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27 September 2010

How Amendment 62 Would Stop IVF

By Diana Hsieh

Here's a great comment from "Emma B.," posted to the NoodleFood comments, on the chilling effect of Amendment 62 and similar "personhood" measures on fertility treatments:

I want to make it very clear just what "dramatically increasing the cost" means from a scientific standpoint, and just how impossible IVF would become under single-egg-collection rules.

When you undergo IVF, you take medications for about 10 days to cause your ovaries to produce multiple egg follicles, and then undergo an egg-retrieval process to remove the eggs for fertilization. After fertilization occurs, the new embryos are allowed to develop for anywhere from two to five days. The best of the surviving embryos are chosen and transferred to the woman's uterus, where they may or may not implant and develop into a pregnancy.

About 50% of eggs collected will not fertilize, and about half of the fertilized eggs stop developing prior to transfer. When two embryos are transferred, the pregnancy rate is 40% AT BEST (for the youngest, healthiest patients), meaning that at least 60% tihe time, both embryos quit developing. (It's also worth noting that about 75% of IVF pregnancies are singletons, meaning that the second embryo died off.)

Back-of-the-envelope math is that any given egg has about a 5% chance of turning into a positive pregnancy test, let alone a living breathing baby. IVF costs about $10-15K a cycle, and switching to single-egg fertilization wouldn't decrease that cost to any measurable degree. Obviously, single-egg fertilization rules would all but eliminate IVF -- at a 5% pregnancy rate, the cost-benefit just doesn't make sense at all. Which, of course, is exactly the point of said rules.

Of course, at that point, infertile couples will simply switch to doing IVF tourism in India or South Africa. Alternately, they will do more cycles of IUI + gonadotropins, which has a higher multiple birth rate and is the source of almost all higher-order multiple pregnancies.

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