Barbados in December 2021 for treatment. Before traveling, she had difficulty getting local pharmacies to fill the prescriptions from the fertility clinic. She had two embryos implanted but neither took.
“We found out we weren’t pregnant on Christmas Eve,” she said. “It was a really bad holiday, many days of crying and not much celebration.”
Two months later, Hoang blogged that she had come to terms with never having a child but the couple still had a fertilized embryo in cold storage in Barbados and decided to book another IVF treatment.
A few months before their trip, Hoang discovered she had conceived naturally. In March 2023, Benjimin Brown was born. Hoang calls him her miracle baby. She believes the failed IVF treatment may have helped.
“It was like, ‘Hey, body, this is how you do it,’” she said.
IVF wasn’t straightforward for Riley, the St. Petersburg flight attendant. Her first cycle resulted in an ectopic pregnancy, which had to be terminated.
But being a mother was worth all the pain and heartache, she said. Her employer, Delta, gave her almost a full year of maternity leave, allowing the single mother time to bond with her daughter. Her mom and dad live nearby and help when she has to travel.
“I just didn’t even know I could love so big and so freely and just so selflessly,” she said.
Riley was so determined to have a baby that she considered moving to Minnesota, one of the states where health insurers are required to cover IVF.
Ironically for her, her company’s health insurance changed after Karsyn was born and now covers IVF.
Now that she’s a mom, she’d like to help other couples and is considering starting a nonprofit group.
“There are a bunch of people who would be great parents who will probably never have the opportunity because they cannot afford fertility treatments,” she said.
