Two weeks ago I was asked to judge a video contest put on by Sher Fertility Clinics to give away a free IVF cycle. I hemmed and hawed for a while. They aren’t a Creating a Family sponsor so I felt no obligation. And Lord knows, I didn’t have the time. In the end I thought, what the heck, I already “waste” a fair amount of time watching and reading infertility and adoption journeys online, so I might as well help a clinic and some lucky couple while I’m at it. I’m a big believer in paying it backward. Sher is an active member of the online Twitter and Facebook professional infertility community. On occasion they’ve retweeted my educational posts, so why not help them if it isn’t too much trouble. Besides, it would give a little bit of publicity to Creating a Family, and that couldn’t hurt us either.
In truth, it took much more time than I had anticipated. Somehow the whole 45+ (# of videos) x 5 (minutes) part of the equation escaped me when I was feeling magnanimous in agreeing. (Math never was my strong suit!) I’m also an incurable optimist on how much I can get done in any given week. I think I’m more efficient than I really am.
I also underestimated how hard it would be to decide. I made a list of five criteria for judging then started watching and ranking the videos whenever I needed a break at work. Turns out I don’t take as many breaks at work as I thought, so I had to set aside 45 or so minutes at the end of a couple of days to catch-up. My plan was to have my five finalists picked at this point. My plan did not account for the majority of the videos scoring so close together– making it impossible to select just five. So I added a few additional criteria and watched most of them again. Better, but I still had way more than five. Sigh. I finally whittled my selection down, but was still angsting over whether # 6 and 7 should actually be #4 and 5 until I finally hit “send”. The finalists from our stage of judging were then voted on by members of the Sher Facebook group. I gladly skipped that vote. I was happy to hear that the clinic eventually awarded three of the couples a free IVF cycle. You can watch the winning videos here.
While I have problems with the overall cost of IVF, the significant regional variations in cost, and especially the lack of health insurance coverage for this medical treatment, I did not have any significant ethical or moral qualms about this contest. Apparently mine is not a universal view. (Imagine my surprise since I am so used to universal acceptance!?!). If you’d rather skip the part about the controversy, feel free, but please please skip to the bottom and read what I think is the heart of this blog.
Time Magazine ran an online article about this contest titled: Baby Contest: Couples Compete for Free IVF — Is This Exploitation or Generosity? Exploitation?? Wow! Others in the infertility community have chimed in with their own criticism as well. This controversy feels a bit of a tempest in a teapot to me.
Bonnie Rochman, who by the way is a terrific science writer, in Time wrote: “For the three winners, it was fabulous. For the others, it must have felt like yet another loss. And for the rest of us — watching these tales of woe on our computer screens — it felt undeniably voyeuristic.”
No doubt the winners were happy and the losers were disappointed, but I don’t see the voyeurism. Or, perhaps the better way to say it is that these videos were no more voyeuristic that the average infertility blog or video that are posted by the thousands each week. I suppose reading about someone else’s life has a voyeuristic quality, but nowadays we call it a blog if online and a memoir if in print. I assume some people read my blog in part to catch a glimpse of my life and me as a person. In fact, blogs which share little of the blogger’s personal story, such as purely educational type blogs, have a hard time attracting readers.
Keiko, over at The Infertility Voice equated this contest to gambling and said, “there are some things on which I just won’t gamble. For me? That’s anything related to my family, whether it’s my husband, our marriage, or our future children.” (The great pic is from her blog.)
While I love Keiko’s blog and am a regular reader, I don’t get the gambling analogy in this situation, or more accurately, I feel that this contest is no more gambling than what we routinely do in life. Gambling for me is when you give something of significant value on the hope of getting something of much greater value, but the odds of getting the something greater are small. The only thing the couples that entered the contest gave up was some time and some hope. Although a few of the videos clearly reflected a significant time commitment, none looked like the applicant had paid to have it made.
