An Update on IVF in the United States

An Update on IVF in the United States

    The first successful pregnancy achieved through the use of in-vitro fertilization (IVF) began on November 10th, 1977. The baby born following this experimental treatment is Louise Joy Brown; she is now 38, and a mother of two. Now is a good opportunity to review the progress made on IVF here in the US.

Comprehensive data on the safety and demographics of many assisted reproductive technology (ART) programs in the US is collected and released by the CDC. Their most recent report highlights  the trends in in-vitro fertilization use in 2013. For someone questioning if IVF is the right way forward this 76-page document is likely too dense and impersonal to play a key role in making that decision. Still,  a large sample size can provide important details on safe IVF practices and the success rates we now see with this reproductive therapy.

    A key issue with IVF, in the bioethics sphere at least, is the practice of multiple implementation. This issue stems from the well known risks associated with multiple pregnancies, including an increased rate of premature birth, low birth weight, and newborn mortality. The risk of multiple-pregnancy can be all but eliminated with the implementation of only a single embryo, twinning resulting from a fissure of the single embryo is still possible. The CDC report shows that this safety measure is not being implemented, as 40% of pregnancies that began with IVF are resulting in multiple pregnancies. One embryo was implemented in only 23.6% of IVF procedures. These risks could be due to the cost of IVF and the concept that multiple implementations will have a greater chance of success through the use of a single ART cycle.

    The CDC report goes on to mention the rate of successful pregnancy through the use of IVF. In examining the trends it is necessary to describe a successful pregnancy. Examining the

“Percentage of transfers resulting in term, normal weight & singleton live births” reveals a success rate per cycle of 1.2-29.8% depending on the health and age of the mother and a number of other factors. In essence, this highlights the success rate is highly dependent on a wide variety of factors. Unfortunately, IVF does not appear to be a fertility problem panacea. Its success rate differs greatly in individual cases.

    Ultimately,  the CDC’s report expands on IVF, which typically involves the implementation of multiple embryos, despite research displaying the increased risk associated with multiple pregnancies. The report also shows that success rates from this procedure are highly variable and dependent on a variety of factors. This is an intriguing data set and something worth following. The history of IVF is a short one. Hopefully developments will likely provide important information about how the public deals with issues of reproductive ethics.

References:

1. "Timeline: The History of In Vitro Fertilization." American Experience. PBS. Accessed October 11, 2016. http://www.pbs.org/wgbh/americanexperience/features/timeline/babies/.

 

2. Brody, Jane E. "Some I.V.F. Experts Discourage Multiple Births." The New York Times, October 10, 2016. Accessed October 11, 2016. http://www.nytimes.com/2016/10/11/well/family/experts-advise-minimizing-multiple-births-through-ivf.html?ribbon-ad-idx=2&rref=health&module=Ribbon&version=context®ion=Header&action=click&contentCollection=Health&pgtype=article.

 

3. “2013 Assisted Reproductive Technology National Summary Report.” Centers for Disease Control and Prevention, American Society for Reproductive Medicine, Society for Assisted Reproductive Technology. October, 2015. http://www.cdc.gov/art/pdf/2013report/art_2013_national_summary_report.pdf.

4. Vilska, S., T. Tiitinen, C. Hydén-Granskog, and O. Hovatta. "Elective Transfer of One Embryo Results in an Acceptable Pregnancy Rate and Eliminates the Risk of Multiple Birth." Obstetrical & Gynecological Survey 55, no. 3 (2000): 157-58. doi:10.1097/00006254-200003000-00021.

5. Brody, Some I.V.F. Experts Discourage Multiple Births.

6. 2013 Assisted Reproductive Technology National Summary Report.

 

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