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Archive for the ‘Single Embryo Transfer’ tag

To Single Embryo Transfer (or Not to)?: That is the Question

By Tracey Minella

February 11th, 2015 at 12:24 pm

 

Credit: stockimages/ freedigitalphotos.net


One of the hardest parts of undergoing in vitro fertilization is the difficult decision of how many embryos to transfer back…because each embryo transferred has the potential to implant and develop into a baby.

In the 1980s when IVF was new and success rates were understandably low, it was common to transfer as many as 6 embryos back. Even then, many women did not conceive. Others conceived multiple pregnancies. Still others conceived only one.

Happily, today the technology has been dramatically fine-tuned, resulting in much higher IVF success rates and, because fewer embryos are being transferred, fewer multiple pregnancies.

Some women can’t or don’t want to have a multiple pregnancy and are interested in a program that virtually eliminates the risk of more than a singleton pregnancy. Some of their reasons include possible health risks for the mother or babies, concerns over the higher costs of raising multiples, or the fear of being placed on bed rest and its potential financial impact.

On the other hand, because IVF can be expensive and often not covered by insurance, and because the couples attempting it may have already been trying to conceive for a long time with and without medical assistance and expense, it’s tempting to want to “put all your eggs in one basket”. These couples want to transfer a higher number of embryos back to maximize their chance of conceiving in that one cycle or because they can’t afford to do more cycles. Many couples think of the possibility of twins as a bonus. Two-for-one. Instant family. Dream come true.

But if the financial burden was lessened, and the odds of a live birth from transferring one embryo were nearly comparable to the odds for transferring more, would that make a difference to you? Would you opt for the statistically safer singleton pregnancy vs. the statistically riskier multiple pregnancy? Would you really prefer a multiple pregnancy or would you rather have a succession of singleton pregnancies, the way you originally planned before infertility entered your life?

Deep, emotionally-charged decision. No right answer. Just the right answer for you.

Some good news that may affect your decision is 20-year study of 92,000 patients from Denmark, Norway, Sweden, and Finland, recently published in the on-line Oxford Journal, Human Reproduction, on January 21, 2015. The Nordic study found that the health of children born from IVF has significantly improved and that the risks of pre-term or severely pre-term births have declined dramatically…and it’s primarily due to transferring just one embryo. In addition, the stillborn and infant death rate for singletons and twins born through IVF has declined. http://bit.ly/1Ejgg1o

For those interested, Long Island IVF has a well-established Elective Single Embryo Transfer Program with success rates comparable to traditional IVF in select patients. If you elect to transfer one embryo in your fresh cycle you get free cryopreservation of your embryos and free storage for six months or until a live birth occurs. As an additional incentive to motivate patients to make safer choices, we offer patients transferring a single embryo during their fresh stimulation cycle up to three frozen embryo transfers, within a year of their retrieval or until a live birth occurs, for the price of one. For more details and information on whether SET may be right for you, visit http://www.longislandivf.com/single_embryo_transfer.cfm or ask your LIIVF physician.

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What did/would you consider when deciding how many embryos to transfer? Is the elective SET program something you did/would consider? Why or why not?

 

 

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Ready, Set, Save On IVF!

By David Kreiner MD

September 3rd, 2014 at 7:46 am

 

credit: stuart miles/free digitalphotos.net


A pharmaceutical company started a new program designed to attract a larger market share by discounting its fertility medications by 50%.  What a novel idea!

Who would not choose to save over a $1000 if given the choice?  It got me thinking…

Do patients know about the many discounts offered by Long Island IVF?  

Here at Long Island IVF, a full stimulation IVF cycle is offered to qualifying patients earning under $100,000 per year at $7,500 and somewhat higher to those earning up to $200,000 per year.  Anesthesia is an additional $525 and medications… including the savings through the new Ferring® rebate program… would range in cost from $1500- $3500 depending on the needs of the patient.  For example, an “average” patient receiving 20 amps of Bravelle® (FSH) and 10 amps of Menopur® would pay about $1,050 for these medications and hundreds more for Novidrel® (hCG)  and Endometrin® (progesterone).  Of course, those requiring more medication would have proportionally higher costs for their medications.

