We received an interesting question for this week’s Creating a Family show on Using IVF Success Statistics to Choose an Infertility Clinic.
You have to be super careful in interpreting the [fertility clinic success] stats. I was choosing between 2 local clinics, BUT, when I did more digging (and when I visited both), I realized that one clinic actively encouraging older (by that I mean >35) patients to either 1) go away, or 2) go straight to donor eggs, both of which inflate their success rates by weeding out more “difficult” cases. The other clinic, on the other hand, took everyone, and tried to work with the patient’s own eggs first (unless this wasn’t possible). This meant that they *appeared* to be less successful, when, in fact, for more difficult cases, they were the only option.
Our guest, Dr. David Ball, Embryology Lab Director at Seattle Reproductive Medicine, Reproductive Medicine and Infertility Associates in St. Paul, and Reproductive Health Associates in Pittsburg, and Past President of the Society for Assisted Reproductive Technology (SART) said it was a very intuitive question. And he’s right.
In fact, our commenter is right that success statistics are greater when older woman use donor eggs rather than their own eggs, but as Dr. Ball said, it is hard to assign motive. Are the clinics pushing donor egg to inflate their statistics or are they pushing donor eggs because they believe it is unethical to pursue treatment with such low odds of success?
The typical odds of a woman over 38 getting pregnant in 2015 using her own eggs with IVF ranges from around 7-8% for 38-40 year olds, to 5-6% for 41-42 year olds, to <1% for over 42. Before spending $15,000+, patients deserve to fully understand these low odds.
Dr. Ball and I both agreed that a woman should not be refused treatment if she wants to use her own eggs after age 38. The truth is that many people need to try to conceive using their own eggs regardless of their age and their chances of success because they need to know that they did everything possible to try to have a genetic connection to their child. They might live with regrets otherwise. However, I can understand a clinic’s hesitancy to go forward with an IVF cycle knowing that the odds of success are so slim.
If you are choosing an infertility clinic, I encourage you to listen to this week’s show explaining how to interpret the clinic IVF success statistics.
What do you think of the question that was asked? Do you think clinics should actively discourage older women from doing IVF with their own eggs?
Image credit: Dick Vos
Add Your Comment
At 43, I just had my first child using my own eggs through IVF. I was 41 when I started treatment. I’m glad my doctor was open to me using my own eggs. They did tests on AMH and FSH to give them an idea of my egg quality before we started IVF. I think it really depends on the individual and I believe a good doctor should treat each case individually depending on those factors. Of course we did discuss donor eggs and embryos during the course of treatment but I really wanted to give it try with my own eggs and I’m glad I did.
Monique, congratulations! Yes, it can work and you are proof. I am sure your doctor discussed the odds with you first, and then left the decision up to you.
Great topic. I’ve been thinking a lot about how doctors say that they are treating their patients with a donor’s eggs or sperm or embryos. It got me to checking licensing laws for physicians to determine what exactly it is that they are licensed to do for people. I also wanted to understand the difference between a patient and a customer or consumer.
Physicians are licensed to diagnose medical conditions (illness, injury or abnormalities of the body) and they are licensed to treat those illnesses, injuries or abnormalities of the body by prescribing medicine or performing surgery for the intended purpose of correcting the condition or alleviating physical pain associated with the condition.
A fertility specialist would be licensed to diagnose illness, injury or abnormalities of the reproductive system. If a physician diagnoses his patient as having a healthy reproductive system then the doctor patient relationship should ethically come to an end as there are no services he/she can provide that will improve their already healthy reproductive system. The physician’s job is not to help them get a baby but rather to treat any medical conditions that might prevent them from reproducing.
If a fertility specialist diagnoses a patient as having a reproductive problem such as having a low sperm count or very few quality eggs due to advanced age then that patient might rightly benefit from treatment with medicine or surgical procedures of some sort. But the treatment is supposed to correct or improve the reproductive ability of the patient – not get them a baby to raise. The physician’s job is not to get the patient pregnant, it’s to provide a course of treatment that improves the patient’s ability to reproduce.
Healthy people should not be referred to as patients at all and nothing a doctor does for them is a medical service and nothing they buy from them is a medical or fertility treatment. It’s pretty much a lie deceptive marketing tactics because the doctor does not want to let go of perfectly healthy patients because there is money to be made doing things for them and selling them things that fall outside the scope of services covered by their license. But nobody will ever know that the patient is healthy because of doctor patient privacy laws.
Same goes for patients whose fertility problems are not correctable with medicine or surgical intervention. They really should not continue to see these people or refer to them as patients but they don’t want to let go of them because there is money to be made performing services and vending things to them related to their continued efforts to become pregnant or obtain a child. Donated eggs don’t treat anyone’s failing reproductive system. In fact the woman who actually consents to the medical treatment for improving her chances of reproducing is the woman donating and not the infertile female patient of the doctor. Interestingly the woman donating the egg becomes a patient herself only all of the prescriptions that she takes will have the other woman’s name on them. It is very shady indeed but doctor patient privacy laws conceal the fact that the physician is not actually treating a patient’s fertility problems – he’s vending services to the infertile person whose problems cannot be treated and that is officially outside the scope of services he is licensed to provide. But he sees himself as helping the infertile patient get a baby which again, is not his job or his concern rightly.
So is it proper for a physician to treat an older woman’s infertility by doing ivf on her eggs? Sure if she’s in an age range where there is a chance in hell that treatment will improve her ability to reproduce. In fact doing ivf with the eggs of a woman who has fertility problems is actually giving her medical treatment for her fertility problem – so it is very ethical. So long as the doctor explains the statistical likelihood of her conceiving, and the chance is greater than 0, it is ethical for a physician to offer the woman ivf as a fertility treatment. It is not ethical to suggest “treatment” with a donor egg because the egg will not treat her fertility problems at all. Again a doctor that suggests donor eggs is not willing to let go of patients that cannot be helped with medical treatment because he knows there is money to be made offering infertile people ways to get other people’s babies without having to go to court and adopt them. This is no different than doctors in the old days arranging off record adoptions for their infertile patients. Those arrangements were not medical treatment for infertile people and neither is donated eggs, embryos or sperm.