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Infertility & Reproduction Health Center

Infertility Tests Every Aspect of a Couple's Life

Infertility Tests for Every Aspect of a Couple's Life
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Beyond the Cookie Cutter continued...

Although diagnostic tests can sometimes be dragged out for as long as 18 months, Daniel Kenigsberg, co-director of Long Island IVF in Port Jefferson, N.Y., advises finding a specialist who will get the testing done in about six weeks and who includes successive options if one course of action fails. He also advises that couples truly understand their chances of conception every month.

"Even if you were to restore a couple's fertility to normal, they'd still only be getting pregnant at a rate of about 20% per month. If people don't understand that basic premise, infertility can become especially stressful because somebody will get a fertility drug or insemination for one month and think it's gotta work."

Couples may be limited to certain programs or treatments by their insurers, and in states with mandated coverage patients are often referred more quickly to in vitro fertilization than they are elsewhere. But experts encourage arguing with insurers if need be. "I think that insurers for the most part want the patients pregnant in less tries, too, but sometimes they're not looking at the success rates as closely as the patients are," says Dr. Michael Zinaman, director of reproductive endocrinology at Loyola University Medical Center in Chicago.

The Numbers Game

Success rates for in vitro fertilization, which average about 23% per attempt by most recent statistics issued by the Centers for Disease Control and Prevention and cost an average of $10,000, are important to compare, of course. That's true now more than ever since some clinics have jumped significantly ahead of others, with some success rates as high as 50% for women 35 and under due to improvements in the procedures and lab conditions, says Dr. Zinaman.

But Dr. Silber suggests that couples also consider a program's cancellation rates, which can make its success rates appear higher than they otherwise might. Programs in high-population areas with long waiting lists often cancel in vitro procedures for women with smaller egg harvests because the pregnancy rate will be lower. "Their overall business plan may be to cancel 20% of their cycles -- that way their overall pregnancy rate will appear 20% higher." He recommends that cancellation rates be no higher than 5%.

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