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May 28th, 2013 11:03 AM #36
A full IVF cycle can cost as much as $10K but some clinics are as low $6.5K. Our public health system covers about half the cost. I know a clinic here that you can do a FET for $700 out of pocket costs. (Not my clinic though sadly! Mine is much more expensive.)
If it were $14K no rebates I doubt many people could afford it.
Some people find Thailand very cheap as an option.
Oh, I totally agree that if it cost that much I'd be pushing my luck with multiple embyro transfer too. Sad that people are forced into that due to money.
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May 28th, 2013 11:58 AM #38Senior Member
- Join Date
- Jan 2013
- SD, CA
I want to chime in again and add on to what tarynkay and emiliaj posted above. I agree that cost is a huge factor. I think they are completely correct.
I would add, and this pertains to IVF cycles anywhere, the drug protocol is quite brutal on the body. Some women tolerate it better than others, but still you are forcing your ovaries to hyper produce eggs, among many other things. It is quite controversial what the long-term health ramifications of these hormone protocols may be to the women's health. The fewer times a woman has to go through a cycle, the better. All of this needs to be factored into the equation too.
Last edited by sdsurfmama; May 28th, 2013 at 12:01 PM.Mama to
Desmond Sanders, born 7/2013
and dog son, Lambeau
May 28th, 2013 01:36 PM #40Senior Member
- Join Date
- Jan 2011
Very good point, sdsurfmama. I would definitely think that would figure into the decision as well. I do not know all of the ins and outs of this, but they told us that they would expect to harvest up to 20 eggs per cycle. I don't know if that is normal or a high estimate or what. But we heard 20 eggs and thought, wow, that is 20 potential embryos, and it was then hard to imagine why they would need to try to harvest eggs multiple times. I mean, I am sure that they do not all survive. But 20! That is a lot.
I don't know if you know, but is this a matter of fresh transfers being more likely to work? Is it that most of those 20 eggs will not turn into embryos? Or is it that they are often unable to harvest so many eggs at once?
May 28th, 2013 09:25 PM #42Senior Member
- Join Date
- Jan 2013
- SD, CA
From my experience, every woman responds differently to the stims. Younger women with healthier ovaries tend to respond better to the stims, thus produce more eggs. PCOS women also tend to produce a lot of eggs, but not necessarily mature or of good quality. Of course, this is a generalization. How well a woman stims also depends on endocrine factors usually determined by AMH levels. In general, the healthier the ovaries, the better the response to the follicle stimulating hormones.
20 eggs is higher than average, but not uncommon. I believe the average number is usually between 6-14 eggs per retrieval. Not all of the eggs will necessarily be mature, though. I've seen as many as 45 and as few as 1 or 0.
Some clinics have the philosophy that more eggs are better because they have more to work with. The more eggs they have, the more they can try to fertilize, and the better chance they have to get the embryos to blastocyst stage (Day 5) vs. the less mature Day 3 embryos. The more embryos they have allows them to pick the very best one or two to transfer. Any remaining embryos will be frozen.
One clinic I am familiar with uses a bit different philosophy. They are moving toward the opposite end of the spectrum, in a sense. With many of their patients, they try to stimulate the ovaries to produce fewer, but more high quality, mature eggs. Some recent research seems to show that the ovaries may produce better eggs in smaller batches. Fewer embryos result, but the hope is that they are of superior quality. I don't have the studies on hand, but I can try to look them up. Just from a theoretical standpoint, that makes more sense to me. It's not the most common approach, but I think it may be the new trend in reproductive endocrinology.
RE: fresh cycles vs. frozen embryo transfers
There is a new trend towards FET's. I think research is beginning to support better outcomes with FET cycles. Now that the vitrification process to freeze the embryos has gotten so successful, the freezing and thawing of the embryos is far less damaging than it was in the past. Putting a women through the stimulation process and retrieving the eggs is traumatic on the body. The hormones are a lot to process, the ovaries can become swollen, the abdomen becomes swollen and painful. The retrieval of the eggs is also no picnic. Emotions may be hanging by a thread, both because of the hormones, but also because of the stress and the poking and prodding. By doing this stage first and then freezing the resulting embryos, the woman's body gets a chance to recuperate. The RE will allow the woman to have a normal menstrual cycle or two or more depending on their clinic schedule and the patient's own specific needs. When the RE is ready to transfer the embryos, s/he will prepare the uterine lining with estrogen and then progesterone, thaw the 1 or 2 embryos to transfer, and then put them into the woman's uterus. Any woman who has gone through the FET cycle will tell you it is much, much more pleasant than the follicle stimulating/ retrieving part of the process. And I think the stats are starting to support its increased success rate. I know I should be backing this up with hard data, but I will try to find it and post it later.
I guess back to the original point, though. No matter if a woman is growing 20 or 5 eggs during an IVF cycle, she is pumping an unnatural amount of hormones through her body, and her ovaries are being made to hyper produce. None of this is what the body was "meant" to do. From a very personal standpoint, the fewer number of times a woman has to endure an IVF cycle, the better her long-term health will be. We will soon see if there are negative consequences to all of these repeated hormone-base fertility treatments in the years to come. Some studies have shown risks and others have shown no risks.
Balancing successful cycles with the appropriate number of transferred embryos is the goal. And some women, after failed cycle upon failed cycle, may opt for more embryos than she would normally choose, hoping that just 1 "sticks". If multiple embryos implant, that's when these ethical issues become very real and hard choices arise.
Addition to my original comment:
I was working with a 26 year old patient today at a fertility clinic. She was doing an FET (I am not actually sure why she is even going this route. She could definitely conceive on her own, but for some reason this RE pushed her to IVF), and the embryos were transferred this AM. I was asking her if she was choosing 1 or 2 embryos. She said she and her husband were going to chose 2. However, her RE suggested transferring 3, and then said that selective reduction would be an option if all 3 implanted. I was really, really surprised, a bit upset, and disappointed in him. She said absolutely not.
Last edited by sdsurfmama; May 28th, 2013 at 09:39 PM. Reason: Needed to add on something at the end.Mama to
Desmond Sanders, born 7/2013
and dog son, Lambeau
May 28th, 2013 10:00 PM #44
Hey Mim - Fellow Australian, Welcome to Nameberry!
You're a write it is an incredibly controversial issue and there are so many different aspects that need to be considered. Personally, I think it should be the woman's choice as to what they decide, and I can't judge because I've never been in that situation. My concern mainly stems from the fact that some people in this world struggle to conceive and spend years trying, and there are women out there choosing which child they want. Some of these women may later decide to complete another round of IVF, to try and conceive once more and that is the part I struggle with. I recognize its a big risk and I am not saying I would know what to do. But I don't know. It's such a tough one to make a decision on. I guess the answer is I couldn't do it. But what's wrong for me could be right for another woman and I could never condemn her for her decision. In fact, I'd probably want to support her, and she'd probably give me a fresh perspective on the matter. So yeah, I think I am a bit of a "fence-sitter" in regards to this.♫ I found a video from back when I was three, you set up a paint set in the kitchen and you're talking to me, its the age of princesses and pirate ships and the seven dwarfs... ♫
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