Ten things about IVF that you must knowDecember 3, 2010Carole No Comments »
If I could only tell you ten things about in vitro fertilization (IVF), what ten things are most important to know? What would I want my sisters to know? Here’s my list. If you want more information, there are links to previous blog posts on each topic. I have added a search box to my blog so you can more easily find posts that interest you.
1. There is HUGE variability in the performance of IVF clinics. Pregnancy rates vary from 9% to over 50%. Knowing what top clinics have in common is useful for separating the wheat from the chaff.
2. Patients considering IVF have a free resource they can use to find the best clinics but relatively few patients use this tool. This resource is the federal mandate that annual clinical pregnancy rates for IVF practices must be reported to the CDC. You can see reports on fertility clinics at either the CDC website or SART website which have searchable databases of almost every fertility clinic in the US and their pregnancy outcomes. Two previous posts take you through the process of using the databases.
3. Insurance coverage for fertility testing and treatments is available and even mandated in some states. Patients often assume they have no infertility coverage, only to find that some services or medications may be covered. Understanding your health insurance policy will save you money. Even without insurance, there are some ways to get more bang for your buck in “Stretching the infertility dollar”.
4. The major patient factor that determines whether IVF will succeed is maternal age. Women who are 35 or older have a lower pregnancy rate than women under the age of 35. After 40 years of age, success rates plummet to less than 5% for women using their own eggs. Using donor eggs from a younger woman can dramatically increase the odds of pregnancy from IVF for an older patient.
5. IVF is regulated (more or less) in the US through a patchwork of state and federal regulations, state licensing boards for physicians and in some cases, insurance coverage. Ultimately, you the patient are responsible for the major decisions about your IVF cycle.
6. IVF is not a cure-all for infertility. IVF, especially with the use of sperm injection has made fatherhood a possibility for millions of men who were previously sterile due to low count or low quality sperm. IVF is the only medical solution for women with blocked or missing tubes. However, IVF can not reverse maternal aging. But IVF provides a technical means to use donor eggs to bypass problems with older eggs. IVF, by producing embryos outside the body, provides a means and a window of opportunity to perform genetic testing on embryos before selection for transfer.
7. IVF can be used to control the rising rate of multiple births and health complications that come with carrying twins, triplets and more. IVF can be misused as well.
8. IVF is not just for patients suffering from infertility. HIV positive couples are turning to IVF to prevent transmission of HIV to their partner or fetus through intercourse.
9. Is IVF safe to use? Yes, for most people. Patients with underlying genetic issues that either caused their infertility directly or may be associated with other genetic problems are able to pass on those troublesome genes, thanks to IVF. This has been proposed to explain the slightly larger risk of birth defects in IVF babies compared to babies conceived with intercourse. Some concerns persist regarding the use of either stimulation drugs and or technological procedures in the lab. Existing research on clinical outcomes has largely quieted those concerns but on-going research is still necessary to study long term effects of IVF.
10. When IVF fails, you still have options to build a family. IVF offers patients opportunities previous generations never had to achieve parenthood, particularly if they are willing to expand their definition of family building to include using donor eggs, donor sperm or gestational surrogacy. The medical interventions of IVF are difficult, emotionally trying and expensive. Sometimes IVF serves as a stepping stone on the way to adoption (embryo or child adoption).
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