Thailand & Cambodia: A coordinated disaster

When I arrived in Thailand, issues related to traveling with a dog and negative pregnancy test results following my efforts in Turkey sent me into a downward spiral of depression and anxiety.  But the lure of inexpensive fertility treatments in Southeast Asia got my attention (see costs at end of post), and I decided to try again this cycle.  After being denied treatment in Turkey, I suspected Thailand also had discriminatory treatment policies, but I was in the country so it didn’t hurt to investigate.  As suspected, Thailand does not treat single women, so any online advice that states otherwise is unaware of a Thai law enacted last summer that bans the import/export of human sperm.  Just to be safe, I called a few clinics to inquire and they cited this law when refusing assistance, although a few sources said SAFE Fertility in Bangkok may be able to help.  (I never called them to confirm.)

After exploring various options and not wanting to repeat my Turkish Tinder fiasco, I decided that I’d start the medical process in Bangkok, order sperm from Denmark, and fly to Cambodia for artificial insemination (where it’s legal to have sperm sent to treat single women).  Coordinating everything took a *huge* amount of work, money, and stress, but I managed.  Overall, I ran into issues with the Denmark sperm bank and the Cambodian clinic which make me reluctant to recommend this approach to anyone, as well as repeat it.  But anyway, here’s how it all went down.


Realizing that I wouldn’t receive treatment in Thailand, I started exploring other available treatment options.  I thought maybe I could order sperm online and do the procedure at home, so I started researching that option.  After briefly browsing Cryos International’s website, I called their customer service with questions.  Ingrid answered the phone, and her soothing voice with breathy Scandinavian overtones immediately calmed me.  She explained that at-home insemination is complicated when ordering sperm from abroad and can be an expensive mistake if carried out incorrectly, and besides, Thai law prohibits importing human tissue period.  So, cancel at-home insemination for now.  Ingrid, proving herself to be a wealth of information, went on to say that traveling a few hours to neighboring Cambodia was the best option, because clinics there affordably treat single women and donor recipients have the option to select sperm donors (aka recipients can provide their own sperm from a bank like Cryos or choose a local donor based on characteristics).  She recommended I work with Leang at the Fertility Clinic of Cambodia in Phnom Penh.  With this information in hand, I hit the floor running with planning.

This was my first time receiving a fertility treatment as well as purchasing sperm online, so I didn’t have the best handle on what I should be doing and questions I should be asking.  Following Ingrid’s advice, I first called the clinic in Cambodia to get their feedback, and they recommended that I receive treatment in Bangkok and forward results to them, upon which the Cambodian clinic would let me know when I should drop everything and come to PP for treatment.   Sitting on my hands in Bangkok for over a week, I had just enough time to find a place to keep my dog AND go crazy with this sit-and-wait approach to planning.

Vejthani Hospital waiting area for international patients

As a traveler, Thailand wasn’t one of my favorite countries but I did like its easy access to impressive, modern hospitals that treated international patients at competitive prices.  I randomly picked Vejthani Hospital for treatment (probably because their phone operators knew English and seemed very accommodating) and they scheduled to see me the next morning.  When making the appointment, I didn’t consider traveling to/from the hospital on multiple occasions, so I ended up spending a lot of time and a bit of money on taxis.  My first appointment was on May 3rd and I was just coming off of a short period, and the Bangkok doctor collected my medical information and performed an ultrasound and blood test.  He told me to come back at the end of next week closer to  my ovulation date, on Friday the 12th.  Nothing too exciting.

Meanwhile, I coordinated a sperm order with Cryos International.  Let me tell you, be sure to allow plenty of time for yourself when looking at cryosinternational.com, because the site provides a wealth of information on sperm donors like baby photos, staff observations, voice samples, and more.   Also, because I’m blonde and fair and would like a donor similar in appearance to myself (by no means mandatory, though), it was a heart wrenching task to narrow my shopping cart down to just one Scandinavian.  Sigh.  But anyway, I placed my order with Cryos online on the 3rd, which was just enough time to prepare and send the “straw” from Denmark and retrieve it from customs in Cambodia so I could use it this cycle.

Finally the 12th arrived and I went to my follow-up appointment at Vejthani in Bangkok.  Another ultrasound and blood test, again nothing ground-breaking.  They gave me some information (my eggs were getting larger but not yet ovulating) and sent me on my way, and I then forwarded that information to Cambodia.  Almost immediately, Leang responded to say that I should book a flight tomorrow to PP for a morning appointment in the clinic.  With these clear and pressing instructions, I hurriedly bought a plane ticket to PP, found a good hotel nearby, dropped my dog off at his Bangkok dog hotel, and wrapped everything up before catching my 6:30 AM flight the next day.

On the morning of Saturday the 13th, I arrived in Phnom Penh and dropped my bag off at the hotel before walking over to the clinic.  Compared to Bangkok with its tall buildings and constant stream of cars, PP had a more relaxed, less developed feel; I immediately liked Cambodia and am glad I traveled there for the treatment, regardless of the outcome.  At the fertility clinic, there was a bit of a language barrier but Leang appeared and helped me out.  After doing an ultrasound and blood work, I was casually told that I’d probably ovulate this weekend but the hospital was closed tomorrow for a local holiday so I’d just have to come back in on Monday.  Wait, what?  That was 48 hours away, enough time to miss my fertile window.   Do these people not know how much time, money, and effort I’ve invested in coordinating this mess, only to be thwarted by a local holiday??  What about their posted hours, which state the clinic is “appointment only” on Sundays and holidays?  Tough sh*t, said the lady at the front desk in so many words.  Great.

