One couple found the procedure cost nearly a third of what it would have in the U.S.

DOVER, N.H. (AP) – Prescription drugs aren’t the only form of medical care that’s cheaper in Canada. Some New Hampshire couples are finding that infertility treatment is much more affordable north of the border.

Marie and Bob Duncan of Dover wanted a second child, but fertility drugs weren’t working. They were told they needed in vitro fertilization, or IVF.

IVF involves using drugs to stimulate the woman’s ovaries to produce multiple eggs. The eggs are removed surgically and fertilized in the laboratory. The best of the resulting embryos are then placed in her uterus.

The procedure wasn’t covered by the Duncans’ health insurance. Clinics in Boston were charging $18,000, and many women require more than one round of IVF to get pregnant.

Then Marie Duncan found a private clinic in Montreal that charged $8,900 Canadian – about $6,400 American. After two tries, she got pregnant with triplets and is due to give birth in a week.

“We’re not rich people,” she told the Sunday Monitor. “But that doesn’t mean we don’t deserve to have children.”

No one keeps track of how many New Hampshire couples go to Canada for infertility treatment, but the Montreal clinic the Duncans used, Procrea, says it performs IVF for more than 100 Americans each year.

When her Canadian doctor finished the procedure, “He stood up and said, Three more Americans made in Canada,”‘ she said.

“At this time it’s a good alternative,” said Dr. Cynthia Cooper, a Dover gynecologist and president of the New Hampshire Board of Medicine. “As long as it’s not covered by insurance, why shouldn’t they go somewhere where they can get the same quality of care for less?”

Infertility is stressful enough without financial pressures, but money worries add to the strain in all but a handful of states.

Most health insurance plans cover some infertility drugs and procedures to remedy problems such as uterine fibroids, but they rarely cover affirmative procedures such as in vitro fertilization.

Massachusetts requires insurers to cover all reasonable infertility treatments, but New Hampshire does not.

Except in Ontario, Canada’s government-run health system does not cover IVF, which may be one reason it’s relatively inexpensive, said Diane Allen, executive director of the Toronto-based Infertility Network.

“I think there’s the sense that the market wouldn’t bear higher prices” because Canadians are not accustomed to paying for health care, she said.

Clinics also compete directly with hospitals, which charge as little as $3,500 because so much of what they’re using, from secondary equipment to staff, is already paid for, she said. And the drugs used in the procedure are less expensive in Canada, too.

Even so, the Duncans had to take out a home equity line to pay for the procedures and their visits to Montreal.

Most of the prep work was done at Garrison Women’s Health in Dover, but Marie Duncan had to go to Montreal for the initial consultation, the retrievals and the implantations.

On the Duncans’ second try last September, doctors retrieved 10 eggs and implanted three embryos. The odds were less than 5 percent they would all survive.

Later the same day, while riding Montreal’s Metro to the botanical gardens with his parents, the Duncans’ son Logan found three pennies lying face up on the ground.

“He gave them to me for luck,” Marie Duncan said. Soon after, she learned she was having triplets.

The Duncans know money will be tight, but they’re ecstatic.

“We always wanted children,” Marie Duncan said. “We just had to do it differently.”

AP-ES-05-09-04 1554EDT