The Fertility Doc | IVF & Infertility Specialist Dr. David Kreiner

The Gift of Life and Its Price

Posted on 07. Sep, 2009 by David Kreiner, MD in Dave Kreiner, MD, High order Multiple Births, Innovating the Financing of Infertility, Regulation of IVF, Single Embryo Transfer

IVF has been responsible for 1 million babies born worldwide who otherwise without the benefit of IVF may never have been. This gift of life comes with a steep price tag that according to the NY Times article, “Gift of Life and Its Price” Sunday, October 11, 2009, hits $1 Billion per year for premature IVF babies. This price tag does not include the emotional hardships, developmental problems and permanent handicaps resulting from these premature deliveries almost always caused by multiple embryo transfer induced multiple pregnancies.

According to the Center for Disease Control, reported in the same NY Times issue, thousands of premature deliveries would be prevented resulting in a $1.1 Billion savings if elective single embryo transfer was performed on good prognosis patients. That brings us to regulating how many embryos to transfer as Octomom went through IVF with transfer of six embryos. At East Coat Fertility, we make it cost neutral to transfer only one embryo at a time by offering free cryopreservation, free embryo storage and free embryo transfers until a patient achieves a live birth, all for the cost of a single IVF cycle. Patients are encouraged by this program not to put all their eggs in one basket. Success rates with an elective fresh single embryo transfer with IVF at our program, is 50% and with subsequent frozen embryo transfers it is over 64%. It is possible that East Coast Fertility is the only center in the country doing this. That is the shame of it.

Fertility treatment without IVF is even more hazardous since as many eggs that are developed with treatment may implant and lead to a hazardous multiple pregnancy. In a perfect world, where a patient’s welfare was put before insurance companies, IVF would be a covered service for all people, and the use of fertility medications in an uncontrolled IUI cycle would not be used anymore. In this perfect world, we would also regulate how many embryos are transferred. It is time to put our professional recommendations of the Society of Assisted Reproductive Technology (SART) into law. There is flexibility built into the recommendations taking into account critical factors such as patient age, embryo quality and past experience.

It is not until we discourage the use of gonadotropins without IVF by offering IVF as a regulated covered alternative will we eliminate risky multiple pregnancies. Until then, all of us including society, the government, insurance companies and employers are to blame for letting these dangerous multiple pregnancies occur.

Tags: East Coast Fertility, featured, fertility treatment, Gift of Life and Its Price, Infertility Information, IVF, long island ivf, microivf, minimal stimulation, multiple pregnancy, Octomom, SART, Single Embryo Transfer, The American Society of Reproductive Medicine