Louise Brown was born 37 years ago as the first human ever conceived from in vitro fertilization (IVF). At that time, infertility was in many ways similar to cancer. It was rarely discussed openly, shattered hopes and dreams, and there were limited treatment options. Since then, major advances in fertility treatment have improved pregnancy success rates and made it much more accessible. Today about 1.5 million cycles of assisted reproductive techniques (ART) are performed a year and 5 million babies have been born! Discussing infertility has become more mainstream and many people know someone who has struggled with it or have gone through treatment. Despite its increasing public attention, there are still many misconceptions about ART and IVF.
IVF takes away eggs that you would otherwise have and diminishes your reserve
At the beginning of each cycle your body recruits a group of eggs that could get stimulated that month. Normally only one matures and ovulates while the others die. With in vitro fertilization (IVF), all the eggs that are naturally recruited that month get stimulated so they all get an opportunity to mature. Nothing happens to all the other eggs that are in the ovaries for the subsequent cycles.
Ovarian stimulation causes cancer
There are numerous well designed studies in the literature that have addressed this specific concern. None have shown that ovarian stimulation with injectable gonadotropins causes cancer. There are some reports suggesting a possible association with borderline ovarian tumors however these malignancies are indolent and have excellent prognosis with preservation of fertility. In fact, the American Society of Reproductive Medicine considers it safe for an egg donor to donate eggs up to 6 cycles!
There is little control of ovarian hyperstimulation in IVF
Choosing an experienced IVF center is important. There are simple ways to predict the right dose of medications. Monitoring visits can allow adjustment in rate of ovarian response. Different medications can be used to facilitate an effective and safe release of eggs but dampen the rise of estrogen after egg retrieval. An experienced IVF center is skilled at prevention. It is extremely rare today for any patient with ovarian hyperstimulation to be hospitalized as it is easily and effectively managed as an outpatient.
There is a higher risk of multiple gestation with IVF
IVF is the ONLY fertility treatment that allows control for how many embryos are implanted. With other treatment such as oral or injectable medications with intercourse or insemination, there is absolutely no control. All the eggs that have matured that cycle have a chance of getting fertilized and becoming a pregnancy. There is a 10% chance of multiples per cycle with Clomid and up to 25% chance of multiples per cycle with injectable gonadotropins!
IVF destroys life
After an egg is fertilized, whether inside the body or in a culture dish, a natural selection process occurs. It is so strict that naturally most fertilized eggs do not develop to a stage that is capable of implanting in the uterus. This helps explain why even in perfect situations there is only a 15-20% chance of pregnancy per cycle! The healthiest embryos are given a chance at life by transferring to the uterus in a fresh IVF cycle or freezing for future transfers.
The future of infertility treatment is today. We now have very effective ways to prevent ovarian hyperstimulation, prevent multiple gestation, and choosing the best and healthiest embryos.