Caser treatment options for infertility

So, you want to have a family. Family planning is much more than picking out a name and nesting – and sometimes, your dreams to have a family can be affected by infertility.

Spain has become a destination for treatment options for infertility, thanks to looser laws and an abundance of clinics that cater to these treatments. Read on to learn more about treatment options for infertility in Spain, as well as options for same-sex couples or single women who wish to become parents.

Demographics of women giving birth in Spain

Much like many parts of the world, Spain’s fertility rate has been low since the start of the new millennia, with about 1.3 children per woman in Spain as of 2020. This number is on a slight increase but is historically low, as compared to other European Union countries. While some cite lack of maternal care and of affordable childcare options, it’s true that women in Spain typically wait longer to become pregnant with their first child. 

According to the INE and El Mundo, the average age of a first-time mother in Spain now sits at 33, up more than four years when compared to 2012; the European Union average in 2019 was 29.4 years (source). What’s more, the number of live births has tumbled 28.6% in the same period.

Infertility in Spain

Spain’s rate of infertility is estimated between 15 and 17% - in 2021, about 800,000 couples had trouble conceiving. This number is expected to rise as couples wait longer to start a family, though it is similar to worldwide figures. 

That said, Spain-based infertility clinics offer a range of services, from consultation to diagnosis to treatment – and this is not limited to women. Clinics also specialize in male infertility, fertility options for same-sex couples or singles and services for non-Spanish citizens or residents. What’s more, success rates in Spain are quite high. This, coupled with more lax laws, have led Spain to become a destination for fertility treatments.

Treatment options for infertility in Spain

Infertility affects as many as one in four women: this can be a long, lonely road but you are not alone.

In Spain, federal laws now allow women over the age of 18, whether single or in a same-sex or heterosexual relationship, to receive reproductive services, and for those services to be made available until up to age 50. The European Society of Human Reproduction and Embryology states that, as a result of Spain’s advanced reproductive laws, anonymity of donors and high success rate, four in ten of all fertility treatments in Europe happen in Spain.

There are about 250 IVF clinics in Spain, and those in larger cities or more touristed areas will offer options for treatment in languages other than Spanish. Many of them offer similar services, and treatment will depend on the causes of infertility in a couple, as there could be factors that are genetic or even based on gender. For example, surgery on a male donor could repair blockages in the tubes that transport sperm from the testicles to the penis. In the case of a female, prescription drugs can be taken to increase ovulation or stimulate eggs to grow in the ovaries. Should these treatments prove ineffective, your doctor may recommend assisted reproductive techniques (ARTs).

Among the most popular assisted reproductive techniques are:

• IUI (intrauterine insemination; in Spanish, inseminación artificial): sperm is collected and placed directly inside a woman’s uterus during ovulation. It’s a cheaper yet less effective option than IVF, as pregnancy rates are lower.

• IVF (In vitro fertilization; in Spanish, fecundación): the sperm and egg are collected, and fertilization happens in a lab setting. After the fertilized egg grows for 3-5 days, the embryo is placed in the uterus.

• Sperm or egg donations (in Spanish, ovodonación).

How much do infertility treatment options cost in Spain?

Due to high wait times in the public healthcare system, many choose to become pregnant by private means. This means that, even with insurance, you will have to pay for diagnoses and treatment. Costs can vary by clinics and autonomous community, so the figures listed below are averages:

• Artificial insemination: between 700 and 1.800€, plus hormonal medicine which is an additional 300-600€. If you use donor sperm, add 1.000 to 1.800€.

• In vitro: being a more complicated procedure with a larger frequency of diagnostic tests, this treatment costs between 3.900 and 5.900€, plus the cost of medication.

• Donor eggs: 5.500 and 7.500€.

So, what’s the first step?

If you have a family history of infertility or pregnancy loss, or you have been trying for at least six months to conceive without birth control and are over age 35, you should seek help with a fertility specialist. From there, you will be diagnosed and options for treatment will be discussed, along with costs for the courses of treatment.

What does Caser Expat Insurance offer as treatment options for infertility?

Yes, Caser Expat Insurance offers coverage in the Integral, Prestigio and Activa plans for the diagnosis and treatment of infertility. This allows you to undergo studies that will help uncover the causes of your infertility, as well as diagnose and treat your specific case. These treatment options for infertility include artificial insemination, in vitro and intra cytoplasmic sperm injection in the case of three failed attempts of IVF. All this, in addition to general medicine and ER visits, plus telehealth appointments. Note: there is an additional cost for these treatments in addition to your monthly coverage cost.

Note that there is a wait period (called a periodo de carencia) of 24 months with all plans, meaning that you and your partner must have been prescribed to your insurance plan for a specific amount of time before you can be considered for infertility diagnosis and treatment. You may also want to consider Caser’s maternity insurance to be sure that you and your baby have a healthy pregnancy.

Can I receive treatment for infertility in the public healthcare system?

Yes, you can, though you may expect a longer wait if you choose to conceive through social security. According to the Real Decreto 1030/2006, since 2019 all women - including lesbian couples, single women and trans persons with capacity to conceive – have equal access to healthcare options, so long as a GP has given a favorable opinion that the party should seek reproductive assistance. Also note that there are age limits to treatments (38 years for artificial insemination with a partner; 40 years for donor eggs or sperm and for in vitro; 55 years for men).

Social Security also limits the number of rounds of treatments – typically three – and there are further restrictions by autonomous community.

For additional information, check your autonomous community’s guidelines or the Spanish Fertility Association (Sociedad Española de Fertilidad): SEF - Sociedad Española de Fertilidad (sefertilidad.net)