independent

Saturday 19 April 2014

Try telling a desperate 38-year-old woman not to rush into using IVF

IVF

A NEW landmark report is claiming that IVF is being overused and suggests that women should exhaust all other options before resorting to it.

Since the first baby was born using in vitro fertilisation back in 1981, it is estimated that over five million children have been born via IVF. For so many couples it's a lifeline after years of disappointment trying to get pregnant naturally.

I know many couples who are now proud parents because of IVF. Some of them had specific fertility problems but many had what's known as 'unexplained infertility'. It is this grey area of unexplained infertility that is causing concern.

IVF was first created as a treatment option for women who had fallopian tube disorders and men who were severely infertile. But the team of experts who published this new report in the 'British Medical Journal' are warning of the risks of overuse of IVF today.

The team of experts who conducted the analysis, led by Dr Esme I Kamphuis of the Centre for Reproductive Medicine at the University of Amsterdam, states that in recent years IVF has been used too often to treat unexplained fertility problems.

Their research shows that between 2000 and 2010, the number of annual IVF cycles in the US increased from 90,000 to 150,000. However, the proportion of IVF cycles for fallopian tube problems reduced from 25pc to 16pc.

Unexplained infertility accounts for around 25 to 30pc of couples now undergoing IVF treatment. The experts are keen to point out that couples with non-specific fertility problems must stop rushing into treatment. They stress that if they are not given IVF treatment straight away and are told to wait, most of these couples are able to conceive naturally.

The report states that when 500 Dutch couples with an average of two years of unexplained infertility were assessed at a fertility clinic and told to hold off on IVF, 60pc of them ended up conceiving naturally.

So the consensus is that you should wait and not rush into IVF. Try explaining that to a 38-year-old woman desperate to get pregnant. Being told to wait in the hope that you will conceive naturally is not easy advice to follow when you can hear your biological clock ticking like a time bomb.

For any woman, trying to get pregnant later in life is stressful. You know that nature is against you. You know that your chances of getting pregnant fall off a cliff after the age of 35. So if you've been trying for a year and want to start IVF but are told that you really need to wait another 12 to 24 months and keep trying naturally, you will be understandably frustrated.

IVF is like manna from heaven for parents who previously had no hope of having biological children. It is one of the greatest innovations of our time, but managing its 'suitability' is a very difficult and emotive subject.

Top Irish fertility experts agree that waiting two years is not always the best idea. Dr David Walsh, consultant gynaecologist and medical director of the SIMS Clinic in Dublin, believes that if a woman is over the age of 35 and has been trying for at least six months, she should consider seeking help. This view is seconded by Donal Buggy, business manager at the Merrion Fertility Clinic in Dublin.

Padraig Kelly, quality manager of the HARI Unit in Dublin's Rotunda Hospital, goes a step further: "In general, our clinic advises that when a couple believe or have any concerns over fertility, they should go to their GP and not wait."

The new study strongly argues that many private fertility clinics are providing IVF far too freely in order to generate profits. Dr Kamphuis noted: "The focus on commercial returns has resulted in less academic oversight of who receives treatment and when."

In Ireland, IVF is not available under the public system and with the cost of one round of IVF coming to between €4,100 and €5,000, it is not a decision that anyone takes lightly.

One can understand Dr Kamphuis's concern and wish for vigilance in IVF treatment. But for the millions of couples who are struggling with 'unexplained infertility', waiting patiently for Hera, the Greek goddess of women's fertility, to grant them a baby is just not a risk that they are willing to take.

Irish Independent

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