While I’m the first to acknowledge that time has a value, we each “gamble” our time daily on things where the odds are against success, and each person has to decide how much hope they are willing to invest/gamble. I am in the process of researching grants for Creating a Family. I will spend a significant amount of time (and hope) applying for these grants with considerable less odds of winning than 3/45+. Next year one of my kids will spend a huge hunk of time, hope, and not an insubstantial amount of money applying for colleges. I’ll encourage her to stretch and try for some schools were the odds of acceptance are significantly against her. I always encourage my kids to try for the team they might not make and ask out the girl that might not say yes. Life is all about the gamble of time and hope. I want to readily and even eagerly participate in these gambles because the alternative is to never try and never reach beyond what is certain. I hope the couples who participated felt the same way.
The Time article also said: “[T]he contest is also a gambit, an unapologetic marketing ploy. Physicians like Geoffrey Sher recognize that their services are elective, much like those of plastic surgeons, who have also been known to host giveaways; in an increasingly crowded field, they have to promote themselves if they want to pack their waiting rooms.”
Yes, this contest was definitely part of Sher’s marketing, and they never hid this motivation. That was the part I struggled with the most before agreeing to be a judge—not whether it was ethical for Sher to give away the IVF cycles as a marketing strategy, but whether I should spend my limited time to help them attract this publicity. In the end I decided that the upside of helping a couple (or as it turns out three couples) access IVF, spreading goodwill amongst my fellow infertility professional online community, and whatever publicity came our way at Creating a Family was worth my time. (I underestimated the time, but that was my own ignorance and no fault of the clinic.)
Terri Davidson, the Fertility Marketing Maven at Davidson Communications with over 16 years’ experience at marketing for infertility clinics (and a darn nice and thoughtful person), addressed this criticism of the Sher IVF contest. And as always, she said it best.
Of course, they were going to use this contest for marketing and publicity. Every health care provider markets; it’s naive to think they don’t. But marketing also promotes education and public awareness. Marketing is not a dirty word. …But here we are debating about the nuances of this so-called controversy, when instead we should be focusing on why only 14 states in the United States have mandated infertility insurance coverage and why residents of the other states have to enter contests, lotteries, giveaways, instead of being able to access the infertility treatment they deserve. That’s the real controversy.
All together now: Amen.
Now, at long last I get to the heart of this blog. As I was preparing for this week’s Creating a Family radio show, I was actually thinking about this contest before I heard about the controversy. The show was on Lower Cost Infertility Treatment and one of our guests was Dr. Joe Massey, a Reproductive Endocrinologist and co-founder of the Servy Massey Fertility Institute. Prior to starting this clinic a few years ago, Dr. Massey co-founded Reproductive Biology Associates in Atlanta, and was a leader in the development of many advances in IVF including the first ICSI pregnancy in the US, the first US egg freezing, and the world’s first successful assisted hatching procedure. I’ve been acquainted with him by his several appearances on the Creating a Family radio show and have always been impressed with his insightful and practical approach to infertility treatment.
Dr. Massey has long been troubled by the cost of IVF limiting access to treatment, and he has made it his professional goal for the last several years to lower the cost of fertility treatment for all his patients. His clinic offers IVF for everyone regardless of age or diagnosis for $6,575 for the first cycle, $5,900 for the second cycle, and $5200 for the third cycle. This covers everything, including ICSI and assisted hatching, if necessary, but does not include fertility medications, which would add about another $2-3,000 to the total cost.
His explanation on the Creating a Family show of how save money on IVF will be useful to all infertility patients, but in the end it seems to boil down to paying a great deal of attention to what each test, drug, and procedure costs to the patient and choosing the most cost effective approach balanced against the odds of success. Sounds simple, right, but I’m sure it is not, and I’m sure it is open to varying opinions of how to strike that balance.
The Servy Massey clinic is just one of a number of infertility clinics that are marketing themselves as “affordable infertility treatment”. Other clinics are trying various cost sharing methods to attract patients and lower the cost, such as multi-cycle programs, shared risk, etc. We’ve done a number of radio shows/podcasts on how these techniques work and who should use them and have resources on our site as well, including a video. Although I don’t begrudge any infertility clinic from marketing through contests, glossy brochures, or posh offices, I’d love to see us reach a place where more and more will try the lower cost marketing approach.Image credit: Paul Mayne, Bernd*