We offer other cost-savings programs at Long Island IVF including up to three frozen embryo transfers for the cost of one and free cryopreservation to patients electively transferring a single embryo in their fresh cycle.  More details on our Single Embryo Transfer (SET) Program and its financial incentives are available here: http://bit.ly/WpzCvv

 

We also offer a minimal stimulation IVF, also known as Micro IVF, at $3900. Because patients using this treatment protocol use less fertility medication to achieve their minimal stimulation than is used in in a full stimulation IVF cycle, there are significant savings on medication costs as well. Patients are encouraged to ask their doctors if they are candidates for Micro-IVF. More details on our Micro IVF Program are available here: http://bit.ly/12ZjvaD

 

Most importantly, these cost savings programs are available with the same high level of service and comparable success that Long Island IVF is famous for where we offer patients as good a chance of achieving a pregnancy as nearly anywhere in the nation.

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Have you researched the many grants and other cost-savings programs available at Long Island IVF?

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National Twins Days

By Tracey Minella

July 30th, 2014 at 10:22 pm

 

image courtesy of david castillo dominici/freedigitlaphotos.net


Twins. Gotta love ‘em.

For the majority of couples struggling with infertility, the idea of having two babies at once…especially in cases of a long, expensive treatment history… is a dream come true. Times two! For some, twins are a “two-fer” that helps “justify” the expense of IVF and IUIs. Twins are also a great way to quickly “catch up” in the total number of children department. After years of having none, suddenly you are the parents of two… instant “standard American family”. In fact, many call it quits after twins.

On the other hand, twins (or triplets) make others nervous. The fact is that a multiple pregnancy can be more complicated than a singleton. Many infertile couples have stressed enough over just getting pregnant and may prefer to avoid the additional worries a high risk multiple pregnancy sometimes presents. This fear, coupled with financial incentives, has driven the popularity of quality Single Embryo Transfer (SET) programs which may offer comparable success rates. For information on Long Island IVF’s SET Program success rates and incentives, click: http://www.longislandivf.com/single_embryo_transfer.cfm

But those lucky enough to have twins will agree that once they arrived safely, it’s mostly two times the pleasure and two times the fun.

This year, August 1-3 is the National Twins Days Festival. http://www.twinsdays.org/, which is billed as the largest annual gathering of twins in the world.

We are inviting all our parents of twins (or more) who are so inclined, to SHOW US YOUR TWINS! Upload your favorite photo to our Facebook page any time between August 1-3. We want to see all those cuties…the ones born this week, the ones who are leaving for college, and the ones in between!

Your success will give others hope. (But those who find viewing baby photos difficult will have advance notice to avoid viewing those posts on the page on those days.)

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If you could control it, would you prefer having twins or one baby at a time?

 

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Long Island IVF’s Fertility Grants Guide

By Tracey Minella

July 9th, 2014 at 9:00 am

credit: StuartMiles/freedigital photos.net

 

Financing…or lack thereof…is the number one obstacle to family-building for the majority of those suffering from infertility. Most insurance companies cover little (if any) of the costs of infertility treatment, especially advanced assisted reproductive technologies like in vitro fertilization (IVF). Even the medications for such treatment can be expensive.

Long Island IVF makes infertility treatments more affordable for patients through maximizing insurance benefit coverage as well as by offering specialized programs, such as our IVF Grant Program, Single Embryo Transfer Program, IVF Financial Share Program or Fertility Preservation Programs. For more information on these programs, see: http://www.longislandivf.com/payment_options.cfm  We also provide each patient with a personal financial counselor to help navigate the available options.

In addition to all the internal financial grant and related assistance offerings, we’d like to share other external grant funding sources which may be available to patients to assist with their infertility treatments. These organizations include:

The Cade Foundation & Long Island IVF

Long Island IVF actively supports the Tinina Q. Cade Foundation as our practice’s philanthropy. Next month, Long Island IVF will host a unique fund-raising event for the Cade Foundation on August 23rd at the Dance With Me Studio in Glen Head, Long Island, home of the Chmerkowsky Brothers and Tony Dovolani from Dancing With the Stars.

The Dancing for the Family event costs only $65 per ticket for a night of dance lessons, dancing, hors d’oeuvres, drinks, desserts, a silent auction and a chance to win a fabulous door prize: A Free IVF cycle donated by Long Island IVF!

Tickets are limited and can be purchased here: http://www.eventbrite.com/e/long-island-dancing-for-the-family-hosted-by-long-island-ivf-tickets-10690187639 The Free IVF cycle is transferrable once (subject to certain restrictions) so here’s a real chance for your fertile friends and family…who wish they could help you… to come out for a fun night and maybe they’ll win the prize for you!

The Cade Foundation is a non-profit organization whose mission is to promote awareness of infertility and serve the needs of couples struggling with infertility by providing educational resources and financial assistance for helping them grow their families. Each year, the Cade Foundation provides grants of up to $10,000 to infertile families to assist them with the cost of infertility treatment or domestic adoption.

Eligibility: In order to be eligible, applicants must have documented infertility, be legal, permanent residents of the United States, and submit the grant application (processing fees apply).

Application Process: The application must also include a detailed plan on how the applicants will contribute financially to their fertility treatments. Grant awards are made once per year.

For more information and to obtain an application, go to: www.cadefoundation.org

 

The NY State Infertility Demonstration Grant & Long Island IVF

Based on meeting high standards of IVF success rates, Long Island IVF is among the select programs chosen to participate in the infertility grant funded by New York State. The amount of treatment funding is based on the patient’s or couple’s combined household income; coverage can range from 2.5% up to 97.5% of IVF treatment costs.

Eligibility: In order to be eligible, applicants must be between the ages of 21 and 44 years, have documented infertility and meet clinical criteria, be residents of New York State, have medical insurance coverage but either be uninsured for fertility or IVF treatments or have exhausted their benefits and have a combined household income of less than $195k annually.

Application Process: Qualified, interested patients may apply through their Long Island IVF Financial Counselor.  Although there is no required application form, applicants must submit proof of NY State residency and income. Grant awards are made during the award period based on availability of grant funding from the State.

For more information on the NY State Infertility Demonstration Program at Long Island IVF and to review the participation criteria, go to: www.longislandivf.com/doh_ivf_grant.cfm

 

Pay It Forward Fertility Foundation

The Pay It Forward Fertility Foundation selects applicants who are uninsured for fertility treatment. Candidates may use their awarded partial or full grant for: IVF, donor eggs or embryo adoption.  Applicants must be under the age of 40 to qualify, unless using donor eggs or embryo adoption.  Although surrogate expenses are not available for funding, the IVF treatment for the preparation of a surrogate pregnancy may be funded.  Funds are paid directly to the clinical program.

Eligibility: In order to be eligible, applicants must have documented infertility, be legal, permanent residents of the United States, have medical insurance coverage but be uninsured for fertility or IVF treatments, demonstrate financial need and submit a grant application (processing fees apply).

Application Process: The grant application requires in depth financial information and physician diagnosed infertility.  Grants are awarded several times each year coinciding with Board meetings.

For more information and to obtain an application, go to: www.payitforwardfertility.org

 

BabyQuest Foundation – IVF Grant

Baby Quest Foundation is a non-profit organization whose goal is to grant financial assistance to those who cannot afford infertility treatments. Funding can be used for a range of procedures including egg and sperm donation, egg freezing, artificial insemination, IVF, embryo adoption and surrogacy.  

Eligibility:  Applicants must reside in the United States. They must demonstrate financial need, submit required medical documentation and a description of their infertility history as well as the grant application (processing fees apply).

Application Process: Grants are given out two times yearly.

For more information and to obtain an application, go to: www.babyquestfoundation.org

 

Long Island IVF is committed to helping couples build their families and is providing this list for informational purposes only, as a courtesy to help those who may qualify for these programs. Long Island IVF makes no representations regarding the eligibility requirements or continued availability of any of these programs. This list is not exhaustive of all the potential grant and financial servicing options available and patients are encouraged to do their own research into these and other programs.

