With IVF treatments, twins have basically become the new norm—46 percent of IVF births are multiples, mostly twins. But now fertility experts want to change that. The new goal: single births, even when using IVF. Why? Twins have a much higher risk of being preemies and having serious health problems that could potentially last a lifetime.
The most recent info from the Center for Disease Control and Prevention states that 37 percent of IVF babies, who are multiples, are born premature, while only 3 percent of babies born without fertility treatments are twins, and of those about 12 percent are preterm.
Many women who’ve struggled to have kids are excited to have twins—even asking their physicians for twins—because they may not have the money for multiple IVF treatments (each round can cost up to $20k!), or they would love to have two kids at once, and never have to go through pregnancy again! But doctors fear that couples are making a rash decision without really knowing the increased medical risks for babies and moms (risk of gestational diabetes and preeclampsia are higher).
The American Society of Reproductive Medicine’s recent guidelines state that women should be counseled on the risks of multiple births and embryo transfers and that this discussion should be noted in their medical records. According to the guidelines, “for women with reasonable medical odds of success, those under 35 should be offered single embryo transfer and no more than two at a time.” They are open to more embryos being implanted, if the woman is over 35.
According to Valley News, with stronger screening of embryos, success rates for single embryos could be nearly as good as when two or more are used, say experts. The new techniques include maturing the embryos a few days longer, improving viability and allowing cells to be sampled for chromosome screening. Embryos can be frozen to allow test results to come back and more precisely time the transfer to the womb.
Taking these steps with single embryos results in fewer miscarriages and tubal pregnancies, healthier babies with fewer genetic defects and lower hospital bills from birth complications, many fertility specialists say.
I’m really torn on this subject, because I don’t think any of us want more Octomoms running around out there, or kids with health problems. But—and it’s a big but—all of the women I’ve known who’ve had IVF (and I should note that all of them have been over 35), have had twins, and are beyond thrilled with their decision to have multiple embryos implanted. Many of them did have complicated births—including extended bed rest, spotting, C-sections, and breathing problems in the children that caused them to stay in NICU for weeks, up to months after their births.
All of that said, as far as I know every single one of them is a happy, healthy kid with no lingering medical issues (at least so far—fingers crossed!). And even though the pregnancies and births were more complicated, required more doctor visits, and now they have twice the expenses with two little ones running around at the same time, the parents’ love for their two cuties made all of that initial anxiety worth it for them, and they would never, ever want to have traded that experience in for a single birth.
TELL US: Do you think women should be discouraged from having twins? Do you have twins? Tell us your story!
Apparently, in our looks-obsessed society, struggling actresses and models in New York City are now the “it girls” for couples undergoing IVF. According to the New York Post, “In an industry where attractiveness is a prerequisite, and steady income is hard to come by, actresses often are an egg agent’s perfect target.” In fact, ads are even being placed on acting trade sites like BackStage.com to entice women looking for work to donate their eggs at a premium. The beautiful wannabes are being paid anywhere from $8,000 to $20,000 for their egg donations—much more than your average bartending actress would make in a month.
It’s like there’s this whole underworld designed to find eggs for rich people—like a black market, only legal. “Egg agents” do a full background check that includes school transcripts and SAT scores, blood tests for diseases, and a psych exam. The higher the woman’s GPA and SAT scores, the higher her payday.
But it’s not exactly easy money. A prospective donor is put on hormones for two to nine weeks to increase her egg production, and the harvesting of eggs for IVF can be very painful. After the surgery, she is left feeling sore and bloated, and as of yet researchers do not know if there are any long-term effects associated with donating eggs. What they do know is that you lose eggs, and it increases your risks of developing cysts. Because of that, there are rules in place that only allow a woman to make six donations in her lifetime.
Trying to Conceive: 5 Common Fertility Mistakes
Those donating the eggs are of course also helping to bring life into the world. But they will likely never know for sure if children were born from their donated eggs, because donors often sign waivers saying that they will not be notified of the outcome. Sperm donors have been around forever and are now becoming trendy with movies like Vince Vaughn’s Delivery Man, and MTV’s show Generation Cryo—which follows a girl and her 15 half-siblings as they try to find their sperm donor dad. So it’s no surprise that egg donors are now in demand, especially considering more than 7.3 million couples in the US struggle with infertility.
Does wanting to have attractive egg donors make us as a society superficial or smart—thinking of survival of the fittest in every sense of the word?
TELL US: Are you surprised actresses’ and models’ egg donations are in demand? Would you choose a pretty donor over a less attractive one?
What if there was a test you could take—at home without having to go into an infertility clinic—that could tell you your chances of IVF success? What if instead of spending up to $20k per cycle of IVF, you’d know how likely you’d get pregnant before going through IVF for only $49.50? I know it sounds a little too good to be true (and it could be—this is in no way an endorsement of the product because I haven’t tried it), but after meeting with Dr. Mylene W. M. Yao, a Harvard-trained reproductive endocrinologist, it sounds like the technology might already be available.
