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Infertility Tests Every Aspect of a Couple's Life

Infertility Tests for Every Aspect of a Couple's Life

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%.

Other techniques for artificially boosting success rates, says Dr. Kenigsberg, are to accept patients with the best chances of getting pregnant or to report only a portion of a clinic's populations, since national statistics are unaudited. Sometimes clinics also might hide the more difficult cases in a "research category" that isn't included in the reportable data, adds Dr. Silber.

A limited but growing number of infertility clinics are distinguishing themselves with the use of a promising method of culturing fertilized eggs called "blastocyst transfer." One of the technique's major advantages is the reduced chance of multiple births -- a concern for many infertile couples seeking reproductive help. By culturing fertilized eggs for five or six days instead of two or three, doctors can return fewer embryos to a woman's uterus in hopes they'll continue to develop. The downside is that leaving the embryos in an artificial environment longer may reduce the chances of a viable embryo for transfer.

The Power of Hot Fudge

When Gellman, the Pennsylvania mother of twins, was trying to get pregnant for a second time, even finding comfort in her two 5-year-olds wasn't enough to offset the grief she felt every time the home pregnancy test turned out negative. "You eat, drink and sleep this stuff," she says, "and when it doesn't work, you feel the loss of this child you haven't conceived, you feel the loss of all the time you spent pursuing it ... you feel many losses.

"Finding out I wasn't pregnant always threw me into a funk for two or three days. I wouldn't want to get out of bed in the morning. Finally I'd drag myself back up, and the only thing that kept me going was knowing I could try again in a month or so." She also knew from her volunteer work at RESOLVE that she wasn't alone. "I did occasionally come across the person who could say, 'Whatever will be, will be,' but for every one of those there were another 10 who cried their hearts out at support group meetings and who fell apart in your arms."

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