Wishing you a fast and successful journey to the crib.

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Was this information helpful? Are there any other resources you can add to this list?

 

Photo credit: Stuart Miles/freedigitalphotos.net

 

 

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The Dream of Motherhood Never Dies

By Tracey Minella

December 15th, 2013 at 8:09 pm

 

image courtesy of David Castillo Dominici/freedigital photos.net


There are women who have babies with ease…they pick the month they’d like the baby to be born, conceive effortlessly, and often enjoy care-free pregnancies and deliveries. Others have unplanned pregnancies and sometimes complain or give up the baby. And some women choose to never have children at all.

And then there is us. The infertile ones.

We began our quest as innocent planners of big families and summertime babies. And as the journey wore on we somehow morphed into women who’d settle for just one healthy baby born on any day of the year. We altered the dream to our reality. And we prayed it would come true.

For many of us with access to quality reproductive medical care, the dream will come true. The statistics for IVF success are rapidly rising as technology improves daily. Single embryo transfers (SETs), already popular at Long Island IVF, are helping to reduce risky multiple pregnancies. And Early Embryo Viability Assessment (EEVA) Testing, which is part of a clinical trial at Long Island IVF, is helping embryologists choose the embryos most likely to result in a pregnancy.

But what about those who don’t have access for financial or other reasons? What about their dreams? If faced with no other options, these women resolve to live child-free. Many end their infertility journeys after having suffered devastating losses or repeated disappointments and are emotionally, physically, and financially exhausted. For most of them, living child-free may not really be a choice, but rather, the only option available.

I don’t think the dream of motherhood ever dies. Certainly not for women who wanted it badly enough to endure the sacrifices and demands of repeated IUIs and IVFs. The journey may end, but the longing remains. Even if the woman stops talking about it. Even if she says she’s okay with living child-free. That’s just self-preservation talking.

This week that theory was validated as a 64 year old woman gave birth after a 41 year infertility journey. She got married six years before the first IVF baby was even born. She tried IVF only once, in 1988, without success and thereafter gave up treatment…for 23 years. But the dream hadn’t died. She went back for another IVF procedure and is finally a mother at 64. Her daughter is named Durga, which means “invincible”. For the full story, clickhttp://bit.ly/INs6ua

This story is offered not to spark debate on how old is too old to become a mother, but as testament to the unwavering power of the dream of motherhood and the miracles capable from modern reproductive medical technology.

What may feel like the impossible dream today may be the invincible dream tomorrow. Dare to dream it.

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photo credit: David Castillo Dominici/free digital photos.net

 

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Infertility Podcast Series: Journey to the Crib: Chapter 34: Fertility Treatment During This Economic Downturn

By David Kreiner MD

December 5th, 2013 at 7:57 pm

 

Welcome to the Journey to the Crib Podcast.  We will have a blog discussion each week with each chapter.  This podcast covers the final chapter, Chapter Thirty-Four: Fertility Treatment During This Economic Downturn. You, the listener, are invited to ask questions and make comments.  You can access the podcast here: http://podcast.longislandivf.com/?p=149

Fertility Treatment During This Economic Downturn


Financial hardships have increased fertility challenges for many couples attempting to build their families.  In regions where patients do not have insurance coverage for their IVF procedures it is unlikely that they proceed with the treatment that is necessary for them to be able to complete their families.

In places that do provide coverage for IVF, such as Massachusetts, 5% of all babies born are as a result of IVF.  Elsewhere in the U.S., IVF accounts for only 1% of births suggesting that the financial cost of IVF denies access for approximately 80% of couples in need.

The problem of the cost of IVF is compounded by the fact that patients are driven to transfer multiple embryos to limit the cost and avoid additional fees from cryopreservation, embryo storage and frozen embryo transfers.  These multiple transfers increase the risks of multiple pregnancy and preterm delivery with subsequent complications to the babies from preterm birth.

We, at Long Island IVF, attempt to make IVF more accessible and safer by offering income based grants, free cryopreservation, storage and discounted frozen embryo transfers to patients electively transferring single embryos.  We have also offered free IVF cycles through best video/essay contests to a few needy patients over the past few years.

It is our sincere wish and hope that a bill that is presently in front of Congress offering a tax credit to patients going through IVF is passed thereby making IVF that much more affordable to our patients in need.

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Was this helpful in answering your questions about fertility treatment during this economic downturn? Are you aware of the pending proposed Family Act, which would offer a tax credit to infertile women wishing to undergo infertility treatment (similar to the current adoption credit for those wanting to pursue adoption)? Have you urged your legislators to support this important legislation?

Please share your thoughts about this podcast here. And ask any questions and Dr. Kreiner will answer them.

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Infertility Podcast Series: Journey to the Crib: Chapter 32: Octomom

By David Kreiner MD

December 1st, 2013 at 8:26 am

 

Welcome to the Journey to the Crib Podcast.  We will have a blog discussion each week with each chapter.  This podcast covers Chapter Thirty-Two: Octomom. You, the listener, are invited to ask questions and make comments.  You can access the podcast here: http://podcast.longislandivf.com/?p=146


A year ago, the Medical Board of California revoked the license of Dr. Michael Kamrava, finding he “did not exercise sound judgment” in transferring 12 embryos to Nadya Suleman, who already had six children at home. The ruling, while not surprising, was illuminating, and it’s worth reflecting on the five things we learned from Octomom:

 

1.      Know How to Say “No”: There is a point where physicians have to make a judgment call. Pregnancies with triplets – let alone eight infants – put the mother at high risk of serious medical complications and put unborn children at risk for developmental disabilities. Physicians need to rely on their professional expertise and experience to know when to turn down a patient request no matter how vehemently it is made.

 

2.      Beware the Patient with Tunnel Vision: Often when a patient comes to a fertility doctor, unsuccessful pregnancy attempts have made her anxious and determined. She might want to get pregnant regardless of the risks that pregnancy may present.

3.      Less is More: In 1999, 35 percent of all transfers involved four or more embryos. In 2009, only 10 percent had four or more. And those high-number transfers are generally reserved for patients with significant fertility challenges. In contrast, Octomom already underwent multiple successful IVF (in vitro fertilization) procedures and had given birth to six children when she had her 12-embryo transfer.

 

4.      Know When to Deviate: While Dr. Kamrava’s deviation from guidelines was an extreme departure, deviations do occur for specific reasons, such as repeated IVF failure, age-related infertility and poor egg quality. It is important to know when implanting several embryos is appropriate.

5.      “Reduce” Risk: Dr. Kamrava complained that Octomom refused to undergo “selective reduction,” which would have reduced the number of embryos she carried to term. Here, again, is an argument for fewer transfers. Had he transferred fewer embryos, Octomom would not have had to face such a difficult decision.

 

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Was this helpful in answering your questions about what could have been done differently to prevent the Octomom case? How much weight do you give your doctor’s recommendation on the number of embryos to transfer?

Please share your thoughts about this podcast here. And ask any questions and Dr. Kreiner will answer them.

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Infertility and National Prematurity Awareness Month

By Tracey Minella

November 19th, 2013 at 10:53 am

 

photo credit: praisaeng/freedigitalphotos.net

Infertility is a disease. Its course often follows a common progression. It often starts with the abandonment of what turns out to have been unnecessary birth control. It then progresses through a repeated series of monthly disappointments until charts, thermometers, and the “chore-mentality” move into the bedroom. ObGyn intervention becomes an RE referral. A battery of tests and invasive procedures follow. Sometimes there’s Clomid. Maybe even ovulation induction with IUIs. Possibly, there’s IVF.

It’s no wonder that most infertility patients are so caught up in the all-consuming grind of simply trying to get pregnant, that they don’t think past getting that positive pregnancy test. They don’t think that…after all that time and sacrifice…something could threaten that hard-earned pregnancy.

It’s National Prematurity Awareness Month. And there is no better time to focus on what you can do to reduce your chances of having a premature baby than before you become pregnant.