She and her team have created what they claim to be a cost-effective IVF success predictor for those who haven’t tried IVF yet (Univfy PreIVF), and for those who already have unsuccessfully (Univfy PredictIVF, a more complicated analysis for $175), and want to know whether their odds of eventual success are high enough for them to put in the added expense of another round of costly IVF.
Univfy’s products—which are three years in the making—take into account multiple factors beyond just age. Dr. Yao explains, “It looks at BMI, reproductive history (whether you’ve had pregnancies or miscarriages in the past), ovarian function, semen function, smoking history, etc and analyzes them together against data from tens of thousands of IVF cycles to provide them with a personalized prognosis that’s 1,000 times (on a likelihood scale) more accurate than age-based estimates alone.”
While recent studies now say, your chances of getting pregnant after 35 aren’t actually abysmal, like we’ve been told for years, Dr.Yao says age is still a factor in fertility. “There’s no question, as each woman ages, her ovaries’ functions are going to decline,” says Dr. Yao, who has more than 15 years of experience in reproductive medicine and embryo and uterine biology research, has been published in reputable scientific journals, and is a former faculty member at Stanford University. ”But for each woman, that decline is happening at a different rate. Someone at 38’s ovaries could be functioning really well, and another 38 year old’s ovaries may not be.”
Univfy’s prediction models actually show more than 60 percent of the women who use them have a higher probability of IVF success than their age-based estimates alone suggest. That in itself can cause some relief in women trying to get pregnant in their 30s and 40s. I’m Ms. Prepared, so I like the idea of being realistic about what your chances of getting pregnant might be, because IVF always seems to be the great unknown.
As Dr. Yao points out, “People think IVF is a roll of the dice,” she says. “You just go try it, and wonder, ‘Why does it work for some people and not for others?’ But there is rhyme and reason to it all. We can’t remove all the uncertainty—it’s not like a crystal ball—but giving women more information about their chances of getting pregnant empowers them to be able to take charge of their reproductive decisions, and make ones that make the most sense for them financially as well, since IVF is such an expensive process and many clinics offer package deals.”
That’s right, fertility clinics do bargain bundles—just like cable companies and fast food joints. A package might be three rounds of cycles, or five. So if a program can narrow down the likelihood of getting pregnant from IVF, you can make a more informed decision on how many cycles you might need, which would save you money in the end. Now the question is: Would you want to know your chances of having IVF work before actually trying it? Or would you rather go in blindly with all of the hope in the world? Only you can decide.
Rosie Pope is an amazing pregnancy concierge, fashion designer, reality star, and frequent Parents contributor. She gives great advice to pregnant women every day on what they can do to prepare for motherhood. But now the “Pregnant in Heels” star is opening up to Everything Pregnancy in the most personal way possible—talking about her ongoing struggles with infertility, which is a topic that is unfortunately still taboo.
Many women don’t want to discuss the feelings of pain, frustration and shame that come with not being able to conceive. It’s obviously a very personal choice, but Rosie and I feel that talking about it, and letting other women know that they’re not alone, is a powerful thing. Here’s my candid Q&A with Rosie, a true inspiration to women with infertility issues, as she’s the proud mom of three, and has another one on the way! She’s proof you can overcome it!
Why do you think talking about infertility and IVF is still so hush-hush? I think throughout our society there is this kind of stigma that to be a real woman you should be fertile and have babies. If we need extra help, somehow we’re less perfect or less of a person. As women, we can’t beat ourselves up about it. That’s why I think it’s important to talk about it.
Did you have infertility issues from the beginning or did you suffer from secondary infertility? I actually had a miscarriage first and it was pretty late on in the pregnancy. After that, it took about 8 or 9 months to get pregnant and then everything went smoothly. But when we were ready to try again, that’s when it became clear that I had a problem. In a nutshell, I never ovulated, and none of the doctors could figure out why. I sort of got bat around quite a lot until I got the right specialist and they discovered the reason why I’d had the late miscarriage, and the reason why I hadn’t been getting pregnant, was I had what they call a septum, which is a piece of tissue that divides the uterus, that can make it difficult for the baby to grow. So they removed that and then they hoped that everything would be fine. It wasn’t—I still couldn’t start ovulating and that’s when you get diagnosed, for me anyway, with “unexplainable infertility”. And that’s when I embarked on the journey of fertility treatments that ranged from taking oral medication to injectables and ultimately IVF.
I’m sure all of that was mentally and emotionally draining for you. Yes, you know, I always thought that because I got married young, and I started trying to have babies young, there would never be an issue. I had been told my whole life about how not to get pregnant that I never even considered, “What if you can’t get pregnant?” So it took a long time to deal with the shock and disbelief that I wasn’t getting pregnant. I blamed myself a lot in the beginning. I felt badly for my husband because there’s nothing wrong with him, and he had married me, and I couldn’t get pregnant when all my friends were getting pregnant. I was very fortunate to be in a relationship where my husband always considered us a team. It was never me by myself, which was really helpful. But you just feel really powerless.
