Overusing IVF: Too Much of a Good Thing?

Since its creation in 1978, in-vitro fertilization has helped millions of couples achieve the dream of having children. Initially, scientists created IVF to help women with tubal disorders conceive and over the years, doctors started using it to treat other infertility problems like male subfertility, endometriosis and even unexplained infertility.

But too much of a good thing may turn out to be a bad thing. Dr. Esme I. Kamphuis of the Centre for Reproductive Medicine at the University of Amsterdam in the Netherlands and his team recently released a study that looked at the potential overtreatment of IVF.

While IVF can help couples achieve pregnancy, it also comes with negative side effects. In a 2012 study, researchers from UCLA found that IVF has a higher risk of birth defects. The IVF process circumnavigates the genetic natural selection process that prevents eggs with defects from fertilizing. IVF often leads to multiples, which can cause issues like pre-eclampsia and gestational diabetes in the mom. The University of Amsterdam study also referenced studies that showed long-term negative effects in IVF children including high blood pressure, high glucose levels and more heart problems.

test tubesThe study did not discredit the effectiveness of IVF for it’s original purpose—tubal blockage and several male factor infertility. It did, however, draw attention to the use of IVF for other subfertility issues, especially unexplained fertility, which can often be solved using other methods. As the study states, “[IVF’s] early pioneers persevered in opposition to scientific, societal, and religious dogma. [But] similar determination is needed in attempts to evaluate the extension of IVF to new indications.”

Nearly 30 percent of couples face unexplained infertility and for these couples, more effective infertility treatments exist that don’t come with the risks of IVF. Sometimes, no treatment at all is needed. Numerous studies published by the U.S. National Library of Medicine and National Institutes of Health have found that between 10 and 20 percent of women who attempt IVF, whether they are successful or not, conceive all on their own within three to four years.

Not only can IVF be risky, it’s also extremely expensive and out of reach for many couples. One IVF cycle can cost between $15,000 and $20,000 and most insurance companies do not include IVF as a covered procedure. Couples are going into debt trying to achieve the dream of pregnancy.

If not IVF, then what for couples facing unexplained infertility or other types of infertility? Couples have other options before jumping straight to IVF. One option is simply to wait it out for a few years. For couples wanting a baby now, that is easier said than done. Women can also become educated on how their bodies work. In the Journal for Nurse Practitioners, Mary Lee Barron explored how out-of-tune women are with their bodies and how basic reproductive education can help women conceive easier. Along with education, apps like Kindara help women track their periods, basal body temperatures, sexual activity and cervical mucus and show them how to use that data to determine their most fertile times.

Another option is ToConceive, which helps a woman create her own natural conception lubrication, which is the key to conceiving. Natural conception lubrication is necessary for sperm capacitation, the key process that prepares the sperm to fertilize the egg. Without suitable natural conception lubrication, the sperm cannot be capacitated. Without sperm capacitation, the sperm cannot reach the egg or properly fertilize it and pregnancy cannot occur. Often with unexplained infertility, a woman is not producing enough of her own natural conception lubrication and the sperm is not being properly capacitated, which is why they cannot get pregnant.

Before jumping straight to IVF, couples can use education, fertility apps and products like ToConceive as a first step in a step-therapy program of infertility treatments. Unlike IVF, these solutions have no ill side effects, are easy to use and effective for many couples experiencing unexplained infertility. Additionally, they are a fraction of the cost. ToConceive, for example, costs just $39.95 for a one-month supply, compared to thousands for IVF.

For some couples, other step-therapy methods for infertility still may not help and in those cases, IVF is an excellent solution. But couples don’t need to go directly to IVF; other easier and less expensive options exist. IVF is a viable option for many couples, but it’s not the answer for all couples. As the University of Amsterdam study states, “we need to evaluate which couples have a reasonable chance of natural conception” and look for other more effective,  less invasive and less expensive methods to help them achieve pregnancy.

Sources:

http://www.bmj.com/content/348/bmj.g252

http://www.medicalnewstoday.com/articles/251768.php

http://www.nytimes.com/2014/01/29/your-money/meeting-the-cost-of-conceiving.html?_r=0

www.pubmed.gov/10731540

www.pubmed.gov/18765012

www.pubmed.gov/8636613

http://www.medscape.com/viewarticle/780444?nlid=30327_901&src=wnl_edit_medp_obgy&spon=16

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