I’m an American woman trying to get pregnant in 2025 — but I don’t feel safe doing so in the States.
I have no intention of going “home” to the United States when I’m pregnant, as I don’t want to risk being refused medical care, which could be fatal, or being arrested should I miscarry. And I’m not alone. Some Americans are opting to carry out their fertility journeys abroad.
U.S. citizens are opting to undergo fertility testing, freeze their eggs and embryos, try to conceive (TTC) via assisted reproductive technologies such as intrauterine insemination (IUI) and in vitro fertilization (IVF), carry out their pregnancies, and give birth overseas. There are various reasons to seek fertility treatments outside of the U.S., from reduced financial costs, lower maternal mortality rates, and legislation that supports pregnant people rather than criminalizes them. Shockingly, the maternity death rates in the U.S. are the worst amongst “developed” nations at 19 deaths per 100,000 pregnant people.
I’m TTC abroad primarily due to the current climate in the U.S. towards pregnant people. Since Roe v. Wade was overturned, states have introduced violent anti-abortion regulations, and people have been arrested after miscarriages. A miscarriage is a natural occurrence in which the pregnant person bears no responsibility. Yet, people have been arrested and even jailed in the United States after losing their pregnancies.
I don’t want my pregnancy to be at risk of being criminalized in any way, so I’m choosing not to live in the U.S while I’m trying for a child. After experiencing a miscarriage at the beginning of the year during a very much wanted pregnancy, I am all too aware of the dangers of being pregnant in the U.S., where in some states abortion procedures like dilation and curettage are illegal, even after a miscarriage when the fetus has died.
Caroline Fazel is an American citizen living in France who got pregnant abroad via IVF. “Being American screwed up my perspective on IVF. “One round of IVF costs around $2,320, which was all reimbursed by the French government,” she says, adding that French residents are entitled to four rounds of IVF per pregnancy, egg retrieval until their 43rd birthday, and embryo transfers until they’re 45.
Then, there’s the astronomical costs of insurance, reproductive technologies, and childbirth. “An average IVF cycle costs anywhere from $25,000 to $60,000+ if donor eggs are needed,” Kristen Delventhal, MSW, says. “Due to the extensive costs in the U.S., many are seeking care in other parts of the world where travel, treatments, and monitoring may end up being more cost-effective for those seeking treatment when their insurance denies coverage.”
Caroline Fazel is an American citizen living in France who got pregnant abroad via IVF. “Being American screwed up my perspective on IVF. “One round of IVF costs around $2,320, which was all reimbursed by the French government,” she says, adding that French residents are entitled to four rounds of IVF per pregnancy, egg retrieval until their 43rd birthday, and embryo transfers until they’re 45.
Not surprisingly, fertility travel is growing as patients seek lower costs outside of the United States.
I’m currently going through fertility treatment to do IUI with a sperm donor in Uruguay, where I’m a dual citizen. As a Uruguayan citizen, this process would be free with the country’s universal health insurance. However, as I approach my 36th birthday and intend to be a single mom by choice, I’m using private insurance as it’s quicker. I pay about $75 a month for insurance, and one cycle of IUI, including all tests, medication, donor sperm, and doctor’s visits, costs around $550.
In Uruguay, my fertility specialist never rushes me through an appointment, which helps me feel safe and cared for during this process. “In many fertility practices in the U.S., the physician visit is capped at less than 20 minutes. Patients feel rushed and apprehensive about the visit,” Dr. David Ghozland, OB-GYN, says. “Patients who go abroad regularly report spending 60 minutes with their physician. That time allows them to feel comfortable while reducing the stress that is inherent in treatment.”