It’s not always known why babies are born prematurely, but according to the Mayo Clinic*, some risk factors can include:

  • Pregnancy with twins, triplets or other multiples
  • Problems with the uterus, cervix or placenta
  • Smoking cigarettes, drinking alcohol or using illicit drugs
  • Poor nutrition
  • Some infections, particularly of the amniotic fluid and lower genital tract
  • Some chronic conditions, such as high blood pressure and diabetes
  • Being underweight or overweight before pregnancy.

 

According to the CDC**, some of the symptoms or warning signs of pre-term labor include:

  • Contractions (the abdomen tightens like a fist) every 10 minutes or more often.
  • Change in vaginal discharge (leaking fluid or bleeding from the vagina).
  • Pelvic pressure—the feeling that the baby is pushing down.
  • Low, dull backache.
  • Cramps that feel like a menstrual period.

If you are doing IVF, one of the things you may want to consider to reduce your chances of prematurity is having a single embryo transfer (“SET”), if your doctor feels you are a good candidate. Doing so virtually eliminates your chance of a multiple pregnancy. In addition to the safety considerations for mother and baby, SET at Long Island IVF offers financial incentives, including free cryopreservation and reduced rates for subsequent frozen embryo transfers. Click here for more information about Long Island IVF’s Single Embryo Transfer Program. http://bit.ly/WpzCvv

As an IVF mom of two preemies myself, let me acknowledge that very often, babies arrive early for reasons beyond our control. Sadly, the outcomes are not always happy. But knowledge is power, so control what you can, watch for the signs, and listen to that little voice if you feel something is amiss. And remember that the vast majority of these hard-earned pregnancies do turn out just fine.

*http://mayocl.in/HWaNGz

** http://1.usa.gov/IdCytZ

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Do you worry about prematurity? If so, would you consider SET to reduce the chance of a multiple pregnancy?

Photo credit: http://www.freedigitalphotos.net/images/agree-terms.php?id=100141619 /praisaeng

 

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Infertility Podcast Series: Journey to the Crib: Chapter 29: Why the Wyden Bill Does Not Support Fertility Patients

By David Kreiner MD

November 3rd, 2013 at 11:20 am

 

Welcome to the Journey to the Crib Podcast.  We will have a blog discussion each week with each chapter.  This podcast covers Chapter Twenty-Nine: Why the Wyden Bill Does Not Support Fertility Patients. You, the listener, are invited to ask questions and make comments.  You can access the podcast here: http://podcast.longislandivf.com/?p=138

Why “The Wyden Bill” Does Not Support Infertility Patients

 

IVF results subjected to government audit were mandated to be reported with the passage of the “Wyden bill”.   The intent of the CDC and national reproductive society (SART) was to assist infertility patients by informing them of the relative success of all IVF programs in the country. 

 

Unfortunately, what sometimes creates the best statistical results is not always in the best interest of the mother, child, family and society.  Now that prospective parents are comparing pregnancy rates between programs there is a competitive pressure on these programs to reports the best possible rates.   Sounds good…unfortunately it doesn’t always work out that way for the following reasons.

 

Patients with diminished ovarian reserve, who are older or for any number of reasons have a reduced chance for success, have a hard time convincing some programs to let them go for a retrieval.  In 2008, we reported our success, 15% with patients who stimulated with three or fewer follicles.  Sounds low and in fact many of these patients were turned away by other IVF programs in our area.  However, for those families created as a result of their IVF, these “miracle” babies are a treasure that they otherwise… if not for our program giving them their chance… would never have been born.

 

Another unfortunate circumstance of featuring live birth rate per transfer as the gold standard for comparison is that it pressures programs to transfer multiple embryos thereby increasing the number of high risk multiple pregnancies created.  This is not just a burden placed on the patient for their own medical and social reasons but these multiple pregnancies add additional financial costs that are covered by society by increasing costs of health insurance as well as the cost of raising an increased number of handicapped children.

