Embryo Debate Raised In An IVF Treatment
RENEE MONTAGNE, host:
As challenging as it is for young women to avoid pregnancy, for older women getting pregnant can be difficult. In fact, one out of every 100 babies born in the U.S. is conceived with medical help. And most of the time that means in vitro fertilization - IVF - where eggs and sperm are united in a Petri dish and then embryos are transferred to the woman.
One thing about IVF; it does increase the odds of multiple births. NPR's Patti Neighmond reports on how some women feel about that and what doctors are doing about it.
PATTI NEIGHMOND: Heather is typical of the patient American fertility doctors see. She's a career woman who got married in her mid-30s and then tried to get pregnant. Heather figures she's spent about $20,000 for one round of IVF treatment. And she says she would've been happy with more than one baby.
HEATHER: We would've been delighted with twins. This round we actually implanted three embryos. At the time I was 38 and a half. You know, would've been delighted to have twins. I, you know, I would've been fine with having triplets, actually. But you know, just didn't work out that way.
NEIGHMOND: Reproductive endocrinologist David Adamson says many patients feel this way. Adamson's the former president of the American Society for Reproductive Medicine, which sets guidelines for how many embryos should be transferred in an IVF procedure.
Dr. DAVID ADAMSON (American Society for Reproductive Medicine): These folks have been trying to get pregnant for usually at least four or five years. They've already spent a lot of time and money, so they really want to get pregnant.
NEIGHMOND: And so most U.S. doctors transfer more then one embryo to their patients during IVF. In Europe it's a different story. According to Finish obstetrician and gynecologist Zdravka Veleva, twins and triplets frequently are born early.
Dr. ZDRAVKA VELEVA (University of Oulu): IVF babies have been traditionally born prematurely. The goal is to have one healthy baby and the healthy baby usually is the one which is born at term.
NEIGHMOND: The priority in Finland then is to achieve pregnancy with only one embryo. Dr. Veleva and colleagues recently did a study where each patient produced an average of five healthy embryos. A single embryo was then transferred to the patient, the rest were frozen. If the patient didn't get pregnant the next month, another embryo was thawed and transferred. If the patient still didn't get pregnant, then the next month another single embryo was thawed and transferred. And so on for several months.
Veleva says in the end women undergoing this process were more likely to have babies than women who received multiple embryos in the first place.
Dr. VELEVA: If you transfer only one good quality embryo and if you freeze all the others, then you have a higher chance of having at least one child from either a fresh or frozen cycle.
NEIGHMOND: But here in the U.S. doctors say that may not work as well. For one thing, women in this country usually have to pay for IVF treatments on their own. Many just can't afford multiple rounds of IVF. In Europe, national health insurance typically pays.
Dr. Marcel Cedars is a reproductive endocrinologist at the University of California, San Francisco. She says European women seeking IVF treatment are typically younger than U.S. women and usually they have paid maternity leave to rely on, and their youth increases the chance of producing healthy embryos.
Dr. MARCEL CEDARS (University of California): The eggs actually age and it's estimated that at age 42, for instance, about 80 percent of the eggs are genetically abnormal.
NEIGHMOND: Even so, doctors are transferring fewer embryos today than in the past. Because of that, there are fewer triplet births - less than two percent. But the twin rate remains high, and Dr. Cedars says that needs to change.
Dr. CEDARS: The holy grail of IVF is really trying to find the way to identify the single embryo so that we can eliminate multiple pregnancies, and I think that's been one of the most difficult strategies, is trying to find ways to identify implantable viable embryos.
NEIGHMOND: And scientists think they are just a couple of years away from figuring that out.
Patti Neighmond, NPR News.
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