Thursday, December 5th, 2013
A rise in the number of multiples–triplets or even more–born in the U.S. is being attributed in a new study to a number of fertility treatments. Though many believe multiple births to be a result of multiple embryos being transferred during in vitro fertilization (IVF) procedures, the study, published in the New England Journal of Medicine, attributes the phenomenon more to drugs given to women to encourage them to produce more eggs. The Associated Press has more:
Multiple births raise medical risks and hospital bills for moms and babies. Guidelines urging the use of fewer embryos were strengthened following the 2009 “Octomom” case, in which a California woman had octuplets after her doctor transferred 12 embryos made from an IVF treatment.
But most cases of infertility are treated not with IVF but simpler measures such as drugs to make the ovaries produce eggs. The first step often is a pill, Clomid, to spur hormones that aid conception. If that doesn’t work, more powerful drugs can be given in shots, but those bring a much higher risk of multiple eggs being released.
Doctors are supposed to use ultrasound and blood tests to monitor how many eggs are being produced and advise couples against trying to conceive that month if there are too many, to minimize the risk of multiple births. But that monitoring often isn’t done, or done well, and couples eager for a baby may disregard the advice.
“It’s very easy to demonize this dumb doctor who didn’t do the right thing. That may not always be the case,” said Dr. Nanette Santoro, obstetrics chief at the University of Colorado in Denver. “Frustrated people who don’t get pregnant after a couple cycles will think more is better. It’s the American way.”
The new study examined trends over several decades and finds that the rate of triplet and higher-order births peaked in 1998 and has been declining since then.
From 1998 to 2011, the estimated proportion of twin births due to IVF increased from 10 percent to 17 percent, while the proportion of triplets-and-more declined.
During the same period, the estimated proportion of triplet and bigger multiple births from non-IVF treatments such as fertility drugs increased from 36 percent to 45 percent.
Image: Infant sleepers on clothesline, via Shutterstock
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Tuesday, October 15th, 2013
An estimated 5 million babies have been born using the fertility treatment known as in vitro fertilization (IVF) since Louise Brown became the first baby born using the technique, 35 years ago. Most of those births took place in the last 6 years, a period when researchers say the stigma surrounding infertility lessened and technology improved. More from NBC News on the first-ever research presented Monday in Boston at the meeting of the International Federation of Fertility Societies and the American Society for Reproductive Medicine:
“IVF has become sort of mainstream,” says Dr. David Adamson, a reproductive endocrinologist in San Jose and Palo Alto, Calif., who led the efforts to analyze 10 reports from two international organizations that monitor births resulting from fertility treatment.
Until now, it’s been hard to get a handle on the number of IVF births worldwide, said Adamson, who is part of a nongovernmental organization called ICMART, or the International Committee for Monitoring Assisted Reproductive Technology.
The reports spanned the years from 1989 to 2007, with a few years missing in between. They relied on available data, which is far from complete, meaning that 5 million births is really a “best guess,” says Adamson.
Researchers are relying on data that assumes they have information on two-thirds of reported IVF cycles worldwide. The figures in the 10 reports come in part from the International Working Group for Registers on Assisted Reproduction, a volunteer group of physicians that banded together in the late 1980s to begin collecting IVF data. About 10 years ago, that organization evolved into ICMART, which has continued to collect information about IVF births.
“There is so much missing data, which is the reason this hasn’t been done until now,” says Adamson. “The reality is no one will ever know exactly how many babies have been born because no one ever counted.”
There are nearly 200 countries in the world, and Adamson estimates that about half have at least one IVF clinic. But just 74 countries have ever tracked and shared their data, and they don’t all do so consistently. China, which is thought to account for close to 20% of IVF births, doesn’t report its data, although Adamson said the Ministry of Health has indicated it’s working toward that goal.
Births have increased exponentially over the years, according to the research. In 1990, a little more than a decade after the first IVF birth, about 95,000 babies were born. By 2000, that figure had grown to nearly 1 million, and by 2007, it had climbed to more than 2 million.
“A lot of this has to do with increased success rates,” says Dr. Robert Stillman, medical director emeritus at Shady Grove Fertility Center in Rockville, Md., which says it performs more IVF cycles than any other U.S. clinic. “There has been a steady improvement in the ability to culture embryos and improve pregnancy rates. A 38-year-old coming to us in 1997 versus 2007 versus 2013 has a very different prognosis.”
Image: Fertility lab, via Shutterstock
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Wednesday, September 18th, 2013
The average out-of-pocket cost of fertility treatments tops $5,000, according to a new study of fertility clinics in the San Francisco area. More from Reuters.com:
As expected, researchers found costs were especially high for couples undergoing in vitro fertilization (IVF) – over $19,000, on average – and rose with each additional treatment cycle.
“One of the very early questions people ask after we figure out what we need to do to help them get pregnant is how much the treatment is going to cost,” Dr. James Smith, director of male reproductive health at the University of California, San Francisco, and the study’s senior author, said.
That expense, he told Reuters Health, “has a big impact – they’re taking out second mortgages on homes, they’re borrowing from friends and family.”
