A Place At The Table

In vitro fertilization wasn’t for me. Until it was.

I am not an anomaly. One in six couples is infertile, and my experience—the in vitro fertilization experience—is becoming increasingly common. I am one of the growing number of women who has had a specialist on speed dial. I’m one of thousands each year who, when passing through airport security, has had a doctor’s note explaining the pouch of syringes and liquid hormones packed deep in her luggage. At a dinner party a couple of years ago, six of the 10 couples seated at the table were undergoing fertility treatments; we just didn’t know it at the time. Today, I have more friends and acquaintances who have sought fertility help than not.

I recently attended a meeting at my older daughter’s elementary school. In that room of 20 parents, three had twins. In nature, the chances of having fraternal twins is one in 60; identical twins is one in 250. The influx of multiples shouldn’t be possible. But since 1980 there’s been a 74 percent increase in the number of twin births in the United States. This is the result of two things: an increase in reproductive technology like in vitro fertilization, and, in our modern world, a surge of women waiting longer to begin a family. Women older than 30 have a higher chance of conceiving twins. I was 33 when Ella was born.

The New York Times reports that in this country, some 58,000 babies—not all of them twins, of course—are born of in vitro fertilization each year. Around the world there are an estimated four million IVF babies alive today. Our daughter Georgia is one of those children. The first published case of a “test-tube baby” was in 1974 (coincidentally the year I was born), but the first confirmed case was Louise Brown, who was born in England four years later.

Fertility treatments have changed dramatically over the years. In the 1970s, they consisted of a lot of guesswork. Today, there’s a fertility industry with multiple entry points. The least invasive option: popping a couple of courses of the ovulation stimulant Clomid (about $100 for a month’s supply). Twenty-five percent of women will get pregnant within a three- or four-month cycle on the drug—which is slightly lower than the normal rate of conception in fertile couples. There’s also intrauterine insemination (IUI, though commonly called artificial insemination), in which sperm are deposited into the uterus via a small tube. IUI’s success rate runs 35 percent when used with a drug like Clomid. The cost is comparatively affordable at $600 to $800 per attempt.

The most effective procedure, however—and, at an average of $15,000 to $20,000 per round, the most expensive—is in vitro fertilization. It’s also the most invasive. Injectable hormones force the ovaries to (hopefully) produce an abundance of eggs, which are captured, fertilized with sperm, and grown in Petri dishes. After several days, any surviving embryos are assessed for vitality and either transferred to the uterus (usually one or two at a time) or frozen for future use. There are multiple variables, such as the quality of eggs and a woman’s age, but success rates for women in their mid-30s come in around 35 to 40 percent.

At Denver’s Colorado Center for Reproductive Medicine—one of the world’s most respected fertility clinics—the IVF success rates are substantially higher at 67 percent. CCRM sees 250 to 300 new patients from all over the globe each month. Starting in January 2010, that new-patient list included my husband, Heath, and me.