The nurse sent me home with instructions to track my ovulation over the next few days with urine test strips.  After what I believe was a positive on the test strip (I found the strips to be difficult to read), I emailed the nurse on Sunday night.  I anxiously waited by my inbox for a response but none came.  I finally went to bed and woke up in the morning with no email response.  By mid-morning, I called the clinic and they said I was supposed to have come in that morning.  What?  The lady on the phone told me to come in right away for the procedure, so I quickly hung up and grabbed my wallet to head out.  But reaching for my hotel room’s doorknob, I was overwhelmed with emotion: what was I doing?  Why the rush?  Was it too late??  And, why do I feel the Cambodian clinic doesn’t give a shit about me as a patient and has rendered my efforts and expenses useless?  Rushed but not too rushed for a quick emotional release, I closed my eyes and allowed my face to contort in anger, confusion, and sadness.  My mouth responded by gasping for breath and my chest shook.  I held this position for a few minutes before composing myself and heading to the clinic.  Be strong, I told myself.

In the doctor’s office, I was given information that confused and angered me even more.  The doctor explained that it was still possible to receive the treatment, but she avoided the question on if we had missed my fertile window and if the treatment would be effective.  She explained that a woman’s egg is fertile for 24-48 hours after getting a positive ovulation strip, but I wasn’t wholly convinced that these people knew what they were talking about.  How did they even know that I ovulated?  Not having responded to my email last night didn’t help, but the doctor insisted that they emailed me right away and sent me an appointment time.  (Apparently Leang never checked to make sure her email sent, meaning that in reality it was stuck in her outbox and I didn’t receive it until almost a day later; if I had not called, I would have missed the treatment altogether.)

Doing my best to remain calm and composed for the treatment, I decided to just go for it and do the procedure as planned (realistically, that was my only option).  I waited for about half an hour as the clinic prepared the sperm and was then led by a nurse into a nondescript windowless room for the treatment.  Now, you can imagine how overwhelming this entire process is for someone in my situation, not only because I knew nothing about fertility treatments or had spent thousands of dollars and countless hours preparing for this very moment, but because of what the nurse was about to tell me.  Awkwardly situating myself in the table’s stirrups while doing my best to remain decent in a stiff hospital gown, a nurse entered the room with my Danish sperm and stood next to me: “Your sperm is no good” she said pointedly.  “What?” I responded, not expecting to hear that.  “Your sperm, that you ordered, it’s not good.”  Are you fucking serious?  Now this??  I explained to the nurse what I ordered, based on the suggestions of the Cambodian clinic and Cryos.  She responded by saying the sperm they received had a low motility and my chances of conceiving with it weren’t good.  Did I want to continue? she asked.  In other words, would I like to continue with an ineffective treatment with some ineffective sperm?  Why fucking not, I wanted to scream.  Let’s get this bullshit over with already and I’ll dispute it with my credit card later.

After the surprisingly simple and straightforward treatment, I anticlimactically returned to my hotel room and contacted Ingrid at Cryos.  Gone was her soothing voice, as she didn’t remember me from our conversation last week and she said receiving bad sperm can happen.  She gave me a form for Leang to fill out and return to Cryos for a possible refund or replacement; I returned the form to Ingrid that day but never heard back from Cryos.  So I ended up disputing the Cryos purchase with my credit card (explaining the situation to the customer service representative was a little awkward, so hopefully I don’t have to deal with that again).


A few weeks after my treatment in Cambodia, my period came: I was not pregnant.  Considering the possibility of a bad sperm sample and questionable treatment, I was expecting this.  Or I should have, if it wasn’t for an irrational glimmer of hope I had been nursing.

Now that I’ve been through my first fertility treatment, I can definitely say it was more stressful than anticipated.  Despite doing my best to be in control of the situation, I ultimately felt helpless to outside factors and alone with no one to lean on.  Of course, it didn’t help that I was by myself in an unfamiliar place and coordinating plans in three different countries (although I hope issues with sperm and treatment aren’t common).  Looking to return to Europe to rest for while and focus on getting pregnant, I bought a ticket to Spain where fertility treatments are available to single women and affordable.  Eastward, to sunny Madrid with its cobblestone streets and endless supply of tapas bars; here we come.

 

Total spent on artificial insemination treatment in Thailand & Cambodia
$362.34 (12,511 baht) – Vejthani Hospital Bangkok, first fertility check-up; ultrasound, blood work
$137.95 (4,781 baht) – Vejthani Hospital Bangkok, follow-up appointment; ultrasound
$55 – taxis to/from Vejthani Hospital
$979.63 (€891) – Cryos International; 1 straw of MOT 20 sperm, special mailing canister (€410)
$170 ($170) – Fertility Clinic of Cambodia, first appointment; ultrasound ($10), blood work, customs fee for sperm ($80)
$265 – Fertility Clinic of Cambodia, artificial insemination procedure; procedure, medicine ($15, Ultrogestan 200mg)
$300-$400 – cost of flights, transportation, and hotels between Bangkok and Cambodia
$2,369.92 total

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