 

William Petok, the Chair of the American Fertility Association’s Education Committee reported on the alternative Single-Embryo Transfer (SET) “Single Embryo Transfer:  Why Not Put All of Your Eggs in One Basket?”.  He stated in November 2008, that although multiple rather than single-embryo transfer for IVF is less expensive in the short run, the risk of costly complications is much greater.  Universal adaptation of SET cost patients an extra $100 million to achieve the same pregnancy rates as multiple transfers, but this approach would save a total of $1 billion in healthcare costs.

 

We have offered SET since 2006 with the incentive of free cryopreservation, storage for a year and now a three for one deal for the frozen embryo transfers within the year in an effort to drive patients to the safer SET alternative. 

 

If we are going to report pregnancy rates with IVF as is required by the Wyden Bill, let us put all programs on the same playing field by enforcing the number of embryos to be transferred and even promoting minimal stimulation IVF for good prognosis patients.  The Wyden Bill without the teeth to regulate such things as the number of embryos transferred and reporting success per embryo transfer does more harm than good.  Let us promote safer alternatives and report in terms of live birth rate per stimulation and retrieval, including frozen embryo transfers, so that there is a better understanding of the success of a cycle without increasing risks and costs from multiples.

 

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Was this helpful in answering your questions about the Wyden Bill, IVF success rates and reporting requirements, and SET?

Please share your thoughts about this podcast here. And ask any questions and Dr. Kreiner will answer them.

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ASRM Retrospective 30 Years Later

By David Kreiner MD

October 17th, 2013 at 1:48 pm

image courtesy of renjith krishnan/freedigital photos.net

 

Flying into Boston this week it occurred to me that this was the 30 year anniversary of the first ASRM meeting I ever attended.  In 1983, the American Fertility Society “AFS” meeting (as it was called then) was held in San Francisco and I attended as a third year ob-gyn resident. I was in awe attending this huge conference of about 3-5,000 held at the Hyatt Hotel as I recall.


Though I was required to man the Ovcon 35 birth control pill exhibit (since Ovcon’s manufacturer was paying my way), I was drawn to the microsurgery and in vitro fertilization exhibits and presentations.  

In the ballroom, the presenters presided over a few thousand of us eager to hear about the most recent successes in IVF.  Already, Norfolk had achieved dozens of births through this new scientific process which brought gynecological surgeons (laparoscopists) together with embryo biologists, endocrinologists, andrologists and numerous nurses, technicians and office staff.  For me, hearing Dr. Howard Jones, American IVF pioneer, and others speak about their experiences with this life creating technique was exhilarating.

Years later, as a Jones Institute reproductive endocrinology fellow, I would hear Dr. Howard proclaim that a chain is only as strong as its weakest link.  IVF required every link to maintain its integrity for the process to work.

In 1985, I presented my own paper at the AFS meeting in Phoenix, Arizona.  My wife and two sons joined me.  My presentation on endometrial immunofluorescence in front of hundreds of experts and specialists in the field remains one of the strongest memories in my life.

Today, the ASRM must be held in mega convention centers like the one in Boston where it could accommodate tens of thousands of attendees.  One presentation estimated the number of IVF births worldwide at over five million. Interestingly, per capita, the US performs one fifth the number of IVFs as Europe–where IVF is much more accessible and typically covered by government insurance.

Today, success in the US is better than fifty per cent for most people, thereby making single embryo transfer (“SET”) for good prognosis patients a viable option to avoid the risk of multiple pregnancy. Minimal stimulation IVF (“Micro-IVF”) is a viable alternative for many patients, offering a lower cost and lower risk option.  Egg freezing offers a means of fertility preservation, especially valuable to women anticipating cancer therapy.  Pre-embryo genetic screening (“PGS”) is an option that allows patients to screen for and eliminate genetically undesirable embryos that may otherwise lead to miscarriage or termination.

Looking back at the past thirty years, I am amazed at the progress and achievements made by my colleagues in IVF and happy that I was able to participate in this most rewarding field that has brought so much joy to millions of people.

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photo credit: renjith krishnan http://www.freedigitalphotos.net/images/agree-terms.php?id=10058384

 

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