It’s so hard when there’s nothing you can do, and every month you try and do every thing, especially when you’re the type of person I am—when you do all the research and you’ve got all the facts, like you’re supposed to be ovulating here and things are supposed to be happening, and when it’s not happening it’s very frustrating. And then for me the hardest thing was after a few rounds of IVF we actually did get pregnant, but we were pregnant with an ectopic pregnancy [one that occurs outside the womb, which can be life-threatening to the mother]. That was just so hard to finally be pregnant and then not be able to keep the baby. Having a baby is a miracle, and no matter what the modern scientific advances are, you just can’t always plan it, even if on paper it seems like it should work.
How did you and your husband get through it as a couple, when communication can shut down during such a difficult time? The thing that worked for us was humor. There’s really awkward stuff that happens on that road to getting pregnant. If you are going through IUI’s or you’re going through fertility treatment, your husband gets ushered off to a room and is given a whole bunch of porn to choose from, and then makes his sperm donation. That’s kind of weird as a wife… waiting in the waiting room while your husband does that! And everybody else waiting in that room with you is doing the same thing. I am very English and awkward about these things, so my husband would make endless jokes about the type of porn he chose and type of porn the person next to us probably chose, because it the whole scenario was just ridiculous. That humor opened up the conversation for us. If you can talk about that, you can talk about anything! That might not work for everybody, but I think whatever works for you and your relationship, you’ve got to keep doing that through the IVF process. If you really like being romantic, somehow you gotta incorporate that into your romantic life. It’s just important that you don’t stop being you as a couple because this is happening.
What’s the best advice you can give another woman going through this sort of struggle? Don’t get mad at your partner! In the early stages of it, you’re taking a medication like Clomid, to make you ovulate, and you get to the window when you’re ovulating, and you’re husband can’t get home from work early that day, or he’s sick, or has to take a work trip. I would get so angry at my husband when something like that would happen, like he was stopping me from getting pregnant. It’s not his fault. Life still has to go on.
What do you think was the key to you getting pregnant? Aside from the anatomy issues I had, I really think it was reducing my stress. I’m high strung, so for me what really helped was just diving into work and being busy. When I’m busy, I’m more relaxed because I’m distracted. And that wasn’t my tactic to start off with. I thought that I had to take it easy and focus only on getting pregnant, and that for me is a trap. It’s just too much pressure on a person.
How has your latest pregnancy compared with that of your first three children?Each one has been really different. My first was ridiculously easy, and I thought I could do this like a thousand times. My second one, after we had all those problems and finally got pregnant, it was very difficult. I was on bed rest for a pretty good portion of it. My third pregnancy was super easy. With this one, my body is kind of mad at me, and I’m just nauseous all the time!
Do you predict there will be live tweeting through this birth, like your last one? We’ll see. I recommend it! I was very distracted by it instead of just staring at the clock waiting for the birth to happen. I believe your birthing experience should be like the rest of your life. If you’re a busy Blackberry-Tweeting type like me, do that in the delivery room, If you’re not and you’re into yoga and massage, do that. You have to stay true to your personality because it’s only going to get heightened in the delivery room. So trying to make a calm environment with incense and massage for a high-strung person like me is not a good idea!
You told me your biggest fear with this birth is that you’d have the baby on the highway. Why’s that? I live in New Jersey now, but I’m delivering in New York with the doctor who has delivered all of my other babies, and each birth has been drastically quicker. My first took 26 hours; my second was 10 hours; and my third was only 4 hours! So who knows how quick this one could come out!
I know there’s no such thing as a miracle drug, but a new version of In Vitro Fertilization—dubbed the mini-IVF—sure sounds like a miracle procedure! It’s half the price of the usual IVF, with fewer doses required, and far less side effects. How cool is that?!
This new method of getting pregnant consists of a daily low-dose pill of the fertility drug Clomid—which helps kick-start egg production—for 10 to 12 days. During this time, ultrasounds are required every few days to check whether the eggs are developing healthily. Around 10 days later, once the eggs are large enough, they are removed with a 5-minute operation that is so minor it doesn’t even require general anesthesia.
According to a trial involving 520 women, which was showcased at the American Society for Reproductive Medicine conference in Boston, success rates in women over 35 were a third higher compared with those undergoing conventional IVF, and women in their 40s were twice as likely to have a baby compared to if they had used the standard IVF. In women 35 and under, success rates are about the same for both IVF and mini-IVF procedures, but researchers say women in that age range still would benefit from using the mini-IVF because it is cheaper and has fewer side effects (it is said to not cause pregnant-like symptoms, including mood swings, nausea or headaches that usually come with IVF treatments).
The Daily Mailreports that “one of the main reasons women in their 30s and 40s have problems conceiving either naturally or with IVF is that they do not produce enough healthy eggs capable of developing into an embryo, and eventually into a fetus.” Well, high-dose fertility drugs used in conventional IVF actually worsen this problem. They increase a woman’s egg production, but they also appear to change the DNA of the eggs, which can sometimes leave them defective. The mini-IVF does not.
While more research may need to be done in this area, all signs are pointing to the mini-IVF being a better alternative for women seeking fertility help.
TELL US: Do you think the mini-IVF sounds too good to be true? Or is it about time researchers found a cheaper, easier, more effective alternative to the standard IVF procedure?