Safe Versus Affordable: Are Couples Forced to Choose?

This article on Australia-based News-Medical.Net reports that increasing numbers of twins and triplets are being born as a result of the global economic crisis.

The increase (in Australia) is due to more infertility patients requesting the transfer of more than one embryo in each IVF cycle. Essentially, in an effort to save money, couples are trying to boost their odds of pregnancy per cycle.

This is an unfortunate state of affairs, since studies have for a long time pointed to several related facts, including the bottom line that multiples and their mothers are at greater risk for numerous precarious health conditions.

Because of the many complex variables at play in each IVF cycle and in each woman's own reproductive condition and functioning, some patients must undergo more than one IVF cycle before successfully achieving a healthy pregnancy. In some cases, one treatment cycle is all that's required.

Now that the combined work of embryologists and reproductive endocrinologists has arrived at a point of making single embryo transfer a viable option for many, and certainly transferring only one or two more embryos to counteract some infertility-causing conditions, my recommendation for struggling couples is to take advantage of seasonal discounts when available.

Rather than boosting your odds per pregnancy, which in turn may boost health risks for you and your hoped-for baby, I encourage patients to time their treatment around clinics' occasional specials. For example, Houston Fertility Center is currently offering IVF for $7,950 per cycle, until June 30, 2010. We've long offered summer price cuts so that patients who typically vacation during summer months can fill their off-time with baby-making. (It's especially popular with teachers, we've learned.) At the discounted rates, if getting pregnant requires more than one cycle of IVF, you'll still be receiving affordable treatment and at a much safer embryo transfer rate.

I know the anxiety that many patients feel, about time passing, about affording treatment, and about possibly never having a baby. But I also know that all of my patients, to a person, want a healthy baby over everything else. Boosting the odds of pregnancy by narrowing down to one IVF cycle with too many embryos is not the safest way to fulfill their dreams.

Summer in Texas Means Heat -- & Babies

I've noticed in my years of practicing reproductive medicine that given every other factor, there does seem to be a calendar-based trend to conception. So I'm happy to find out about studies that point to what we've seen in our practice here in sub-tropical Houston. It appears that summer is a great time to try and conceive with IVF.

In this study, published in Human Fertility (Vol 9, No 4, 2006), the researchers looking at more than 2,700 IVF/ICSI cycles saw "significant improvement in assisted conception outcomes performed" in summer months.

They're not exactly sure of what causes the boost but they propose it may be related to production of melatonin, a light-inhibited hormone that regulates sleeping and waking cycles.

This bit of information turns out to be in many patients' favor, since summer is the traditional season to take time off from work for vacation.

We've always encouraged our patients with seasonal jobs, like teaching, to take advantage of those stretches on the calendar when they're likely to be less stressed and busy on a daily basis. IVF treatment is carefully timed, so fitting it into a more relaxed schedule is beneficial -- lessened stress has also been linked to better fertility treatment outcomes.

Not only do I consult with patients to determine best times to schedule fertility treatment, I've started offering discounts timed specifically so they can take advantage of summer months.

TV Reflecting Hopeful New Reality

Especially after hearing from my staff (who atttended the annual Young Survivors Conference in Dallas last month ) about the mix of hope and anguish that young women with cancer express about their future motherhood, it was reassuring to see the very popular TV show, Grey's Anatomy, work the forethought of fertility preservation into a current, compelling storyline.

A young woman must undergo intense and immediate treatments for invasive cancer. Her colleagues and friends think ahead for her and automatically include the OB team in her treatment plan.

In this related scene, the cancer patient's boyfriend reveals the understandable and expected emotions involved as people struggle to muster hope amid fears: