Balancing The Risks And Benefits Of In-Vitro Fertilization

In this week's New York Times, Stephanie Saul takes a fascinating look at the world of in-vitro fertilization, exploring the safety of IVF treatments and the willingness of families to undergo the risks in order to conceive a child.

Saul's piece concentrates mainly on the fertility industry's inability to reduce the rate of twins being born to IVF recipients, and the difficulties that the pressures of mulitiple births have not only on a woman's body, but on the health of the children and on the economic system set up to support premature babies as they struggle with long-term intensive care hospital stays. "While IVF creates thousands of new families a year," Saul writes, "an increasing number of the newborns are twins, and they carry special risks often overlooked in the desire to produce babies."

The normalization of twins, Saul argues, which springs not only from celebrity births but from record numbers of twins being born in the U.S. each year, has contributed to a culture where the medical risks of multiple births are often overlooked. 60% of twins are born prematurely, Saul notes, adding that "their chances of death in the first few days of life, as well as other problems including mental retardation, eye and ear impairments and learning disabilities. And women carrying twins are at greater risk of pregnancy complications."

The fertility industry, however, is serious business, and a need to supply customers with a successful pregnancy leads many clinics to implant multiple embryos in order to increase their success rate, and as Saul notes, increase their chances of attracting new clients. "A busy fertility clinic can be extraordinarily lucrative, generating millions of dollars a year. And fertility doctors can take on godlike status in their communities for delivering their priceless commodities."

It is a heartbreaking piece, in that Saul speaks with many families who put themselves through serious financial, physical, and emotional strain to conceive children, and often enough, once those children are born prematurely, the stresses continue to take their toll. However, one gets the sense from all of the families interviewed that the ends justified the means, and that speaks to the real heart of the IVF industry—a desire for a child, no matter what it takes. All of these families, I'm sure, would tell you that the risks were well worth it. But the skyrocketing prematurity rates, strain on resources, financial hardships, and the difficulties faced by the children once they are born tell a slightly more pessimistic story.

One only hopes that someday the focus will be shifted to a more rounded measure of success; IVF shouldn't just be about implanting embryos for exorbitant sums and upping a clinic's success rate; it should be about providing families with a safe, healthy option where the focus is more on the safety and overall wellbeing of families, their children, and society rather than on cashing in a family's desires and hoping for the best.

[Photo by Kevin Moloney for the New York Times]

The Gift Of Life, And Its Price [NYTimes]