Smith and his colleagues interviewed 332 couples attending one of eight fertility clinics for their first evaluation and gave each a cost diary to record all treatment-related expenses. They then interviewed the couples three more times over the next year and a half about those expenses, including money spent on clinic visits and procedures, medications and miscellaneous items such as travel and parking.
Among all couples, the average out-of-pocket cost of fertility treatment was $5,338. However, that varied depending on what type of treatment they received – from $595 for basic, one-time procedures such as uterine fibroid removal or counseling about timing sex to $19,234 for IVF, the technique used by a majority of couples.
Expenses were higher for couples who took more time to get pregnant and underwent more treatment cycles, the researchers found.
However, there was no clear difference in out-of-pocket expenses based on whether couples reported having insurance coverage for fertility care, according to findings published in The Journal of Urology.
“Usually insurance companies will cover things like labs, the basic diagnostic testing,” Smith said. “But the expensive items, like in vitro fertilization, that’s much less well covered.”
He said that is the case in California and most other states, but that a few – including Massachusetts and Illinois – require insurance companies to have more extensive coverage of fertility treatment.
According to the Society for Assisted Reproductive Technology, women received more than 150,000 cycles of IVF in 2011.
Image: Fertility lab technician, via Shutterstock
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Thursday, August 15th, 2013
With many women waiting to get married and have children, the number of couples who pursue medical treatments to become pregnant seems to be growing exponentially. But new data from federal researchers at the National Center for Health Statistics shows that the national infertility rate has remained virtually unchanged for the past 20 years. More from NBC News:
“Infertility rates have come down a little bit,” says Dr. Anjani Chandra, researcher at the NCHS, part of the Centers for Disease Control and Prevention. “That surprises people because they think it is going up. In fact, it really hasn’t been the case.”
Chandra and colleagues looked at data from the National Survey on Family Growth, in which more than 22,000 people were interviewed face to face between 2006 and 2010. The survey was also done in 1982 and 2002.
The surveys showed that 8.5 percent of married women aged 15 to 44 were infertile in 1982 – defined as having been married and having unprotected sex for 12 months without becoming pregnant. This fell to 6 percent of the same age group, married or unmarried, in 2006-2010.
When they added in women who could finally get pregnant but who miscarried before giving birth, the number rose to 11 percent
“Contrary to popular perceptions based on infertility service use and media coverage about biological clocks, we still don’t see that,” Chandra told NBC News.
It hasn’t changed for men, either.
“Some form of infertility … was reported by 9.4 percent of men aged 15–44 and 12 percent of men aged 25–44 in 2006–2010, similar to levels seen in 2002,” Chandra’s team writes in the report.
One obvious answer would seem to be increased use of fertility treatments. Since 1982, in vitro fertilization or IVF has been perfected, and more than 163,000 treatments were done in 2011 – just about double the number done a decade before. Federal law requires doctors and clinics to report fertility treatments and success rates to the CDC.
But this data doesn’t show whether 163,000 separate people were treated, and the new statistics suggest that in fact more people aren’t being treated. Instead, individuals may be undergoing more treatments in the same year, says Chandra.
That’s because the percentage of women who have ever gotten fertility services was the same in 2006-2010 as compared to 2002 – 11.9 percent in both times.
Dr. Richard Reindollar of the American Society for Reproductive Medicine said the findings were encouraging.
“Even though the ages at which women in the United States have their children have been increasing since 1995, the percentage of the population suffering from infertility or impaired fecundity has not increased,” Reindollar said in a statement.
Image: Fertility lab, via Shutterstock
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Tuesday, July 16th, 2013
Crowdfunding, the phenomenon whereby people raise money for all manner of business and personal endeavors, is increasingly becoming a resource used by couples who are facing expensive fertility treatments or the costly and complicated adoption process. More from The Huffington Post:
Since May 2010, GoFundMe has helped raise nearly $1.1 million for couples looking to cover the costs of infertility treatments and adoption. Currently, about 100 couples are looking to do the same on GiveForward.
The first “crowdfunded baby,” Landon Haley, was born after his parents conducted a campaign in 2011 that raised $8,050 to help fund infertility treatments.
“Twenty years ago this wouldn’t have happened,” his mother, Jessica Haley, told CNN Money. “Because of the Internet, that’s why we have Landon.”
Fertility treatments, such as in vitro fertilization, can cost upwards of $8,158 per cycle, according to RESOLVE: The National Fertility Association, and one estimate by the American Society of Reproductive Medicine put the figure at $12,400.
Because it can take several rounds of treatment before a woman conceives, costs skyrocket quickly. But insurance companies will only cover so many attempts, if they provide coverage at all. In fact, only 29% of couples said their insurance covered their infertility or adoption expenses, according to a 2012 poll conducted by RESOLVE.
Adoption expenses can lead to even bigger debt. The U.S. Department of Health and Human Services estimates the cost can be anywhere from $2,500 to over $40,000 per child.
While couples can subsidize the cost by applying for grants from nonprofits, with aid from employers or by taking advantage of the nearly $13,000 tax credit for out-of-pocket adoption costs, some still seek other means to help foot the sizable bill.
The first adoption-specific crowdfunding site — AdoptTogether — was founded in 2012, and has helped provide over $1 million to 300 adoptive families so far.
Image: Money, via Shutterstock
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