Tag: IVF

What is Wrong with Our Fertility?

 

My blood silently boiled back towards the end of 2019, when I consulted on a 43-year-old woman with a BMI of 48 who smoked, did drugs, had uncontrolled diabetes… and was 32 weeks gestation. How did she get pregnant and I can’t?!

“I just don’t understand why so many of you young women are having trouble getting pregnant! My friends and I, none of us had difficulty having kids. I just don’t understand it,” is what my mother said as I was talking to her after my third embryo transfer. The first one didn’t take at all, despite the 80% chance of success I was quoted by our previous fertility doctor, a guy who had helped several people I know get pregnant. “It has to work, I thought. I went in for more testing, and my medication regimen was adjusted accordingly. With the second transfer, I got a faint second line on the home pregnancy test, which was encouraging at first, any second line, no matter how faint means that something is trying to grow. The line faded over the next couple days, and by the time I went to have my beta hCG blood work drawn, it came back as zero; I had had a chemical pregnancy. The embryo implants but fails to progress and spontaneously aborts. That one hit me real hard. Seeing those two lines disappear caused a sadness I was not expecting. Mustangman and I cried over that loss. I took a break from all the stress and hormone injections for a couple of months, and in the meantime joined an IVF support group on Facebook for women in Ohio. Boy, did I learn a lot! Besides being introduced to the clinic I just switched to, I found hundreds of women struggling to get pregnant. Like buying a new car, suddenly you start noticing all the other people that drive the same car. I began hearing about fertility struggles from the nurses that take care of my patients. It seemed that the list of couples I knew having difficulty with getting pregnant was growing exponentially. I thought about my own friends, many requiring assistance with medication or procedures in order to conceive. And while infertility is as old as the Bible, my mother’s query rang in my ears: why are so many young women having trouble?

Member Post

 

It has been witnessed with the conception of other animals, but now it has been witnessed with humans as well. Life begins with a spark — literally!  “At the moment of conception, the egg releases massive amounts of zinc, which creates a spark that can be seen with the aid of a microscope.” Preview Open

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The Next Wave of Reproductive Technology

 

Embryo,_8_cellsIn following the trajectory of the new CRISPR technology, I found myself digging into data that is relevant to the periodic Ricochet debates on artificial reproductive technologies (ART), specifically in vitro fertilization (IVF). I’ll get to both tech and politics shortly, but I’m going to start with numbers: specifically, using market sizes as a proxy for demand, and an indirect indication of social and political impact. (All of these are public numbers that are “rough order of magnitude,” and I have done some mixing of products and services totals.)

IVF of all kinds is about a $10 billion/year market worldwide. When I compare that to other categories that are somehow connected to fertility, it’s larger than I expected:  The total worldwide market for contraceptives is about the same size;  Infertility drugs are a bit short of $5 billion world wide; The total global market for erectile disfunction (ED) drugs – Viagra and kin – is $2 to 2.5 billion per year; and Abortion and related services are about the same size (US only). I also looked for figures on surrogacy — the other bete noir here —  but they are scarce. The best I could find suggests that surrogacy makes for, at most, a couple of percent of all IVFs in the US, but there are no reliable numbers for elsewhere.

Combining the above categories, about $30 billion a year is spent on the technologies derived from the Sexual Revolution, about $17.5 billion of which goes toward trying to become a parent, and about $12.5 billion spent trying to avoid it. IVF is about a third of the total, so — much to my surprise — it’s something of a whale in the category.