This headline is a bit misleading in that a similar technique was used in the 1990’s before it was decided that we need to proceed more cautiously in mixing DNA. Currently, the technique described is not available for couples treated in the USA and is only approved for use in treating specific genetic conditions. However, this is an exciting breakthrough that may prove to be useful in areas of reproductive medicine. https://www.newscientist.com/article/2107219-exclusive-worlds-first-baby-born-with-new-3-parent-technique/
This news will come as no suprise to our patients as we have been demonstrating this for years. It is good to have yet another study that further supports this recommendation. The cautionary note here for patients is to check with their center on the method of freezing used in their lab–if it not the modern rapid-freeze technique called vitrification then you might be better served by a fresh transfer. http://www.latimes.com/science/sciencenow/la-sci-sn-ivf-frozen-embryos-20160809-snap-story.html
Most of us have learned to rely upon numbers. Their dependability, their consistency, their ability to communicate an unemotional truth is something that most of us have come to value. However, as a fertility specialist that counsels patients on a daily basis, I’ve come to realize how subjective numbers can be misinterpreted by people wanting to have a child. The same numbers that may discourage some; serve as a source of hope for others.
The most glaring example from recent history is the case of the “octomom.” None of us was present when she was counseled so we can only guess what was or was not discussed between her and her doctor. However, based upon the low success rate of the center that she was treated at, the odds of her accepting 6 frozen-thawed embryos and them resulting in 8 babies was calculated at 1 in 3.4 trillion. Yet we all know how that worked out.
Let’s consider a less dramatic example. The estimated chance of achieving a pregnancy for a very fertile couple on a given month is roughly about 15%. A common strategy to improve upon this for couples that experience infertility is to promote ovulation induction. Despite its popularity, studies show that this treatment either doesn’t result in pregnancy for most couples or it results in an adverse outcome. What makes ovulation induction an appealing option to couples is the perception that it is less costly. In reality, studies are consistently demonstrating that it delays the initiation of pregnancy and results in higher treatment costs due to repetitive cycles. Furthermore, the Centers for Disease Control and Prevention along with the March of Dimes just published a report that about one out of every four multiple pregnancies are due to the use of approach. Advanced treatment options such as In virtro fertilization provide us with the ability to dramatically improve pregnancy success rates and outcomes.
The process of IVF allows for more effective management and also makes it easier to prevent twins and higher order pregnancy by performing single embryo transfers and freezing extra embryos for future pregnancy attempts. Better still, the information that is gained from a single IVF attempt can be diagnostic. Therefore even when a cycle fails it can provide closure or offer new information that can be used to redirect treatment. So what seems like the most costly treatment can actually save you both time AND money.
Here are some steps that you can take to protect yourself from making decisions that don’t add up right:
- Create a “family building plan” rather than focusing on just getting pregnant—In my book, Perfect Hormone Balance for Fertility I provide a series of questions that you and your partner should consider. Some treatments are more effective than others in reducing the risks of multiple pregnancies while others are more likely to be effective quicker—a key to success for couples wanting to have more than one child or those in their later reproductive years.
- Ask your doctor what your prognosis is in words like “excellent, good, fair or poor” rather than as enticing numbers—Since statistics are calculated based upon groups of people, they don’t apply to an individual cycle. Instead, they can often be misleading. By using words to express your chance of success, you’ll get a much more accurate estimate of your chance for becoming pregnant.
- Encourage your employer, insurance coverage and legislators to make fertility treatment part of their covered benefits package—As insurance options are being evaluated, consider switching coverage to meet your needs. A recent study demonstrated that plans that paid for IVF coverage can cost less than an extra $1 per month. If you’re not currently offered a plan with fertility coverage, request it of your employer.
The most common and unanswerable question posed is that which follows one failed IVF cycle. Although our success rates continue to improve, on average about 1 in 3 couples is successful after one IVF attempt. However there are a growing number of studies that show that that success rate at least doubles when couples undergo at least 3 cycles. This is according to a just released report out of Sweden. A larger study published in the New England Journal of Medicine earlier this year was even more optimistic. In a study which followed more than 6,000 women through nearly 15,000 IVF cycles, they found that the live birth rate on the third attempt was between 65% and 86% in younger women and between 23% and 42% for women beyond age 40. Yet despite these advances in success rates, many couples drop out after only one attempt.
I regularly counsel my patients that a single IVF cycle can provide valuable information that can be used to plan future treatment; yet rarely does a single cycle serve to definitively identify those that will not conceive with one or more additional attempts. As a former IVF patient I personally understand the frustration at receiving a negative pregnancy test. That’s why I feel it is essential that good communication occurs throughout the treatment process.
Current estimates from the National Center for Health Statistics indicate that over 6 million women between the ages of 15 and 44 are affected by infertility. Yet many either never seek treatment or don’t complete enough therapy to be certain of their potential benefit. As our treatment attempts become increasingly more successful, I think it’s important to realize that a single cycle of IVF might only be the beginning of treatment and should only rarely be considered the end of the line.